Help! I need advice!

morphed · Jun 27, 2010

I'm not speaking from experience, but based on what I've read on this site (and others) LTC has a pretty high turnover rate. It's not like NICU where the jobs are really hard to find. Considering that, why don't you stick it out in ICU for a year? If you still don't like it, you'll probably be able to find another job in LTC. Also, with a year's of experience, would you be offered a higher starting pay? I know in some facilities anyone with 0-6 months experience gets paid the same starting pay but then it goes up, but that's at a hospital so I don't know about your LTC.

Maybe with more experience in ICU you'll like it better, you're still learning now and I'm sure running around all day and not having mastered things yet has a part in not feeling so happy with your job. I think with more experience you may change your mind.

JenniferSews · Jun 27, 2010

I kind of agree to stick it out a year unless you're really unhappy. LTC will require you to master time management very quickly. I don't think I can think of any field more opposite ICU than LTC. :lol2: Instead of 1-2 pts you will likely have 20-40 depending on the facility. I rarely have time to think, nevermind use my communication or interpersonal skills.

As for skills, I work at a subacute facility and the only skill I rarely use is my IV skills. Most of our patients arrive with a PICC already in place from the hospital.

Zookeeper3 · Jun 27, 2010

" I am content in my position but not happy! I have learned a lot but the ICU doesn't really allow me utilize my communication and interpersonal skills that are my strong points. This is a second career for me and those skills were a key factor in my decision to up and quit my career and become a nurse. The stress of not knowing where I belong has at times made me question my decision to ever become a nurse. Is it uncommon to feel this way? I am curious as to how long it takes and how to go about finding my niche! Any advice?

Welcome to the versatile world or nursing! I deleted a bit of your post to point out the major issues. Learning and professional growth is different from communication and interpersonal skills. In the ICU, much of it is with the family, in longer term care you have a chance to bond with your patient and family and see them through. In the ICU, we stabilize and ship off. Because this is so important to you, you're already seeing that need to make you whole lacking.

In the ICU, we never see the ending, the success, we don't discharge home, teaching for home care is rare, you miss the celebration of discharge. That seems to be a big issue for you, the ICU is a tough environment... where many die and few live to send you success cards, depending upon the acuity of your unit.

I can tell you honestly that 15 years in, I'm exhausted with death, and grief and mourning and the hopeless cases that family demands we carry on... the lack of ability to be an advocate, but I sense strongly that you are already there.

You have a beautiful position of having been through the toughest and the worst, and have so much to give to a long term care area. Skills don't make you whole, they are simply tasks to do while punched in on the clock.

If you feel you need to make a difference somewhere else, and I strongly believe you will... mindless hourly charting and tasks will not compare to what you wish to bring to others.

I wish you well in your decision, you never ever need to be in an ICU to make a difference... we ALL make a difference where we are.

TennBSN · Jun 27, 2010

I agree that you sould hold on to the ICU job for a little bit longer. Being a new grad in an ICU is overwhelming which contributes to many unhappy days at work. It does get better. I was a new grad that started in the ICU so I really know what it feels like to be in your situation. You say in your post that working in the ICU does not allow you to use your communication and interpersonal skills. This is very untrue for the ICU. You might not be able to communicate with your patient but you can communicate with their family members. You meet the patient's family on what might be the worst time in their lives. They are facing the possibility that a loved one may die soon. This situation would be a perfect opportunity to use your great communication and interpersonal skills. There is no shortage of opportunities to use those types of skills in the ICU. If the patient's family members feel the nurse is kind and caring toward them, they will be convinced that their loved one is receiving the same.

Hang on in the ICU. The longer you stay there the more confident you will get with your nursing skills and nursing knowledge. This will make you feel more comfortable at work which will probably make you like the job a little more.

One more thing. Some nurses that have worked ICU for a long time have strong personalities. Don't let them intimidate you. With time you will have as much nursing knowledge as they do.

morphed · Jun 27, 2010

I would never consider "communication skills" when looking for a job or career. I know it's one of those things you list on your resume, but it's just there because interviewers like it. What does "communication/interpersonal skills" really mean? And how can it make you leave one career/job and pick up another? We ALL need great communication skills on a daily basis. You need to communicate with doctors, RNs, LPNs, CNAs, PCTs, Housekeeping, families and be very clear with all of these people. When you go to the bank to get a mortgage, you need to be very clear and see what the fine print is and know exactly what you're getting yourself into. When you go to a hairstylist, you need to communicate clearly exactly what you want and don't want. Communication is what we do as humans. I think you're missing out on something else that you're mistaking for communication/interpersonal skills, but I'm not sure what it is.

plain disgusted · Jun 27, 2010

As a LTC nurse for 15 years I can tell you that in all the years I have worked LTC only about 2 hospital nurses lasted more than week in a LTC setting (slight exageration). My advice is to do both jobs trying LTC part time or contingent, till you see if you like it. A bird in the hand is worth 2 in the bush!! plus you would have 2 incomes for awhile.

imintrouble, BSN, RN · Jun 27, 2010

Welcome to the versatile world or nursing! I deleted a bit of your post to point out the major issues. Learning and professional growth is different from communication and interpersonal skills. In the ICU, much of it is with the family, in longer term care you have a chance to bond with your patient and family and see them through. In the ICU, we stabilize and ship off. Because this is so important to you, you're already seeing that need to make you whole lacking.
In the ICU, we never see the ending, the success, we don't discharge home, teaching for home care is rare, you miss the celebration of discharge. That seems to be a big issue for you, the ICU is a tough environment... where many die and few live to send you success cards, depending upon the acuity of your unit.
I can tell you honestly that 15 years in, I'm exhausted with death, and grief and mourning and the hopeless cases that family demands we carry on... the lack of ability to be an advocate, but I sense strongly that you are already there.
You have a beautiful position of having been through the toughest and the worst, and have so much to give to a long term care area. Skills don't make you whole, they are simply tasks to do while punched in on the clock.
If you feel you need to make a difference somewhere else, and I strongly believe you will... mindless hourly charting and tasks will not compare to what you wish to bring to others.
I wish you well in your decision, you never ever need to be in an ICU to make a difference... we ALL make a difference where we are.

Sometimes I read things on this site that move me. That I wish I had written. Thanks. This is one of those posts. :yeah:

oncnursemsn · Jun 27, 2010

Dear OP Juliebug- yes.

Hang in there. Your first year will not ever be perfect but you are learning skills that you would never learn in LTC. I have done both. LTC- actually can be so much more difficult. Give yourself time. It's not perfect. It never will be. Be the best nurse you can, give as you can (don't deplete your resources) but learn. You are gaining skills that will give you ability to change jobs once you get experience. Don't burn bridges and I agree with other posters. You are in great (really great- believe me, many of my former students never got acute care jobs) so you must have made amazing impression.

If you're not drowning and I pray you are not, hang in there. Do you not know that the job market for us is less then desirable? I would thank your blessings, hang in there, do what you can and hold on for a year's ride. After that- you could write you own ticket.

Just MHO. (My humble opinion) as I struggle to get job after many interviews. I'm a nursing instructor. MSN. AOCNS. Taught for 10 years, nurse for 27. Praying for good news tomorrow that I will have job. So... Give yourself a break and know you're doing the right thing.

Just MHO.

Jessie

achot chavi · Jun 28, 2010

add my voice to those who say stay for now in ICU unless you really hate it, Good luck and my wishes for a long, successful career.

emtb2rn, BSN, RN, EMT-B · Jun 28, 2010

OP,

I agree with the advice to stick it out for a year. As you gain experience and begin to manage you time more effectively, you'll find more time to utilize your "soft skills". I am also a 2nd career rn whose resume is heavy on the interpersonal communication skill set.

While a previous poster stated that we're "all great communicators", that's simply not true. The majority of communication is the music not the lyrics. How you communicate is critical to getting a message through to a pt and/or family (although stupid is as stupid does).

Stick it out, use those soft skills and have fun.

jmho

gentlegiver, ASN, LPN, RN · Jul 6, 2010

As a LTC nurse for 15 years I can tell you that in all the years I have worked LTC only about 2 hospital nurses lasted more than week in a LTC setting (slight exageration). My advice is to do both jobs trying LTC part time or contingent, till you see if you like it. A bird in the hand is worth 2 in the bush!! plus you would have 2 incomes for awhile.

Not 15 yrs, only 5, all spent in LTC. I too have seen hospital nurses come & go fairly quickly. In my job I assess, treat, comfort, pass meds, do paperwork, talk to Dr's, family, Pharmacy, handle emergancies, you name it. Time management is a real big skill to gain, without it, your lost. I agree with above writer, try it part time or per-diem, keep your current job, you may find that all the things your looking for are in your current job, you just couldn't see it. LTC is hard, demanding, and mostly thankless. You get to care for the same people everyday, but, that means your relationship with them is stronger so when they pass (and they all do) you stand the chance of getting your heart broken. There are times when I wish I had your job, but, in Massachusetts LPN's are not allowed in hospitals, so that wont happen.