Hospital Setting - Not a good fit

[kschindlerRN, BSN]

Hello!

I'm a new nurse, graduated in May 2017. I was offered a position on a Family Birth Center at a small community hospital that I precepted at during the last stretch of nursing school, I have a long commute to work but I believed it worth it because they wanted me and I liked the setup. I began my job with a 2 month orientation on the Med/Surg unit in order to be able to float when needed. I then switched to the OB department which encompasses L&D, postpartum, baby, and outpatient. I was promised a 3-9 month orientation, and that I would be let off orientation when I decided. It has been 4 months and I'm being kicked off orientation due to "understaffing." I in no way feel comfortable with this decision, as we are such a small hospital that I have not had much exposure to anything other than uneventful deliveries and postpartum. I have become uneasy and anxious over the past few weeks. I work the night rotation and I am losing sleep, weight, my blood pressure is through the roof, and I'm in a general state of being unwell. I thought that L&D was certainly without a doubt the area of nursing I wanted, but I'm beginning to think that the hospital setting is not well-suited for me and that I may thrive more in a public health/community nursing position. I love the patient care, working with moms and babies, and teaching but have found that I'm disinterested in any other aspect of the work, especially L&D. I hate to quit and be viewed poorly by future employers for leaving so soon, but I'm in no way happy here. I know there are so many other areas of nursing out there and I hate to be stuck in this position because of fear of not being hired elsewhere. Any advice on this situation?

[meanmaryjean, DNP, RN]

First, I would say that without some solid experience under your belt- the types of non-hospital jobs you mentioned are not going to be open to you.

Second, use the 'search' feature here and explore some of the threads about adapting to night shift, There is a lot of helpful advice - because you sound like someone in the throes of sleep deprivation / circadian disruption.

Next, could you move to lessen the commute and the stress you experience from that part?

You best bet is to utilize the night shift advice found here, stick it out until at least your one year mark, and then - if things aren't better - start exploring other jobs.

[FolksBtrippin, BSN, RN]

First, I would say that without some solid experience under your belt- the types of non-hospital jobs you mentioned are not going to be open to you.

Second, use the 'search' feature here and explore some of the threads about adapting to night shift, There is a lot of helpful advice - because you sound like someone in the throes of sleep deprivation / circadian disruption.

Next, could you move to lessen the commute and the stress you experience from that part?

You best bet is to utilize the night shift advice found here, stick it out until at least your one year mark, and then - if things aren't better - start exploring other jobs.

Not at all true (in my area at least) that you will be ineligible for non hospital jobs. If you want to work in the community there are many, many opportunities but they pay less than the hospital.

Home health is a big one. By me, you would walk right into a job. You would make about $8 less per hour than the hospital though with inferior benefits.

You might also consider nurse family partnership. Google it. That is probably right up your alley.

College health centers.

Dialysis.

[turtlesRcool]

I agree with meanmaryjean that it sounds like sleep deprivation and the schedule might be a huge part of the problem. Some people adapt better than others to working nights, and if your body is having difficulty with the transition, it's going to carry over to your mental state.

I'm not sure from your post if your 2 months of med-surg is included in the 4 months of orientation you've had or if you've had a total of 6 months (2 in med-surg and 4 in OB). Either way, you should be okay on your own at this point, at least with stable patients, always assuming you have colleagues who can help you out if you hit a snag. If you really feel unprepared, see if you can be scheduled primarily for postpartum, and continue to orient in L&D. Perhaps there are other nurses who would be willing to have you observe/help if a difficult birth comes through so you can get that experience.

You say you've only had experience with uncomplicated births and postpartum. Do you feel comfortable with those? Is the anxiety about the unknown of something going terribly wrong and not knowing how to cope? I ask because at a small hospital, you probably won't see enough complicated births on your orientation to really feel comfortable with them. Actually, I'm not sure if you'd feel comfortable with them, even if you saw many on your orientation. One of my friends from nursing school went into OB right after graduation, and she was told that the most important thing was to RECOGNIZE when something was starting to go wrong. She didn't have to be able to handle it, just pick up on it, and get a more experienced nurse involved. Maybe thinking about your job in those terms would help you feel less anxious.

[anewsns]

I agree with above.. fear of the unknown is the most difficult. You'll never be totally ready even if you stay on orientation. You could have been on orientation the whole 9 months and not been comfortable. One of the things I've always liked to do is identify who likes to teach and who I feel comfortable with, look at the schedule , and identify my "go to" people every shift. Hopefully your supervisors are approachable. Is your other staff supportive? That can make or break the whole thing. If they aren't supportive then it's not the hospital setting , it's the unit. And yea, add all that to nights , commute.. it sounds like you just need some guidance and support to me reading between the lines. I'd say try to stay and reevaluate what you want in another year if possible. Yet, also try to make yourself a number one priority. You didn't good to reach out here.