How Do You Know When to Call It? (Career)

[bluegeegoo2]

As the title states, how do you know when it's time to throw in the towel? Especially if you are nowhere near retirement age?

A little history: I am currently being treated for an autoimmune process that has yet to be named. I am being treated with a drug most often prescribed for SLE, Sjogren's, and/or RA. The symptoms I experience are debilitating, and wax/wane with the wind.

That being said, I have "tried" to quit nursing twice now, only to end up going back for the money and ability to work a reduced schedule as I can't for the life of me maintain a 40 hr workweek. I only work e/o weekend because of the cognitive/physical issues I experience. Even that has become a challenge.

Physical issues aside, the issue that scares me the most is the cognitive dysfunction. I have questioned my ability to make prudent nursing decisions and question whether or not I am truly safe to practice. There are times I seem to be unable to process or sequence thoughts/activities and often have trouble with recall and finding words. Fortunately, no one has been harmed (to my knowledge.)

I guess I have answered my own question. I know in my gut that I should take an extended leave of absence at the least. I also know that it is probably dangerous and morally/ethically wrong to put others in harms way by continuing to accept assignments knowing that I am not consistently cognitively intact.

So, for the foreseeable future, I am throwing in the proverbial towel. It hurts. It's defeating. It's demoralizing. Gonna cry now.

Thank you for reading.

[bluegeegoo2, LPN]

My empathy for you echoes what the other members said, bluegeegoo. My heart goes out to you.

I can identify with you, not in the realms of your illness, but in terms of making prudent nursing decisions due to my age and attitude. In this way, I have discussed my concerns with my medical nurse wife Belinda and close coworkers and have asked them for their feedback. When it is a consensual perspective that I need throw in the towel, this I will do.

In fact, Belinda and I were discussing this subject just last night. She foresees no problem leaving nursing when it's time. That surprised me and she said, "It's only a job. It's not who I am."

I on the other hand see myself as a nurse and foresee that I will feel a little like a duck out of the water. I feel a need to paddle around in my profession and nursing does define part of me as who I am.

I encourage you to continue what you have already started, bluegeegoo: Discuss your thoughts, concerns and feeling with others who opinions matter. Others' opinions should not be the totality of our major life decisions, but their perspective always needs to be considered.

My very very best to you.

Thank you! I think most of us will have to make this decision at some point in our career. The catalyst for the decision may differ, but the ultimate question will remain: Should I stay or should I go? (cue The Clash...)

I have been discussing this decision with my husband for months now, as my abilities have slowly dwindled. He keeps telling me that I should stop working and focus on getting better. It took awhile for me to see that he was right. Of course it did. I am hard-headed, lol.

[bluegeegoo2, LPN]

You have my sympathies. I had to quit nursing five years ago for similar reasons...cognitive impairments such as being unable to learn/retain new information, short-term memory loss, and difficulty with multitasking. I didn't want to retire at 55 but I could no longer care for patients in good conscience. I've been on Social Security Disability for almost four years now because of severe mental illness and moderate physical limitations, which make it all but impossible to do other work.

I hope you will be able to find something else that pays the bills and makes you happy. Congratulations to you for recognizing that it's time to hang up the ol' stethoscope...some nurses who should, don't. Best of luck to you.

I followed your posts and ultimate decision to retire, and my heart went out to you. I admired your honesty not just with yourself, but for sharing it with us as well.

I am having those exact same cognitive difficulties which is what has prompted me to call it. For some odd reason, the song "The old gray mare she ain't was she used to be..." comes to mind, lol. We gotta laugh, right?

[bluegeegoo2, LPN]

Think about another nursing field... someone mentioned per diem, except I'd say per diem private duty- you'd only have one patient... so no juggling of multiple patients with multiple needs. And you'd only have to work when you want to. Some agencies have you call in by a certain time and tell them you are available, others just call you to offer the shift, and you can accept or decline at that time.

Also consider the possibility that your cognitive issues could be a side effect of your meds, or if you were having issues when your illness began, your meds could be making it worse. You should discuss it with your doctors and see if they have any suggestions. My docs put me on an Alzheimer's med when my MS caused cognitive dysfunction for a time. But I first had to bring myself to tell them. I thought, if I know I'm not as sharp or "smart" as I used to be, then I can't be that bad.... while at the same time feeling like the stupidest, slowest-thinking person ever. It's terrible to find oneself in such a foreign place.

But there are people who can help....

Consider asking to be sent for a med-psych work-up. They can do testing to see if your cognitive processing is actually getting worse or if it is stable. Unfortunately, when you are having cognitive difficulties, you are not really able to gauge severity accurately. That's because when you know things aren't "normal", it's hard not to let your mind jump to worse-case. But there are standardized tests that can give you an accurate measure. Who knows, you may find out that your function is better than you think. That's what happened to me... it turned out I was doing better than I thought I was... I was very fortunate because my functioning went mostly back to normal as time went by and I went into the remission phase of my MS.

For me, the cognitive changes were harder to deal with than any physical disability I developed. I suddenly understood the bumper sticker: "Of all the things I've lost, I miss my mind the most." What was once kinda humorous, became my truth.

Above all else, remember-- you aren't alone!

{{{{ Hugs }}}}

I have an appointment today to discuss options and address the cognitive decline. I don't feel comfortable being responsible for anyone at this point in time, regardless of the type of nursing. Maybe one day?

I occasionally ask my husband, "Have you seen my mind? I seem to have misplaced it..." lol.

[bluegeegoo2, LPN]

There's no shame in leaving if it's not working out! Your health and sanity are always number one.

Agreed.

[bluegeegoo2, LPN]

I'm so sorry you're experiencing this. I pray you find peace with your decision and that healing and recovery will be swift for you.

Thank you so much for you kind thoughts. Support goes a long way toward peace of mind.

[DowntheRiver]

First off, I want to tell you that I believe you and your symptoms. I'm sorry you are in pain and that you still don't have a diagnosis. I believe you when you say that you outwardly appear normal but inside it hurts. It is difficult to have an illness and not outwardly appear ill.

I was diagnosed with AS (Ankylosing Spondylitis) about 7-8 months ago. I also tested + for Sjogrens (SSB and early antibodies) but since I am asymptomatic I have opted not to take Plaquenil at this time. I started taking it but it did not make me feel any better and just gave me GI issues so I stopped, partly also because I want to take fewer meds when I get pregnant. Technically with my SI joint issue I qualify for disability but I'm not ready to go down that road yet. But, I do qualify to disability protection, and I do have intermittent FMLA in place for job protection when I have a flare.

I'm in my very early 30's and have been a nurse almost 5 years. I, too, suffer from debilitating back pain, fatigue, and the occasional brain fog. In order to be properly diagnosed I took a short term leave of absence (5 weeks) and used FMLA to protect my job and STD to help with finances. I finally was diagnosed on the week I went back to work. Since then, I have reduced my hours per week from 32 to 24 so I only go in 3 times a week. I am about to reduce my hours to work 40 hours every 2 weeks and then 24 hours every two weeks at home doing care plans. I am slowly transitioning to per diem while I work on my MSN in Nursing Education. I eventually plan on having 2 or 3 per diem jobs and then an educator job online.

I'm also a cancer survivor so I deal with the long term effects of treatment from ABVD, such as neuropathy, lung, and cardiac issues. Nothing TOO severe and manageable but it is a nice cherry to top the cake off, haha.

Please feel free to PM me if you need someone to talk to.

[TinyDancer01]

If you are questioning the competency of the care you can give then I do think it's time to let that go or find something less demanding.

I also struggle with auto immune illnesses and did try Plaquenil which helped me so much with joint pain and flare ups. However my hair kept falling out to the point I was going to need a wig and it did decrease my immune system to the point I was sick all the time and kept needing antibiotics every couple months because I caught everything going around and it would turn into an infection of some sort (sinus, upper respiratory, ear, etc). My dr told me to try CBD oil (hemp based products) which she has had a lot of patients have success with so you may want to try that. I'm currently waiting for mine to arrive. If I were in a position to retire I would but I can't afford it. I'm on a plan to pay off all my debt including my house and then either work prn or plain quit depending on how I feel at that time. My job is not physically demanding (school nurse) so I'm lucky there. I was debating going back to the hospital to make more working less and be able to watch my grandson and get my skills back, etc but I'm starting to see that would probably be too much. It's not like we can predict when a flare up is or even make it stop!

Best wishes to you. There is absolutely nothing to be demoralized about. You have worked hard for many years and it's absolutely not your fault your body is not wanting to cooperate. Your life can still be meaningful. You can volunteer, find a nice hobby, spend time with family, or even come on here to encourage people. :)

[Kallie3006, ADN]

I can not personally relate to you and the challenges you face, but I can tell you my heart goes out to you. Reading the initial post brought a piece of you to life through your words, painting a picture of a selfless, compassionate colleague that some of us can only dream of possessing a minute portion of the strength you display. Thank you for sharing such a precious piece of yourself and I wish you the very best on this newly laid path on your journey.

[bluegeegoo2, LPN]

First off, I want to tell you that I believe you and your symptoms. I'm sorry you are in pain and that you still don't have a diagnosis. I believe you when you say that you outwardly appear normal but inside it hurts. It is difficult to have an illness and not outwardly appear ill.

I was diagnosed with AS (Ankylosing Spondylitis) about 7-8 months ago. I also tested + for Sjogrens (SSB and early antibodies) but since I am asymptomatic I have opted not to take Plaquenil at this time. I started taking it but it did not make me feel any better and just gave me GI issues so I stopped, partly also because I want to take fewer meds when I get pregnant. Technically with my SI joint issue I qualify for disability but I'm not ready to go down that road yet. But, I do qualify to disability protection, and I do have intermittent FMLA in place for job protection when I have a flare.

I'm in my very early 30's and have been a nurse almost 5 years. I, too, suffer from debilitating back pain, fatigue, and the occasional brain fog. In order to be properly diagnosed I took a short term leave of absence (5 weeks) and used FMLA to protect my job and STD to help with finances. I finally was diagnosed on the week I went back to work. Since then, I have reduced my hours per week from 32 to 24 so I only go in 3 times a week. I am about to reduce my hours to work 40 hours every 2 weeks and then 24 hours every two weeks at home doing care plans. I am slowly transitioning to per diem while I work on my MSN in Nursing Education. I eventually plan on having 2 or 3 per diem jobs and then an educator job online.

I'm also a cancer survivor so I deal with the long term effects of treatment from ABVD, such as neuropathy, lung, and cardiac issues. Nothing TOO severe and manageable but it is a nice cherry to top the cake off, haha.

Please feel free to PM me if you need someone to talk to.

Thank you! It IS difficult looking "ok", but not being ok. When I'm having a "good" moment, I tend to question myself. Then a flare hits (like a truck) and quickly reminds me that, yeah, I am not ok.

I currently have a positive ANA and SSA, so could be SLE, Sjogren's or both. I have symptoms of both, so my rheumatologist is waiting for other symptoms/lab abnormalities before diagnosing. I am also on Plaquenil which had helped with the joint pain/stiffness, but it's wrecking my stomach so time will tell if I can continue to take it.

I'm so sorry that you're having to deal with all of that! I, too, have gradually reduced my hours in this last year to none now. I tried and tried to find a workable solution to maintain employment, but since the cognitive decline has reached the level it is, I feel it's safest to call it.

I apologize if I glossed over anything. I am attempting to respond on my phone which is a challenge and lose my place going back and forth.

Good luck in school and many pain-free moments to you!

[bluegeegoo2, LPN]

If you are questioning the competency of the care you can give then I do think it's time to let that go or find something less demanding.

I also struggle with auto immune illnesses and did try Plaquenil which helped me so much with joint pain and flare ups. However my hair kept falling out to the point I was going to need a wig and it did decrease my immune system to the point I was sick all the time and kept needing antibiotics every couple months because I caught everything going around and it would turn into an infection of some sort (sinus, upper respiratory, ear, etc). My dr told me to try CBD oil (hemp based products) which she has had a lot of patients have success with so you may want to try that. I'm currently waiting for mine to arrive. If I were in a position to retire I would but I can't afford it. I'm on a plan to pay off all my debt including my house and then either work prn or plain quit depending on how I feel at that time. My job is not physically demanding (school nurse) so I'm lucky there. I was debating going back to the hospital to make more working less and be able to watch my grandson and get my skills back, etc but I'm starting to see that would probably be too much. It's not like we can predict when a flare up is or even make it stop!

Best wishes to you. There is absolutely nothing to be demoralized about. You have worked hard for many years and it's absolutely not your fault your body is not wanting to cooperate. Your life can still be meaningful. You can volunteer, find a nice hobby, spend time with family, or even come on here to encourage people. :)

I am looking into CBD oil as well. Hell, at this point I would seriously consider Eye of Newt if there were sufficient data to support it's efficacy.

I'm sorry the Plaquenil didn't work for you! I know how hopeful we can get that this pill or that pill is going to be the magic bullet only to find that no, not this one...

I tried to reduce my days to 2-12 hr w/e shifts, then moved to 3-8 hrs days, but even that was too much. Too many hours in a day or too many days in a row and I'm down for a week or so. Most employers will not allow for me calling off every 3rd weekend or so. I don't blame them. They need to be able to depend on staff showing up consistently which I am unable to do.

The best to you as well!

[bluegeegoo2, LPN]

I can not personally relate to you and the challenges you face, but I can tell you my heart goes out to you. Reading the initial post brought a piece of you to life through your words, painting a picture of a selfless, compassionate colleague that some of us can only dream of possessing a minute portion of the strength you display. Thank you for sharing such a precious piece of yourself and I wish you the very best on this newly laid path on your journey.

Thank you so much for your kindness. It is hard to quantify in words how much the support that I have received here has helped me mentally.

I feel a sense of peace creeping in, which is most welcome. I wish you all the best as well and will continue to visit and post.

I still have much to offer as far as advice and experience goes. Just don't ask me to dig a ditch or anything. :)

[monkeyshines, ASN]

Not a nurse yet, so I can't advise on the working conditions. I have had RA and Sjogrens since I was 16 so I'm familiar with what you're dealing with. Only you and your rheumatologist can ultimately figure out your specific conditions, but I would say don't be afraid to try more meds once you get closer to a diagnosis. Plaquenil by itself does almost nothing for me. It plus methotrexate and prednisone held me in check for a few years, but I'll be starting biologics soon (today!!!) to ultimately keep me treated. There ARE solutions, but it takes time to find them. It took several months and a new rheumatologist for me to finally get on a care plan that kept me as functional of a person as I wanted to be.

All the best to you!