I have worked in an ER for a little over a year and a half now, doing permanent nights. I love the adrenaline, the codes, traumas, and really sick people. I’ve been pushed to new limits and gained so much confidence. I learned how to voice my concerns, opinions, and a big one: how to say no and set limits with people. But now, the honeymoon phase is over and it’s not all new and exciting. Daily I feel beaten into the ground. When I try to explain how I feel about my job, the best way I can put it is, “it’s sucking the life out of me.” I used to be a really naive, docile person who wanted to please. I don’t feel that innocence anymore. I feel cold, jaded and emotionless. I still love the teamwork (I work with a great crew) and the codes, critical pts, etc. but I don’t know if that’s enough to keep me in the game. I’m depressed, my sleep is profoundly messed up and I never feel physically energized or well. I love the ER but it’s becoming toxic for me. I don’t want to go into work every day to be belittled, verbally and physically abused by patients and their families. I’ve seen some sad things happen to patients that I have trouble forgetting. I feel like my nervous system is shocked and burnt out. I don’t know where else to go. I don’t want to switch jobs and lose my skills and I will miss to critical care aspect. Yet I don’t want to stay and lose my darn mind. Do other people have experiences like this where they stayed and they got over it? Where else have others gone after ED that gives them a better work-life balance? I feel so lost and frustrated...any response helps!!
Normally, I'd offer up life advice about coping and setting expectations or whatever - some of the advice you've already gotten is quite good.
But in this case, I'll just add that you sound like some of the ED nurses who have jumped ship and done fairly well in the ICUs I've worked in, so I'll second the recommendation to give that a try.
It's not all sunshine and roses, but the work is interesting and you are somewhat less likely to get punched.
I am in the same position. I feel like I worked hard to get good at it and I don't want to lose my skills, but I am tired of the anxiety, the abuse, and the violence. I have a second job on an observation unit. I feel like a sheep there. I can't seem to give up on ED. It is so great, but it makes you feel like a different kind of animal. Working in observation makes me feel like a person who just got back from war. It's like you don't fit there or anywhere else.
You need a decent amount of deep sleep. Night shift is really destructive for most people. It is totally unnatural, unless you are the rare person who is a natural night owl.
You can't afford to lose your shift differential, but you think you can afford to lose your health and joy.
Wrong.
I'm sorry you are having difficulties and I do hope you find what you are looking for. Make the needed change. Good luck to you.
Normally, I'd offer up life advice about coping and setting expectations or whatever - some of the advice you've already gotten is quite good.
But in this case, I'll just add that you sound like some of the ED nurses who have jumped ship and done fairly well in the ICUs I've worked in, so I'll second the recommendation to give that a try.
It's not all sunshine and roses, but the work is interesting and you are somewhat less likely to get punched.
If you do get punched, call the police. The hell with being compassionate and docile. you are not a punching bag and no one is allowed to assault you without consequences - patient, family, nobody.
I'm a former ED nurse too. It was hard to let go, because I was so invested in the whole image of emergency nursing, which other people feed in to. But there's no prize for working the hardest or being the toughest- it's your life, you don't know how long it'll last, and you should find whatever happiness you can. What is all the struggle getting you?
I found other jobs to be so BORING at first. It took months for my brain to recalibrate. Then I was kind of angry.... Like "seriously?? Other people have just been going about normal days, no one dies, no one punches anyone, nothing terrible happens, they're not working at 100% of their physical and mental capacity for hours on end? And they still get the same paycheck and go home?". Then I eventually got used to a more normal life... I say try it, you might like it ?
A friend said to me, "just because you're good at something, doesn't mean it's good for you! And it doesn't mean you have to do it either." I think that sums it up.
Thanks for your post! I love your perspective on this. These words and words your friend told you are what I need to keep repeating to myself. It’s all so true and I need to keep reminding myself it’s not a sign of failure or “I couldn’t hack it” if I leave. I interviewed and shadowed some other jobs and I can totally relate to how boring you found other jobs. After a shadow i’d feel like I couldn’t wait to go back to the ED. For about a month it gave me a new appreciation for the adventures of the ED. I felt like I could never go elsewhere, and I don’t know what I was thinking trying to leave. But now the job is starting to weigh on me again. It took one bad patient/case to just suck the life right out of me all over again. The job is endless highs and lows. It’s very emotionally and physically taxing. Do you mind sharing what kind of job you’re in now?
I'm a former ED nurse too. It was hard to let go, because I was so invested in the whole image of emergency nursing, which other people feed in to. But there's no prize for working the hardest or being the toughest- it's your life, you don't know how long it'll last, and you should find whatever happiness you can. What is all the struggle getting you?
I found other jobs to be so BORING at first. It took months for my brain to recalibrate. Then I was kind of angry.... Like "seriously?? Other people have just been going about normal days, no one dies, no one punches anyone, nothing terrible happens, they're not working at 100% of their physical and mental capacity for hours on end? And they still get the same paycheck and go home?". Then I eventually got used to a more normal life... I say try it, you might like it ?
A friend said to me, "just because you're good at something, doesn't mean it's good for you! And it doesn't mean you have to do it either." I think that sums it up.
Absolutely true! I worked Urgent Care as an LPN for years. I loved it! Now in school for RN, I thought for sure I was going to go to the ED once I graduate. Now I am older, and trying to come to terms with how much a few days f clinical in the ED beat me. I physically can’t do it. I am depressed about it, my dreams are shattered, but no job is worth your physical or emotional health. There are so many opportunities in nursing. and I think all nurses get itchy feet and bored, and want to challenge themselves with another specialty.
Sometimes moving to a different ED helps - to either a faster or slower paced ED, depending on what you need. Pediatric EDs, Trauma EDs, community EDs, free-standing EDs....etc. I have always been in the ED as well. I have been on every shift and can say that night shift can be very destructive on family/social lives/emotional health/etc. Or maybe this is coming from a person that is truly an early riser so I may be biased ?
I was in your exact position. Worked in the ER, did evenings (3p-3a) loved it but eventually the frequent fliers, poor staffing, and constant stress was weighing me down. Never got a break and got down to almost 100 lbs (best diet I ever went on!). It got to the point where if a patient wasn't dying or about to die, I did not care at all why they were there. I just wanted them to leave. I became mean.
Finally switched out to the OR. It was a rough couple of months because I was new to the OR and there was so much to learn and it was very overwhelming. I almost went back to the ER because that was what I "knew" and I was good at it. Finally I got the hang of it and never looked back at the ER. I told myself I would pick up shifts, but I just couldn't convince myself to go back. I actually got a 15 minute breakfast break AND a 30 minute lunch break with opportunities to use the bathroom. I worked twelves and a lot of times we were done after 3pm, so I got to actually sit and relax! Yeah, it got boring sometimes circulating, especially if it was a long case. But I learned how to scrub, and be decent at it, so it was nice to change it up and scrub in every once in a while.
Don't be afraid to branch out - it'll save your sanity. I took a paycut switching but it was worth my mental health. My depression got better and I actually enjoyed working with patients again. Most OR patients are lovely and they're so grateful towards you (except when they wake up wild but that's not their fault).
You need a decent amount of deep sleep. Night shift is really destructive for most people. It is totally unnatural, unless you are the rare person who is a natural night owl.
You can't afford to lose your shift differential, but you think you can afford to lose your health and joy.
Wrong.
I'm sorry you are having difficulties and I do hope you find what you are looking for. Make the needed change. Good luck to you.
Over a year later, but I am reading back to this chain as I’m reflecting on my next moves. Everyone had such thoughtful and helpful responses.
I did eventually make the change to ED day shift! It is much better for my personal life and my sleep/health. Totally worth the pay cut. I’m glad I did it and wish I did it sooner. However I do feel very burnt out still and dread coming into work. I’ve been on days for many months now. I think my next move should be to leave the ED completely.
I did eventually make the change to ED day shift! It is much better for my personal life and my sleep/health. Totally worth the pay cut. I’m glad I did it and wish I did it sooner. However I do feel very burnt out still and dread coming into work. I’ve been on days for many months now. I think my next move should be to leave the ED completely.
You're in an even better position to make a decision about leaving now, having tried some adjustments that were an improvement and months later recognizing that you still aren't feeling all that well and good.
A huge part of the problem, IMO, is that it isn't just patient-related stressors or patient care-related stressors. It is an increasingly abusive environment for other reasons entirely. Corporate healthcare has sucked the life and joy out the ED in a very big way. Being constantly "behind" from the moment you punch in, feeling worried about things you can't keep your eyes on while running around with hair on fire the entire shift, the inappropriate resources being used on non-urgent matters, the timers showing you how long "you" are taking to do x, y, z, the "nothing is ever good enough" attitude from management (or, there being something new every day that nurses are supposed to break their necks to improve...) that's all unnecessary. It is all BS.
It's okay to leave. Really, truly. I suspect that the thought of leaving is much worse than what you will discover when you actually leave.
Plus...they'll take you back if leaving turns out to have been a mistake.
I was in a very similar position as you not too long ago. I kept blaming it on being on night shift, then blamed it on picking up too many hours, etc. The excuses kept going on and on because as miserable as I was in my job the last year or so, it was what I was good at. I have always been in "emergencies" since starting as a paramedic and it was what I felt competent in and comfortable with.
However, emergency nursing is just not what it used to be. It is not even the same as a few years ago. I definitely agree with what JKL33 said above....I feel like the ER does not revolve around saving lives, but instead defending your license and constantly "ruling out" emergencies....about being pushed to go faster and faster with a more skeleton staff every single day. That the ER becomes more abusive every single day....no one cares that there is verbal or physical abuse - instead, management wants to know what the nurses did to "provoke" the abuse. I hated the fact that I felt like my license was on the line constantly....that there were multiple level 2s in the waiting room or all my patients turned into ICU level of care and administration didn't care about. However, if sentinel events happened, then they could not seem to piece together why these happened.
Anyway - I really do emphasize with what you are going through because I have been there, done that. There is nothing wrong with needing a change. I do miss parts of the ER - my team, the critical thinking, teamwork, the ability to not sweat the small stuff, etc. Pre-op and PACU is a very different field - however, I am happier with my life and how my license isn't on the line. I am becoming more patient and compassionate again. I occasionally have time to sit and talk with my coworkers....laugh or talk about our lives.
I don't think you will ever regret your background as an ER nurse, but as a former ER nurse - I can promise you there IS a need for a change sometimes...and you will be happier with yourself with a change even if it is only for a year or two.
Cowboyardee
472 Posts
Normally, I'd offer up life advice about coping and setting expectations or whatever - some of the advice you've already gotten is quite good.
But in this case, I'll just add that you sound like some of the ED nurses who have jumped ship and done fairly well in the ICUs I've worked in, so I'll second the recommendation to give that a try.
It's not all sunshine and roses, but the work is interesting and you are somewhat less likely to get punched.