I MUST be out of my mind...

[NurseCard, ADN]

Okay, so I have decided pretty much to leave my current job doing eight hour night shifts in psych... and return to Med/Surge.

Med/Surge used to leave me so mentally and physically drained at times... I used to have to go into the bathroom and cry sometimes because I was so stressed out at work... I used to hate, hate, hate to call docs in the middle of the night for fear of getting yelled at... and the list goes on and on. So why in the world am I going back???

Well, first of all I'm doing it out of financial necessity. I'm currently trying to find a job doing 12 hour shifts, three nights a week, closer to where I live. My current job is five 8 hour shifts a week, and almost an hour drive to and from where I live. Plus, benefits at my current workplace are horrid; I pay out the rear end for a family health insurance policy that isn't even very good/inclusive, just for one example.

There aren't many psychiatric positions available closer to where I am, but I probably COULD land one if I tried hard enough. But... even though psych is physically much less demanding, and most of the time even mentally less demanding... I'm really not happy.

I actually MISS the fast, hectic pace of Med/Surge! I never thought I would say that, but perhaps I really am more Type A than I'm willing to admit. =) I miss the hands on stuff like starting IV's, catheters, dressing changes, etc.. I miss running around the unit. I miss the feeling at the end of every shift of being physically exausted but feeling like, well SOME of the time anyway... like I had totally kicked BUTT that night and really helped some people and actually had a good time doing it. =)

Plus, I miss mostly being my "own employee". Meaning, I was responsible for myself, a CNA (possibly two), and my patients, and that was it. I never did charge nurse when I was in Med/Surge and never wanted to. In my current job, I'm responsible for a whole 22 bed unit every night, and I have one LPN and 4-6 techs that I'm responsible for. And that, is mostly what I do. Supervise. I supervise my employees and tell them what to do, I'm supposed to discipline them (and I'm not good at it at all), and I push a pen. Plus, I'm responsible for everything that happens on the unit. Funny thing though, my autonomy is very limited. I have to call the house supervisor every time I or my LPN give an IM injection, and my house supervisor has to come behind me and inspect my initial patient assessments. I feel useless most nights, bored, and then stressed like crazy when a patient acts up, because it is so NOT cut and dry what to do in those cases.

I just don't feel very fullfilled or rewarded by this job at all, and I hate that and I miss those feelings... even though they didn't come all the time and sometimes, I'd go a long time in my Med/Surge job without having those feelings. I never feel rewarded at this job. I mean, even though at times our patients do thank us for what they do for them, and I know that sometimes they really do mean it... for the most part, I deal with the sickest of the sick patients, and they have been in the system for so long and have become so manipulative... you can't trust or believe anything they say, and you know that while they seem like they are better... next month, they are going to be right back there, as bad off as they ever were, because they stopped taking their medicine.

So, as much as it sounds like I don't like this job at all... if it weren't for the severe financial strains that it is causing on my family, I would probably actually stay at least a while longer. But, because it is so financially draining, I have to find another job, and I just don't have the heart to stay in the psychiatric field. I feel like med/surge, and similar fields... that is where my heart is. I would like to build my confidence back up in med/surge... perhaps higher than it was before... and then I might move on to something else, who knows.

But, am I crazy for wanting to leave a job that is, for the most part, NOT really all that stressful about 70-80 percent of the time, for a job that was pretty stressful most of the time??? That I even complained about quite a bit??

And before you suggest it... I can't at this time look for anything like home health, community health, day surgery, doctors office... anything like that that is still hands-on but a tad less stressful... because I still have to do shift work. I can't work days. My husband works days and is very happy with his shift and hours and I'm trying not to mess that up for him.

But like I said, I think I MISS the hectic, fast pace of med/surge. Isn't that just... CRAZY? =) I've got applications in to three diff. hospitals at this time, including my former employer.... and I am nervous about this. I do hope it works out and things are better for me than they were when I left. I think I was burned out but I think I needed a break and a new perspective and now that I've had all that... I think I'm ready to go back.

That was LONG!!!! Sorry.... :)

[clemmm78, RN]

No, you're not crazy. I thought I had the dream life when I landed a job in a school: Monday to Friday, no holidays etc. We don't even have school nurses here any more really, but this was a school for physically handicapped kids. YOu know what? I enjoyed it, but it wasn't for me. I needed to back to the stress I knew and I did. I did bounce around until I found what I really did like and that's what I'm doing now, palliative. So no, I don't think you're crazy or wrong to do what you're doing, I understand.

[Soup Turtle]

:wink2: Some people just shine when the pressure's on. If I'm not at least a little stressed, I feel start to feel the stress of no stress.

[rehab nurse]

have you ever considered acute rehab? it's got patients with med/surg problems (IV's, wounds/dressings, etc) and they are inhouse for PT/OT.

at least in my area, the ratios in hospital are 1:6-7. In subacute areas (not hospital) the ratio is around 1:9-10. I'm sure it's different in every area due to the hospital system running it, but if you like med-surg but don't like the patient load, inquire about rehab positions.

good luck to you, wherever you end up!!!

[NurseCard, ADN]

Yeah, I've considered rehab, and I've worked with, and enjoy, ortho patients. There is a rehabilitation hospital in my area that is looking for, actually practically SCREAMING for, many RN's, and is offering a sign-on bonus.

[rehab nurse]

well a bonus is nice...if it's a real one. we all know of places who offer "bonuses" because the work conditions are horrid. is there any way you could talk to the nurses who work there to see the real scoop? i love(d) working rehab...i am like you and enjoy keeping busy. makes the time fly by.

right now i'm off work due to health problems. don't know when i'll return, as i can't work right now.

i hope you find a place you love and one that you are valued and appreciated at as well. very much luck to you...

let us know how everything turns out, ok??

[JeanettePNP, MSN, RN, NP]

Funny thing though, my autonomy is very limited. I have to call the house supervisor every time I or my LPN give an IM injection, and my house supervisor has to come behind me and inspect my initial patient assessments. I feel useless most nights, bored, and then stressed like crazy when a patient acts up, because it is so NOT cut and dry what to do in those cases.

I don't understand this part. Why would an RN have to be supervised by someone else to do assessments and injections? That's what you're licensed to do. Is it like this in any other hospital?

[NurseCard, ADN]

Good question. All I know is, after my LPN and I have given a patient any IM injection of any neuroleptic medication, we are supposed to inform the shift supervisor. After I do the initial assessment on a patient, the shift supervisor is supposed to come along a couple of hours later and check it and make sure it is complete.

It isn't like this in all hospitals. It may be something that is unique to psych facilities. For one thing, we don't do a LOT of initial assessments because we don't tend to admit a large amount of patients at one time; one unit at my hospital might admit 2-3 patients in one day at the MOST. Patients tend to stay longer; therefore we aren't ABLE to admit a lot of patients at once.

[Purdue_Nurse]

I don't think you are out of your mind at all. You've got to do what makes sense to you and what will make you happy. I am getting ready to do the same thing myself by leaving a nice Monday through Friday job and heading back to the hospital, which I swore I would never do. You never know where life will take you!

[RunningWithScissors]

You're just replacing mental stress with physical stress. No biggy. You probably will enjoy the change.

[xwannabenursex]

Your not crazy at all!!!! When you work in med/surge not only are you working hand-on, but you can also see immediate (sometimes) progress in what you're doing. Lots of people wish for a slow paced job, but in all actuality, having something so demanding, so face paced, works out so much better.

[Antikigirl, ASN, RN]

I worked a few jobs in nursing before returning to med surge and frankly...I love it being back!

Yeah it is stressful, but I really worked hard on my time managment skills and interpersonal skills so I would become stronger in those areas...and it has paid off!

As far as MD's...heck they are responsible for the patient PEROID, and if that means that a patient actually can have a probelm in the middle of the night...well gee...that is par for the course and why they have us to be there to notify them huh? Change your mindset to one of intimidation to "I am doing this for you and the patient!!!! It is my job!!!". I don't take much flack from MD's when I have to call late or weekends! I state the facts and NEVER appologize for calling...that always opens up a social excuse for them to fit in a little of their mind...(that was hard for me to stop...always said "sorry to disturb you"...but DON'T DO THAT!). Keep it simple and as quick/accurate as possible...and if they get ticky..do not respond, repeat the question and that puts them back on track to answering and moving on! Pride yourself as a nurse, be professional, realise it is part of the job, and basically sc**w their attitude, that is their probelm (which is exactly what I tell MD's dealing with ticked off nurses too!!! Goes both ways!)! Boy...it has helped me!

Enjoy the change as a new adventure...sure it will be stressful at first...but keep thinking like I do...better pay, awesome benis for my family, and a chance to use skills I miss!

Good luck!