Just Want to Cry and Quit

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

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Dear Nurse Beth,

I am currently feeling lost and let down by nursing. I feel like I made a huge mistake by taking a gamble with a nurse manager job at a facility I did not know was failing (I did know that there was an issue with them keeping managers, so that one was on me and my inexperience in leadership positions to see it as a HUGE red flag) before the pandemic hit, but they were in a state of transition. So many of the issues that would come to break me I did not realize were the norm, not a product of the transition.

The job I had at my other facility was one that I was well suited for and paid well but the commute was taxing and I was in school for my MSN in leadership and management and I viewed the open position at the new facility as an opportunity to grow and learn, I also had the new nursing team at the new facility asking If I would put in for the position so I confidently took the leap. Fast forward through 2020 and after being asked to give more than I ever wanted or agreed to, after being pushed and demoralized and asked to cross lines repeatedly that I did not agree with and forced to ask my staff to give and give when there was nothing left and told we didn't have value over and over and over again, I stepped down from the position.

I am now trying to piece together PRN jobs for survival, the job I left at the old facility no longer exists and has been broken up and given to 5 other people, I have a useless masters degree as I will never ever again seek out a management position and I am completely disillusioned with the whole thing. Working in a rural area my options are extremely limited, I'm just so very disappointed and don't know what to do, I'm tired, nursing is exhausting and it feels like it just isn't going to get better anytime soon.

I screwed up and lost on a huge career gamble. I have chosen to go back to school for my NP because at the end of the day I really just want to take care of people and to help the system be better. But after this experience, I just want to cry and quit. I guess I really just want to ask how after all that I do how do I even start to love nursing again? How do I reset and reopen my mind to giving more than I will ever get in return? Why is it expected that we break ourselves for facilities that will never value ones personal sacrifice? Why can't it be better?

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7 Answers

Specializes in Tele, ICU, Staff Development.

Dear Demoralized,

I had a very similar experience years ago. I took a high-level job at a poorly-run facility as soon as I completed my Masters degree, eager to change the world.  Turns out they wanted a yes person, definitely not someone like myself who raised questions and wanted policies in place.

Chalk it up to a learning experience, my friend. Do not let them win by breaking you down and squashing what you have to give. You were not let down by nursing, you were used by an employer. There are many good organizations out there that would appreciate your skills and dedication.

A Masters degree is never useless, and opens many jobs.  Often employers who list a Masters degree as required or preferred just want to see a Masters in nursing, no matter the specialty.

If you decide not to pursue your NP or need a supplemental job, you could teach online with your Masters since you live in a rural area, or look on indeed.com for remote jobs. 

Specializes in Critical Care.

I think that is a greater chance of this if you go with a small company or alternately a for profit or even some large national so called Christian organizations.  On the bright side this job did at least give you some experience to add to your resume and now you will be more careful when looking for the next job.

I would check out reviews on Glassdoor or Indeed, but specifically nursing staff and also managers.  Nursing staff will definitely tell the truth, although many may still give the place 3 or 4 stars, but if you actually read the review you will find the place is subpar.  Some managers are even willing to stick their neck out and speak critically about their organization.  The one that took my hospital over had critical reviews by both nurses and managers.  Also Google the company and look for news, my Christian system has been fined for medicare violations etc which I would put as a red flag, but I think they view it as all in a days work and probably figure the fine is less than the profit they secured.  Read the local business journal as they will tell you what is going on with the larger players as well.

A couple of our previous nurse supervisors took management jobs at small nursing home and hospice companies.  Once they realized the job was too overwhelming, they simply found a better job and quit.  Both did get extra experience and talking points for their resume and came out OK.  There is no reason you can't do the same thing as well.  You could try to get your old job back or get your foot in the door at your old employer and then still continue your job search in the future.  One of our supervisors did just that and we were glad to have her back, but she didn't recognize the place anymore because so much damage had been done by the top management in her absence.  Still her job is hourly and plenty of OT available so she seems content at this time.  Another family friend was fired from a hospital, found a job at a nursing home after she took a Summer break, got more experience and left that job for a nice one working for a ritzy assisted living place.  It looks right out of Downtown Abbey and she is happy now.

I would encourage you to keep looking and not give up.

 

I see you feel devastated by your experience.  I urge you to reframe your experience. I encourage you to use your finely tuned analytical nursing skills to walk through, reflect upon your lived experience and look for the hidden gems. The title of your prose was "How can I come back to nursing after abuse by an employer".

The questions I encourage you to consider are these.

Did every single solitary facet of nursing fail you? Do not forget the career title labeled "nursing" is held by humans who are flawed.

Did every single solitary area of your employer abuse you? Do not forget the company for whom you worked is also made up of humans who are flawed. As you know, money is the central focus of business and the health care industry is a business. As a well-educated Master's degree holding nurse leader and administrator, you know how centrally focused "money" remains. There is no amount of money that can quantify or balance out the emotions families (whether work-family or by blood) have for each other. The two will always be in conflict.

As nurses typically many of us are people pleasers and came to the profession to help others.  If we can't or we are prevented from giving our best, oftentimes we feel like a total failure. I encourage you to reflect on the one nurse you helped or one single incident you handled well while in your administrative position. And hang on to that memory.  You never know the reverberations of that one incident. Like throwing a small pebble into a pond, the ripples extend beyond what you can see.  You don't know how that one act of kindness you extended onward past what you can see.

Consider the lessons you learned in your last post.  Learning what NOT to do is as valuable as learning what to do. Learning how not to treat your fellow co-workers and employees is valuable for your future nursing experience. Perhaps you'll   Perhaps you'll decide to be an entrepreneur and go into business for yourself.  You have more than enough compassion for your future staff. Perhaps you'll work for the ANA to change advanced practice nursing policy. Perhaps you'll decide to work in the political arena so that you can apply your experience to educate lawmakers to change the nurse staffing ratios and billing practices.

Do not discredit your administrative experience or your leadership MSN as useless.  Acknowledge the administrative experience's devastating effects not only on you but on all the employees and the patients at that facility. It was horrible for you. But use it as a lesson of what NOT to do. You don't have to change the whole system to be a success. You just have to show great compassion and touch the heart of one other person. You did that. You did your part. You tried. You stepped up. You didn't let someone else do it for you. You made an amazing effort.  The task was enormous. But you didn't fail. (Keep in mind the opposite of love is not hate. Both have an enormous passion driving action forward. The opposite of love is apathy, where you do nothing at all.)

Hold your head up high. You endured the storm and you're still standing.  Look at the extraordinary perspective you will bring to the table as an NP. I have every confidence you will continue to be amazing.  After all, you're a nurse. ?

Specializes in BSN, RN, CVRN-BC.

If you have the ability to travel for work have you thought about taking one of those high paying COVID travel positions.  I've heard of as much as 150K for 16 weeks work.  You could bury yourself in patient care and bank some money so that you can take your time finding your next opportunity.  

Another idea, check with your former employer.  Just because they broke up your old job doesn't mean that there isn't an opportunity there.

Nurses in rural settings seem to have so many fewer opportunities, lower pay, and seem to be treated poorly.  Good luck with whatever you decide to try next!  

Specializes in Critical Care.

Your experience seems to mirror what another OP Silverbells has mentioned working as a floor manager of a nursing home.  She speaks of working 16 to 20 hours on salary, being pulled to be a staff nurse and basically a never ending list of job duties where the higher ups refuse to lend a helping hand or hire additional staff to deal with wound care, admit discharge, audits etc.  It sounds like you both have had similar jobs.

The only thing you can do in that situation is walk away and look for something better if your attempts to hire additional staff or delegate are refused.  Just as it is common for floor nurses to be overworked and short staffed, it is fairly common for managers in such facilities to be put in the same situation and even employer owned doctors who gave up independent practice due to high overhead.  It is all the same corporate greed, do more with less.  I laugh as I say that the last two years I worked at the dump no one had job evals because the few managers left were too swamped to even give out evals.  I am not kidding!  We still got meets expectation raises, but that is all.  Doctors asked for scribes to cut down on paperwork but were refused.  Doctors asked for the H&P's to be printed and placed in the charts but were refused.  There seems to be no respect left for anyone lower on the food chain than the few at the top.

While you are devastated and feel you can't go on, believe me your experience is not unique or unusual at all for anyone working in healthcare these days if that brings you any comfort.  I've seen CNO's walked out of the building with no warning and one that replaced the first was eventually fired and walked out herself.  I've seen multiple educators, supervisors, managers and directors let go not for anything they did wrong, but because they represented the old guard and needed to be replaced with the new Corp hand picked yes people.  My director was ready to hand in his resignation, but he was laid off instead at least allowing him to get severance on the condition that he did the next years budget first!  If you read the news multiple companies have been outsourcing computer programming jobs to foreigners from India and Phillipines and their severance was contingent on training their replacements first.  Sadly this is the world we live in.  We are all dealing with this type of disrespect and incivility to some extent.  They even fired a cafteria worker for the nerve of eating a donut sitting out that a person was going to buy but never came back, it would have been thrown out, but instead they fired the worker.

So I don't think it matters what job you have the same issues can arise.  The best you can do is try to find a good, decent company.  That is why I suggest looking at reviews on glassdoor and indeed, searching for news on the internet and thru the business journal to get an idea of the character and financial soundness of the company you hope to work for.  While you are being interviewed you should also be interviewing them and deciding if you really want the job.  As you've learned listen to your gut and watch for red flags.  But even though this was a bad experience it still allowed you to learn and grow and use your MA. 

There will be issues working as an NP too just as primary care hospital employed Dr's deal with.  Pressure to see more patients and multiple hoops to jump thru, hours of unpaid charting, unless you find a place that pays for scribes.  You will need to carry and some law firms have even posted videotaped depositions on Youtube to show what could happen if a wrong diagnosis was made or a bad outcome and they come looking for a payout.  Are you ready for the responsibility of making the right differential diagnosis of the many for common ailments?  Some places make you a 1099 where you have to pay all social security taxes and pay for all your benefits like retirement, insurance and CEU's.  Don't just blindly go back to school piling on more student loans if you are not sure this is what you want and are simply running away from the previous job.

Specializes in Geriatrics.

Don't EVER TAKE A SALARY RN JOB. these facilities know exactly what they are doing and they will throw you under the bus quicker than you will come to find out. 

Specializes in Oncology, dialysis, progressive care, telemetry.

I had a similar experience a few years ago that made me say, no more manager or salaried jobs for me!  I was salaried, and not only was I the manager, I soon found out I was the only nurse available to cover sick calls, day and night! I later learned that the person before me had stayed only a short time. I lasted a year, and 3 years later, that position had eaten up 4 more people and ultimately been eliminated. 

For now, I think do what you want to make money!  I don't have my MSN yet, but I am starting a new part time position that pays more than my current full time gig. It's in the same health system where I have worked for most of my career, so I'm familiar with the culture and how they treat employees. If I love it, I can go full time and rake in money, and if I hate it, it's only 2 shifts a week until I find something else. I don't know where you are located, but here in Indiana, I have always had my choice of jobs and tons of recruiters reaching out consistently since I became an RN 8 years ago. A lot of times they are just looking for anybody with a nursing license, and if I show up and surpass their expectations, they love it and I feel great. I found that I value my life outside of work and want a job where I can go home and not stress too much when I'm off the clock. 

I hope you are treating yourself well. No need to beat yourself up, there are bigger and better things waiting for you and it takes a lot of trial and error to find a sweet spot.

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