Least stressful nursing job at a hospital?

Forest2 · Mar 28, 2019

18 hours ago, Workitinurfava said:
You can run into the problem of later needing to go back to the bedside and not having recent hospital or acute care experience. It may help to go per diem and keep your foot in the hospital door.

Well, uh, I am at the bedside. At the hospital in rehab. I did more nursing and more intensive acute nursing when I was in home care. It's really funny. I had to be checked off on accessing a port yesterday. I've done it for years and she had me do a sterile procedure. I mean using sterile saline syringes on sterile field, the whole bit. She didn't even follow policy because I read it before we started. Oh well I said, we'll just do it your way. Well, she said, this is the way I was taught, I wanted to argue and say, it doesn't matter what you were taught or not taught, you have to follow the hospital policy and procedure. Duh, I hate trying to please people that don't follow the rules. She instructed me and watched me do it step by step, but guess what. Next time when I am doing it, I follow the policy. I am sort of a stickler for that sort of thing. I should have been the one teaching her.

buttercup9, ASN, BSN, MSN · Mar 29, 2019

Transplant coordinator

Stroke RN

something in quality improvement

interventional radiology

allnurses Guide · Apr 1, 2019

On ‎3‎/‎28‎/‎2019 at 2:44 PM, Forest2 said:
I'd love a job like that. My MSN is in education, but they don't think home care qualifies as experience( even though I have been a nurse since 1983). I find that most nurses don't know what home care is. I guess they think it is sitting with the patient and reading to them or something. We had an interim director once that was also the ER director of nursing. He said he had no idea what we did. Was totally impressed and surprised that what we did was above and beyond what hospital nurses do. You better know your stuff if you are going to work homecare. AND we teach allllll the time. Dang, I feel so unappreciated and looked down on. So, here I am at a hospital, just basically not using my talents just to prove I have recent hospital experience. It, to me is not nursing. You click boxes for things because it is required and don't really assess patients or teach them, just pass out meds. Geesh. I used to really make a difference as a nurse. But , this, I do a lot of aide work and pass out coffee, tea and sugar and what ever else they ring the nurse for. Guess I will put in another year of my life and maybe before I die I might get someone to give me a freaking chance. I am really good at teaching( so I have been told). It's easy to be good at something you have a passion about. As you can tell I am pretty down to earth and don't Lord it over anyone. I feel I am just playing a part. Sigh.

I am sorry you are feeling so down. Its understandable.

I would strongly suggest, if you can, that you use your current rehab position to catapult into a stepdown unit at an acute care hospital for a couple of years. I know that isn't really what you want, but you will find it easier to transition into an educator position if already employed in acute care. Sadly, rehab and LTACH are often discounted at the acute care level. Right, wrong or sideways, sometimes you have to play the game that is and while it can be frustrating and disappointing, the emotions wasted on that just get in your way.

I would in no way denigrate the experience of a nurse who has been doing nursing since 1983. I would, however, encourage you to become very knowledgeable on TJC requirements for acute care, the standards of regulatory requirements for onboarding and ongoing competencies for not just nursing but also unlicensed assistive personnel and to work hard on not being bitter, as building relationships is going to be your fastest way to get to where you want to be.

Home health gives good experience, it is true, but there is much much more to professional development than teaching the skills utilized in being a good nurse and definitely way more than doing patient teaching, which is almost a different subspecialty of nursing education. So much of professional development is regulatory and relationship based, including how one department impacts the work flow of another and what details have to be carefully managed and documented so as to utilized resources wisely and remain in legal compliance with CMS standards, all within knowledge of hospital resources, budget and how to get money freed up for projects, which requires a thorough knowledge of stakeholder priorities and good relationships with those who hold the purse strings. This is the kind of experience that is difficult to prove unless you have worked it recently. The recently part is important because of the swiftness with which regulations change and the acute care part because all the varying departments, the way they inter-relate to one another and all of the varying requirements are very, very different from Home Health. Home health is a niche. What you need is recent, broad qualification and some good networking relationships. Rehab is closer and you may find an education opportunity in subacute, but you will get more attention if you work in acute care.

You may also wish to consider looking at pharmaceutical companies and insurance companies, which often have positions for nurse educators. I was contacted urgently by BCBS just a few weeks ago wanting me to give them a look. I have seen places like Alliance Rx and Amerisource Bergan looking for nurse educators too. They will be lower paying than acute care but much lower stress than what you are doing. I hope something great happens for you soon and I am sorry you feel so belittled.

Forest2 · Apr 2, 2019

Thank you Not.done.yet. Great input. My HHC was JC approved. And I have participated in surveys, for JC, state and federal and written plans of correction, created preceptor programs, home care aide programs, taught and supervised these programs too. I have written numerous policies and procedures that meet or exceed the requirements set by regulatory agencies. I have created and ran an infection control program and QI. I have a vast amount of acute care experience. Even more so than the nurses I am working with now. It amazes me at the lack of experience with ports, piccs, trachs, and all sorts of tubes, I haven't done one single wound vac since arriving in this job. I used to do this stuff daily. I can't wait to get into something more acute but couldn't get anyone to hire. Now I am sitting here getting stagnant. I have taken over 140 hours of ceu's in the past year and continuously study. I just finished 3 hours this past weekend on intubated and ventilator dependent patients and management, and will be doing some study on cardiac pharmacology. I can do an EKG but they won't let me because that is delegated elsewhere. Seems like everything I am skilled out is delegated to some other person. Yep, sure is discouraging. Meanwhile, hey nurse, can I you get me some creamer?!

I nearly lost it a couple of weeks ago. A visitor came in and called the nurse. Apparently the aide had not passed water yet. So the visitor wanted me to get water. OK, no problem. I went to the other side of the unit, got a cup, got some water and ice with a sippy type cup lid. Not good enough, "Doesn't she get a straw?", back to the nutrition room, get a straw and take it to them. Now, she's cold. Can't she get a heated blanket? OK, back down the hall, get the blanket, wrap her up good. OK, I think they just might be satisfied. Two minutes later another call to the nurse. "Can she have a Sierra Mist now?". Sure she can, I smile, go to other side of unit, bring back a cold can. She now needs another cup of ice, a lid and a straw. Guess I should have brought 3 of everything to begin with. I nearly walked out never to return. OH, how I wanted to give the evil eye!!! I feel like a highly paid waitress some days.

Well, that's enough of complaining, I am tired of hearing myself. I will follow your advice because it seems sound to me.

Forest2 · Apr 2, 2019

OH, I started passing out handfuls of condiments, etc and telling patients to keep them in their overbed tables. Out of necessity.

Workitinurfava, BSN, RN · Apr 2, 2019

3 hours ago, Forest2 said:
Thank you Not.done.yet. Great input. My HHC was JC approved. And I have participated in surveys, for JC, state and federal and written plans of correction, created preceptor programs, home care aide programs, taught and supervised these programs too. I have written numerous policies and procedures that meet or exceed the requirements set by regulatory agencies. I have created and ran an infection control program and QI. I have a vast amount of acute care experience. Even more so than the nurses I am working with now. It amazes me at the lack of experience with ports, piccs, trachs, and all sorts of tubes, I haven't done one single wound vac since arriving in this job. I used to do this stuff daily. I can't wait to get into something more acute but couldn't get anyone to hire. Now I am sitting here getting stagnant. I have taken over 140 hours of ceu's in the past year and continuously study. I just finished 3 hours this past weekend on intubated and ventilator dependent patients and management, and will be doing some study on cardiac pharmacology. I can do an EKG but they won't let me because that is delegated elsewhere. Seems like everything I am skilled out is delegated to some other person. Yep, sure is discouraging. Meanwhile, hey nurse, can I you get me some creamer?!
I nearly lost it a couple of weeks ago. A visitor came in and called the nurse. Apparently the aide had not passed water yet. So the visitor wanted me to get water. OK, no problem. I went to the other side of the unit, got a cup, got some water and ice with a sippy type cup lid. Not good enough, "Doesn't she get a straw?", back to the nutrition room, get a straw and take it to them. Now, she's cold. Can't she get a heated blanket? OK, back down the hall, get the blanket, wrap her up good. OK, I think they just might be satisfied. Two minutes later another call to the nurse. "Can she have a Sierra Mist now?". Sure she can, I smile, go to other side of unit, bring back a cold can. She now needs another cup of ice, a lid and a straw. Guess I should have brought 3 of everything to begin with. I nearly walked out never to return. OH, how I wanted to give the evil eye!!! I feel like a highly paid waitress some days.
Well, that's enough of complaining, I am tired of hearing myself. I will follow your advice because it seems sound to me.

Your post is a very real and direct picture of nursing. Thanks for your input.

srahamim, ASN, MSN · Apr 7, 2019

What about working in a Blood Center? I have found it very rewarding and the donors are healthy and want to be there.