Leaving Bedside? Adult ICU->NICU

[Lindseyh09]

I was a 2020 grad that start in CVICU. I used to take all of the ecmo, impella, iabp, lvads.  I could take any crash and burn patient. I was well loved by my coworkers and patients. I ultimately left due to burn out after almost 2 years. I thought I would give it one more go and see if switching specialties made a difference. I landed in a very prestigious Neonatal ICU and I’ve been there for 4 months now. I just feel like a new grad nurse sometimes. Everything is different compared to where Im coming from. It’s also a huge unit and I just don’t feel like I know anyone. 

 

I do my best but I just don’t think I enjoy being an ICU nurse anymore. I’ve never felt like I was great at it, despite what people say. To me, I’m just trying to get through my day without anyone dying. I used to get cards and “shout outs” all the time but I still just feel like I can never do enough for my patients. I don’t get any gratification from being a bedside nurse and I just feel like working COVID ruined me. Don’t get me wrong, I like taking care of the babies. It’s just all of the other things I don't want to deal with anymore. I’m tired of fixing things. I’m tired of having to be patient. It all just feels tedious to me. I’m looking for some kind of end goal for my career, and I don’t think its in bedside.  I’ve been a nurse for 2.5 years now. When I talk to nurses with 5+ years, they all say the same thing… that bedside nursing is just getting worse and worse. I think I should cut my losses.

 

The only reason I haven’t left yet, is that im worried I will end up bored. Or feel like im not doing anything with my life after a while. Or that I won't make as much money. 

 

Do I try giving NICU more time? I’ve only been out of orientation for about 3 weeks. Or do I go and do something totally different? I would love to find a work from home job that pays the bills (don't we all!). I just feel like the stress and worry is killing me.  

[EricJRN, MSN, RN]

I think if you really want to assess whether a specialty change is going to do the trick, I would give it at least six months off of orientation. At three weeks on your own, you are probably still trying to figure out some basics like getting to know your coworkers.

NICU nurses are pretty protective of their patients, and on some units that comes out in the form of not being super welcoming to new people at first. I know it's uncomfortable to be new to a specialty but not new to nursing. (I had a midlife crisis a few months ago ? and left the NICU for an adult specialty after 16 years of only NICU.) 

If uncertainty about patient care is part of your struggle, I think there is good news. There are like five newborn disease processes that constitute most of your care - maybe a handful more in a Level IV unit - so after a few months I bet you'll feel more confident as far as knowing what to anticipate for your patients. 

My other thought is that if you come up with an end goal at 2.5 years, that would be way faster than average! I'm hoping you'll stick it out for a bit, but I hope you do what you need to do to maintain your mental health. 

[Lindseyh09]

2 hours ago, EricJRN said:

I think if you really want to assess whether a specialty change is going to do the trick, I would give it at least six months off of orientation. At three weeks on your own, you are probably still trying to figure out some basics like getting to know your coworkers.

NICU nurses are pretty protective of their patients, and on some units that comes out in the form of not being super welcoming to new people at first. I know it's uncomfortable to be new to a specialty but not new to nursing. (I had a midlife crisis a few months ago ? and left the NICU for an adult specialty after 16 years of only NICU.) 

If uncertainty about patient care is part of your struggle, I think there is good news. There are like five newborn disease processes that constitute most of your care - maybe a handful more in a Level IV unit - so after a few months I bet you'll feel more confident as far as knowing what to anticipate for your patients. 

My other thought is that if you come up with an end goal at 2.5 years, that would be way faster than average! I'm hoping you'll stick it out for a bit, but I hope you do what you need to do to maintain your mental health. 

Well, I think a part of my struggle is that I used to be a “go to person” for new nurses, the providers knew me and trusted my judgement. The unit is so big I also barely know my coworkers. Most importantly I was confident in my decision making and care. I just feel like they kind of tossed me out on my own because of the experience I have. Im sure you are finding that adults are pretty different than our NICU babies. Even the way we do line changes is totally different. Some of the “basics” are even different. 
 

Its a level 4 NICU too. I am used to high acuity patients, but there arent many despite it being top 10 in the country. I've seen a UAC/UVC once. Never used one of their arterial lines. Never had an oscillator. Its just I had low acuity pts in orientation, and as soon as I was out I definitely was thrown to the wolves. If I did not have the experience I’m coming with I 100% would have drowned.  Im just afraid that I will make a serious mistake due to my inexperience in NICU. Not that I've done anything beyond silly stuff, like spilling milk! A lot of it is coming down to me just not feeling comfortable. But I was really uncomfortable in CVICU when I started too and ended up being successful. 
 

I kind of feel like I suck at NICU. Which is annoying, my preceptors always told me I was doing great and no negative feed back. Maybe im just being dramatic!