Leaving Bedside

[Nora Joyce, ASN, BSN, MSN]

Good morning-

I have been a bedside ICU nurse going on 19 years. I left briefly for about a year and a half to take a breather during COVID but I came back. It is not my place anymore. I feel it with every shred of my body. But I am terrified to leave the stability. I am afraid of failing but this job has caused me so much stress and anxiety the last few years especially and the toll on my mental health is too much. Any support/advice is much appreciated. Thank you so much. 

[Nurse Alexa, MSN, RN]

I'm so sorry that you're going through a rough time in the ICU Nora. Why do you believe this change of heart has occurred? Is it from burnout and just being over-worked - too many demands on you as a nurse?

These are all aspects of being an ICU nurse I would consider. I've had multiple co-workers go down to part-time hours and this has helped them feel refreshed and ready to work.

However, 19 years is a long time at the bedside and I admire your time! I would weigh all the options about where you want your career to go - and think of what's best for you and your situation. 
Possibilities:

1. Part-time ICU

2. Per-diem ICU

3. New nursing job

I hope this helps. In addition, do not feel guilty about any of your decisions surrounding your career. What works for you might not work for others - and you just have to figure out what's best for you. ? 

[Nora Joyce, ASN, BSN, MSN]

Personally it's been too long. Covid pushed me over in terms of exhaustion, stress and moral distress. I really shouldn't have come back but needed a job. I now feel like a square peg trying to shove myself in a round hole and it doesn't work. I'm supposed to go down to part time next month. I have some PRN options I'm hoping to utilize to help reduce my stress but ultimately I need to leave the bedside job within the next 6 months to a year. I'm done. 

[Peachpit]

With your experience there are many options for non bedside nursing jobs where you wouldn't have to wait 6 months or more to get away from it.

Have you considered hospice? Home health? Management/supervision positions in assisted living facilities? Case Management w/insurance companies or other hospitals? United, Humana and such have on site and remote positions that always have your type of experience listed as well as a plethora of other companies offering remote care/case management. I'm sure there are also outpatient clinics, free standing surgical clinics and MD offices around that are hiring and would be thrilled to have someone like you on board.

I understand completely what you mean about being a square peg in a round hole. I was going back into the hospital setting a few months back after several years away and realized that bedside nursing/hospital nursing, while in many ways the same, has in most ways completely changed over the short time I was away and frankly, I had too. I miss somethings about working bedside but realize it no longer is the place for me either - for many reasons.

I hope you are able to find something soon, even if it's out of nursing, so you don't spend one more minute that you have to working at a job that obviously causes you too much emotional and physical stress. It's not worth it. And employers, no matter how much talk they put out about loyalty to employees/valuing nurses, at the end of the day, the will move onto someone else and not remember your name in a week.

[Robmoo, ADN, BSN, RN]

I'm in the same boat in that I am bright enough to work in the ICU, but I don't have the temperament.  When my patients do well I am happy.  When they take a turn for the worst, I keep asking if there was something that I could have done.  This leaves me stressed out.  I worked endoscopy to 5 years and now I've been doing cardiac stress testing for 5 years.  I went back briefly during the pandemic, but nothing had changed.  It was a bit worse because the computer charting had gotten ridiculous.  The patient care wasn't bad, but those long hours with only a 30 min lunch break are just too much.  I love cardiac stress testing.  If something goes wrong then that is what we were testing for in the first place.  You call the cardiologist, ONA (we don't have morphine), and get them to the ED or cath lab.

I suppose that my point is that you will find stability in other areas also.  Leave the bedside and try something else for a while.  Find your bliss.  I like procedural areas.  YMMV

[londonflo]

Robmoo said:

I'm in the same boat in that I am bright enough to work in the ICU,

When many of the graduates from our program, say they are accepting an ICU job, my colleagues and I have truly questioning looks. These were students who could barely draw up insulin, hang a piggyback, adjust pumps (when they had full on hands time in the nursing lab for all skills), unaware of when their RN or patient left the floor, had little curiosity of pathophysiology etc in their clinicals.   

[Been there,done that, ASN, RN]

Change is hard. However, you are suffering in your current position. You are qualified for many positions.

Start by scouring the job boards, reading the job descriptions, and see what sounds interesting to you. Then... go for it! I found my dream job at 61 working from home for an insurance company.

Good luck.

[mdsRN2005, ASN, BSN, RN]

I can relate, after years away from the hospital it is very hard to go back, especially to an environment like ICU!  Listen to what you know in your gut.  I know many will say just go part time or wait to see if it gets better.  But the best cure for burnout is often a change of scenery.  Best of luck and keep us posted! 

[Nora Joyce, ASN, BSN, MSN]

I've always done ICU. I stepped away for almost two years bc the pandemic really destroyed my love of nursing. I went back bc the ICU is that dysfunctional relationship you seem to keep going back to but I think this time around it solidified it's not my space anymore. Even in a short time being gone bedside has changed so much. All the reasons I left in the first place are still there and worse now. It's tough to keep walking into that every day. I found another job away from the bedside that has a much better work life balance for me and I'm going to get out for good. I don't need to rescue anyone anymore. That job is for someone else now. 

[subee, MSN, CRNA]

Nora Joyce said:

Personally it's been too long. Covid pushed me over in terms of exhaustion, stress and moral distress. I really shouldn't have come back but needed a job. I now feel like a square peg trying to shove myself in a round hole and it doesn't work. I'm supposed to go down to part time next month. I have some PRN options I'm hoping to utilize to help reduce my stress but ultimately I need to leave the bedside job within the next 6 months to a year. I'm done. 

Wait and see what happens when you go to part-time.  Starting a new speciality can also be stressful.  PRN is so psychologically different because you CHOSE to go to work that day.  Spend some of that extra time learning a meditative activity like yoga or Tai-Chi that you can use when you get home from work.  At the end of my career I cut back from 5 days to 4 with every Wednesday off.  No way could I continue to do 5 days in my 60's but 4 days made it possible for me to hold out until I had full social security.  Of course  3 days would have been better:) but I wanted to get as much in my 401K as I could.

[Robmoo, ADN, BSN, RN]

londonflo said:

When many of the graduates from our program, say they are accepting an ICU job, my colleagues and I have truly questioning looks. These were students who could barely draw up insulin, hang a piggyback, adjust pumps (when they had full on hands time in the nursing lab for all skills), unaware of when their RN or patient left the floor, had little curiosity of pathophysiology etc in their clinicals.   

My hospital takes new grads in the ICU.  They have a 6 week preceptorship which approx 1/2 of the candidates fail.  It is a STEEP learning curve!  When I entered the ICU over 20 years ago I had 2 years of experience in Oncology.  I would have been better off if it had been telemetry.  Coming from anywhere else to ICU is a major learning experience.  I was lucky that I had many nurses who were willing to mentor!  

[Nora Joyce, ASN, BSN, MSN]

I started as a new grad in the surgical ICU in a level one trauma center 18.5 years ago. It's possible. Not easy but if that's where you want to be then you can do it. I've been ICU my whole career and that's where I wanted to be.