Leaving before 1 year? Don't know what to do..

[Birdsofprey]

Hi All,

I have been working on a telemetry unit in a public hospital in NYC and this month makes 6 months experience for me as a new RN (I was an LPN prior to this but it was in a clinic setting). I am so stressed out and burned out already due to short staffing and caring for 10-12 patients per night (many of which are severely ill and should be in a stepdown or even ICU). I am learning by sheer force. I know that nursing does not have to be as bad as this, but in a way I just want to run and do home care or something that still in the nursing field but is not as stressful as this. I have trying to get in with private hospitals but they want me to call back at 1 year of experience(6 more months from now). A friend recently told about her experience as a UAS assessment RN and enjoys it. I am wondering several things-

1) Is leaving a hospital job prior to 1 year of experience going to bite me in the a## later?

2) If I leave for a less demanding/stressful position (UAS, dialysis clinic, or home care gig or something like that), I am concerned that this will make it very difficult for me to return to the hospital setting later (ideally I want to do ICU or ER)?

NOTE: Further complicating matters is that I am finishing my RN to BSN program online and am less marketable due to this. I feel kind of stuck in my current position until I finish it, or get a year of experience. I just don't really know what to do here. I almost want to plow thru my BSN course work just to be more marketable but this will add even more craziness to my schedule of working 12 hour night shifts and already being a student at the same time.

I could just tough it out for another 6 months... but a large part of me would rather just take another job ASAP. Perhaps I am being too impatient?

I know there are many posts about things like this. I know that adjusting to an RN career is difficult. But I know it is not this bad in other places. I guess if anyone has advice or words of encouragement, this can help. Much appreciated. Even if it is just to politely say this is "how it goes".

[LibraSunCNM, BSN, MSN, CNM]

15 hours ago, Birdsofprey said:

Yes, on telemetry. They get away with it by calling it a combination med-surg/telemetry floor. But my hospital has no step down units so patients are often sent to my floor from the ICU whether they need tele monitoring or not. I know I must be learning a lot but it feels like I'm just mediating the most pressing situations as opposed to learning a ton about skilled care.

All I can say is I'm sorry, for both you and the patients actually. That should be criminal. You are definitely learning how to prioritize! If you can mentally/physically make it, try to press on towards that one year mark and then get the hell out of Dodge.

[bugya90, ASN, BSN, LVN, RN]

It depends on your long term career goals. Since you say you want to do ER or ICU in the future, I would recommend you stay or try to find another inpatient job. Though other inpatient units may require 1+ years of RN experience and/or BSN.

However 10-12 patients at night is a bit extreme. Are all the units in your hospital like this or just the one you are currently on? How is the management, do they help at all?

I was similar to you. Had been a LVN in ambulatory for several years and went to inpatient when I finished my RN. I knew right away inpatient was not for me and went back to Ambulatory after 10 months. I will probably never be able to go back to inpatient but that is fine with me as my heart is in Ambulatory.

[Zeek, LPN]

I would like to add that being a dialysis nurse is stressful as well. You may be in charge of 12 patients and the technicians that do the actual care. It seems that some people have the idea is that you just put them on and take them off and it's no big deal. Except it is. Just like you are seeing more critical patients on your floor (and I agree that 10 - 12 is too many), we are seeing sicker patients released from the hospital to dialysis and it seems like we are an outpatient hospital ward LOL! I don't want to dissuade anyone from trying dialysis - I love it and have stayed for 35 years in this field. But just be aware that other types of nursing are stressful too but in a different way. I wish you the best of luck in whatever you decide. By the way - it is not true that you cannot get a job in the hospital after being a dialysis nurse. We have had 3 new grads start here and then transition to the hospital for acute care. You have to be able to sell yourself!!

[adventure_rn, MSN, NP]

12 hours ago, Birdsofprey said:

I may not have better opportunities elsewhere, though I can try. I won't leave unless something really good comes my way.

Came here to say precisely this. It sounds like your work environment is unsafe, but if at all possible, I'd wait to leave until you have another job in hand. If you have any interest whatsoever in taking a hospital job in the future, I really think it's best to hold out for another acute care job. Your concerns about being unable to get back into acute care if you leave now are well-founded. By all means, go ahead and start applying to other acute care jobs now; however, as others have said, you may not have any luck until you hit your full year of experience.

Hang in there!

[egg122 NP, MSN, APRN]

10 to 12 is too many but the sad reality in many NYC hospitals, public or private (particularly in Brooklyn for some reason). Stick out the year if you can then look for hospitals in Westchester or LI.

[CVVH, MSN, RN]

Try to finish finish the year and your BSN in that year if possible, then transfer to one of the private hospitals in the city. I work at one of the major private hospitals in NYC, and having 10-12 pts in telemetry, let alone any inpatient unit, never happens (same at NYP, NYU, Mount Sinai, Sloane, etc). Max in med-surg at my hospital is 6. And the salary is a lot higher as well than the public hospitals (like 20-30k higher). Good luck!

[Nurse Beth, MSN]

I was shocked to read that you have 10-12 patients on Tele. I don't know how they justify this or how those in charge can sleep at night.

In California, safe staffing laws limit the nurse-patient ratio to 1:4 on Tele. It's a reasonable number given the acuity of patients, the fact that often more than 50% of staff have less than 2 yrs experience, and the shortened length of stay. Four beds can mean 6 patients due to discharges and admits.

All this to say that it's not you, it's the situation. I agree with other posters saying to hang in there 6 months if you are able. At 1 year, you are marketable and should never have to work under these conditions again. Best wishes.

[Birdsofprey, BSN]

Apparently all the floors are this bad, and the ER is even worse. The ICUs are even short-staffed. Management is complacent and does not help, they always claim they are "hiring more nurses" but even when they do, those new nurses simply replace the ones who leave due to burn out and frustration and find opportunities at better places. I will definitely try to hang in there until 1 year unless I get a call from another hospital gig.

[LibraSunCNM, BSN, MSN, CNM]

7 hours ago, Birdsofprey said:

Apparently all the floors are this bad, and the ER is even worse. The ICUs are even short-staffed. Management is complacent and does not help, they always claim they are "hiring more nurses" but even when they do, those new nurses simply replace the ones who leave due to burn out and frustration and find opportunities at better places. I will definitely try to hang in there until 1 year unless I get a call from another hospital gig.

It probably doesn't seem like it, but this hellhole will soon be a faint memory for you and you can always look back on it with pride for what you survived there. It will have helped you grow immensely. Plus, you can start your job search probably around the 9 month mark to be able to start at the 1 year mark, so it's even closer than it seems ?

[ihavealltheice]

I left my position on a telemetry unit at the 8 month mark. I was driving over an hour, working a shift that I didn't like, and was stressed. I also wanted a job in ICU. So, I took a transfer to another hospital within the system at an ICU. It was worse than the first job. I was extremely overwhelmed and for the safety of my patients, I told my manager, she let me go on the spot and left me in limbo. So, 14 months as a nurse, there I was interviewing for my 3rd job. It was awful.

As much as you don't want to hear it, my advice would be to stick it out until you have your BSN. Get that experience in the trenches. It might be stressful, but what you're learning is invaluable. Plus, if you want a more autonomous job such as home care, you'll need that experience under your belt.

Hang in there. 6 months will fly by.