looking for my niche in nursing

[sophie<3]

Hello :)

I have been a nurse for almost 2 years and unfortunately, I am feeling more lost now than when I started this career. In these 2 years I have worked on a Bone Marrow Transplant/Oncology unit for 14 months and then a Level III NICU for 6 months (my current job). In nursing school I felt like NICU was where I belonged and completed an externship and really enjoyed it. When I graduated and started working in the real world reality slapped me straight in the face. I don't like NICU nursing...there are some days that I enjoy my job but those days still feel few and far between. I have considered leaving nursing altogether and going back to school for something else and have questioned myself several times if this is something I want to do forever. I was advised before leaving nursing to try to find a more nontraditional nursing job...in a clinic, as a case manager, or something similar. I like the idea of working in a clinic..and maybe even going back for an FNP at the same time..but I am not ready to pursue ANOTHER nursing degree ( I have an ADN and BSN) without feeling the passion that I am lacking now. I also don't feel like clinic nursing is something that will challenge me enough to be a long term fix...I feel like the pay cut wouldn't be worth it either.

Then someone mentioned an OR position to me and said this might be something I should consider. In the OR you have 1 patient, you are challenged each shift but maybe in a different way than floor/ICU nursing..you work as a close-knit team, there is room for growth, and the pay is still competitive. I like the idea of OR nursing but I am terrified. I have heard some negative things about surgeons and even OR nurses and I am afraid I might be eaten alive there. The only OR experience I have is 2 observation days in nursing school where I literally watched surgery after surgery for 8 hours each day. I was fascinated by the surgeries and loved the anatomy, the environment, and the people were nice but I didn't really pay attention to the nurses role. I feel like I would really love to be a scrub nurse and be in the action but I also feel like the I could enjoy the circulator role as well. My main dilemma is that I am not sure I can take another let down in this profession. I want so bad to love my job or even just like it..I want so bad to remember WHY I went to nursing school...and why I worked so hard for this...because right now I just want to bail. I was wondering if anyone else has entered the OR with similar feelings? Did you enjoy it? Do your regret leaving the floor? Does anyone else just want to find their niche or am I in this struggle alone? I would love to hear from OR nurses perspectives but I am open to any input at all.

Also..another thing that is holding me back is the job availability for OR nurses in my area. Many of the hospitals want 2 years of experience...the teaching hospital that I work for has an amazing perioperative residency/internship that is 6 months long and they train you to scrub and be a circulator. The only problem is that you sign a contract for 2 years following that 6 month training. I'm afraid I won't like it and be stuck for 2 years..that's such a huge commitment

[Altra, BSN, RN]

Some perspective ...

Two years in a highly specialized environment like the OR is barely getting your feet wet. It's like the blink of an eye.

Your profile lists your age as 25 -- you likely have another 40-ish years of your working life.

The rest of your decision will need to take into account what you haven't liked about your two nursing positions so far, and how a different nursing specialty or advanced practice will be different.

[RNperdiem, RN]

Your post doesn't make it clear exactly what you are unhappy about. Overwork? Boredom? Maybe you need to do some soul searching to figure out exactly what you do and don't want.

In any specialty, it is a job. It will feel like a job once the newness wears off.

I also get a sense of a vague, generalized unhappiness + fear of stepping outside your zone of comfort =inertia.

[sophie<3]

Thank you all for your replies...I can't really point my finger on what I don't like about my past and current job...I think it is just the feeling of being stretched thin all the time! Admissions, discharges, and bad assignments in general.

In oncology I would always get assigned the patient that no one wanted..either really sick and unstable or a total care patient that would break your back or 3 RSV patients which required you to do the nurse AND tech work for all 3 because our 1 tech couldn't care for RSV patients and then go into the room of an immunocompromised patient. Or if there was ever a time when one or two nurses (out of the 5 nurses staffed on nights) would have to take an extra patient and be a 4:1 rather than 3:1..it would ALWAYS be me. I left because nothing was changing..as one of the newer nurses I felt dumped on constantly and was tired of it. My friends on that unit who still work there told me that I should be glad I left when I did because it only got worse.

In the NICU I simply feel like the orientation was not satisfactory. 10 weeks of clinical training and 1 week of NICU courses and then you are expected to care for babies who are 400 grams, on nitric oxide, intubated, and trying to die on you all night. I have heard so many girls say that 6 months of training would still be stretching it thin in NICU and many girls who have been there close to year still pray they don't kill anyone! It just scares me..and I like a little bit of unpredictability in a job so that it keeps me on my toes...but I don't like feeling unprepared. And that's every shift for me. I am a good nurse, I worked hard in school and continue to work hard in my practice but I am starting to wonder if this hospital or these units I have chosen are the problem or if it is me.

I really do enjoy nursing..I love helping people, I love learning, I love medicine. I do not love feeling like I am not being supported by my coworkers and team and feeling dumped on. I do not love feeling stretched thin and being afraid of providing unsafe patient care because of acuity or patient assingments. I know I will be leaving my unit..it's just a matter of where to go next.

I want to try OR..I know some things I have complained about are on every nursing unit/specilaity, etc. But I feel like 6 months of training sounds so much more ideal...and having one patient allows me time to focus on that specific person/case/surgery and then moving on to the next. I feel like I can still enjoy the things I love about nursing and maybe leave the other things behind. Does that make sense?

Thanks for listening. :)

[OCNRN63, RN]

Why don't you post this over in the OR Forum? You might get some good feedback from people who work in the OR.

[beckster_01, BSN, RN]

In the NICU are you using your resources? I started in the MICU after two years but had my orientation during "slow season," which meant I had NO sickies while I was on orientation. That meant that when I had my first really unstable patient you can bet your butt that I was finding my charge nurse for help every step of the way. It's been a year now and when I see something I haven't seen before or if I have to make a judgement call that I'm not 100% sure of, then I look for the most experienced nurse (or even the doctor if it's a good one) and I ask for help. It just seems to me that the common factor in both of your jobs is a lack of support. I may be naive, or I may be lucky, but I have never worked a job where I felt like I was left in the dark. So make sure you are swallowing your pride and try to identify one nurse you feel comfortable going to for help (it doesn't have to be charge). For the patient's sake the ICU should work as a team, always.