LPN: To RN? Or Not to RN.

[CoCat]

I've been an LPN for 5 years and aside from some time at a DOC drug detox, I've worked entirely SNFs. Im generally regarded by my NPs and MDs as "the best" nurse they work with, which is probably true. But not because I'm brilliant or anything, I just see a lot of nurses in this setting who don't seem to want to learn on the job. I love learning. I love discovering Why something works the way it does, I ask questions and I've been lucky to work with NPs and MDs who immediately see this in me and teach me things or point me in new directions to research why they're making the treatment plans they're making or how they got to their diagnosis of a problem-on my own time of course.  
 

So nobody gets why I don't want to go back for my RN. The thing is, I really hate the job. A love of learning and critical thinking and solving puzzles is great, but it also predisposes me to a true hatred for our broken healthcare system. I hate petty redundancies in charting. When the order says "Give 3 units of lispro with meals,” and the documentation requires me to state how many units I gave, I die a little inside. I gave 3. I gave 3, or I marked it as Not Administered. Because that's legally all I am allowed to do. "You know, I gave 7 units actually thanks for asking. Just, felt like changing it up!” *fingerguns*  "Place 2 drops in the Right Eye" and then to document it as administered I have to state where I put the drops. "For funsies I put 1 drop on her Left Knee, haha!” I cannot understand why this kind of charting is required. If the order doesn't leave anything open to interpretation, there's no use of a sliding scale or the words "to affected area,” then by marking the order as Administered I am Documenting that I Gave the Medication in the Correct Dose to the Correct Patient via the Correct Route exactly as it was ordered, am I not?  I mean, it's not as though I'm having to type in exactly how many mgs of each pill I mark off as given?  Or type that I gave the med by mouth for each individual PO order?  So why am I having to document site and route and dosage for insulin, creams, drops, etc.?  If I'm giving 40 mg of Lasix IM I'm not asked how many mls I actually drew up?  Why these inconsistencies?

It's a stupid reason to hate a job. But it's the way this type of thinking, this flawed logic, is just Accepted, and proliferated, by nurses and healthcare administrators, that has me hating this field. I sit in clinical meetings and sign stupid In Services reminding me to do things in a way that is inefficient and illogical, and I want to scream. I want to tear my hair out. I want to jump on the table and shout at everyone to stop sycophantically nodding along and Be More Intelligent. 

I can't want to advance my education in a career field where all I see ahead of me is the opportunity to become dumber.  And that's what I see. 
 

I also hate the long shifts, and I hate patient's families.  I hate weekends where I have to fight off this patients Daughter who is an RN and that patients son who lives across the country and likes to micromanage moms care over the phone to assuage his guilt.  They come for me like a pack of hyenas with their questions on a Sunday afternoon that are reallllly more appropriately asked Mon-Fri when the people who can actually answer them are in the building.  And I smile, and make assurances, and scroll pointlessly through progress notes generated by the computer that are not informative or helpful at all, and hope to just make it to Monday morning without making someone mad enough to complain about me to management.  
 

I love my patients usually, I'm a sucker for a little old lady or gentleman with a little dementia onboard.  But mostly I work with subacute boomers whose hard living brought on COPD and CHF in their early 60s, or worse, Gen Xers after their first heart attack or joint surgery.  They've never been in a rehab facility, never been admitted inpatient anywhere for any length of time, and are angry and scared and entitled and bewildered at how this could happen to them, even though we all know that there were countless warning signs along the way that this was coming, that they completely ignored.  And they use me.  They want to take it out on someone.  They want someone to talk to.  The ones that manipulate situations so that I can't easily escape their room make me sick with dread every time I have to do something for them.  The talkers who see me back away, but refuse to acknowledge that I need to leave.  The ones who hold the pills but won't take them, essentially holding me hostage in the room as I can't legally leave until those pills are either swallowed or officially Refused.  The ones who give me a hard time about every accucheck, like come on Judy, we have to do this 3 times a day every day can we just cut the crap?

I am just too tired of human beings and their personalities to keep this up.  On an assignment of 17 skilled patients, it only takes one who does any of the above to completely destroy my ability to enjoy working with the other 16 who aren't that way. One set of overbearing family members is enough to send me home from work wishing I could quit my job, unable to care about anyone else or anything else including the family that's been waiting for me to get home. I wonder if they even realize?  I feel like I pour out all of my niceness and compassion, all day long, and am left empty and dead inside when I'm finally released back to MY life. The life I'm barely living because I'm too numb and tired and overstimulated from work, and need at least 2 Full Days of isolation in order to recover from the 4 13-hr shifts I worked. In the 5 years I've been a nurse I've gained 45 pounds, because I can't seem to consistently work out anymore, mostly because I can't seem to want to do anything outside of work that I used to enjoy doing before taking on this career. I drink more, run less, have zero hobbies and no friends unless I work with them. I am on track to become one of my own patients:  obese, diabetic, with CHF and worn out joints that will need replacing early.  And I blame this field. I blame this job. I blame my bosses and administrators and patients and their families. And I blame myself for putting myself into a career I am clearly not cut out for and do not enjoy, even if it did double my earning potential and enable me to be a single parent who lives in a nice rental and can buy happiness online one Amazon cart at a time. 
 

So I can't justify the pursuit of more education in this field. I'm afraid I wouldn't be able to keep my cynicism to myself, that I'd sit in classes and listen to lectures about Evidenced Based Practice and Lie My Buns Off making up care plans with interventions that have never, and will never, actually be implemented in the field due to the reality of time constraints or availability of equipment or staff, and I'd lose it. I'd lose it, and get escorted off the property by security, and wind up at an inpatient psych facility on an involuntary basis. 
 

We are all defrauded daily by the Healthcare Systemin the US.  We are All suffering as nurses, I know we are because I see us all living like this, and trying to like it, or at least tolerate it. Nurses take care of EVERYBODY else at the expense of their own physical and mental health and wellbeing.  I know I want something else from my professional life, I just have no clue how to get there.  I got too deep into this career to see any effective way to get out of it without it costing myself and my family everything we have. I feel trapped.  Does anybody else feel this way?  Why are we doing this to ourselves? 

 

 

[San Diego LVN]

Oh yes I hear what you're saying! I have been known to say "screw nursing I'm going to pour wine for a living" Haha. I do find working with families of patient's/client's the most difficult part of nursing especially the control freaks. When it gets to be too much then I move on and work a less stressful nursing job. The key is to find less stress with same amount of money. I've done that working in medical/behavioral group homes. Only four clients.

[Namgyal, LPN]

Cocat, hopefully you will find the peace in whatever way you would find soon. How about working in less hours like there are many agencies these days where you could pick hours whenever and wherever you want. and keeping a part time job on side like barista or something lighthearted job? since your nursing knowledge has already deepened, I would rethink this option. Good luck for your future endeavors 😊

San Diego LVN said:

Oh yes I hear what you're saying! I have been known to say "screw nursing I'm going to pour wine for a living" Haha. I do find working with families of patient's/client's the most difficult part of nursing especially the control freaks. When it gets to be too much then I move on and work a less stressful nursing job. The key is to find less stress with same amount of money. I've done that working in medical/behavioral group homes. Only four clients.

I hear you 😄