Med-surg to NICU, MB or L+D

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I posted this on another discussion board but would appreciate the input of this board's expertise.

I have been a med-surg float pool RN for 5 years. I have about a year of full time telemetry experince, too much med-surg experience, and about 4 months of peds( was short term assignment for RSV season). I have fibromyalgia and stress causes it to be worse, so the flexible schedule of the float pool has worked well for me, but lately I am so stressed over dreading work that I don't call in to get placed, which leads to lack of a decent paycheck. Which leads to bills not getting paid on time always. and that leads to stress, which leads to worse fibro ( see the pattern?) Working 24 hours of the float pool would equal working 40 hours on a regular unit ( in hourly pay only). As a float nurse, I can buy my health ins at a higher premium, but still good, and I don't have any further benefits that a FT position would have (vacation time, sick time, etc)

I had an awsome manager for 5 years who was so good to us, until she 'managed up' and a new position was created. My new manager and I just haven't gotten off to a great start. We rarely see each other, which is the norm, and she only knows what other people tell her. The hospital keeps opening new units ( I could be sent to any of around 10-12 units), and new places ( mostly bad) keep getting added to our list of units we float to. (we don't have a choice where we work).

I have asked my manager if I could cross-train to CC float pool. She was initially recpetive and then hasn't replied to my furher request. I will be doing most of the education and classes on my own time since she is not replying.

Today I had another awful day, have come home with my back aching, and a dread of working again this weekend...... I am a single mom of a 14 yo daughter, I love my flexibilty but I am thinking it may be time to move to a stable unit full time. I work another job at an eye center one day a week. If I leave the pool, and try to rejoin later, I will have to take 6 months of working evening shift ( the worst).

I am in a tough financial situation right now, and am considering quitting the hospital so I can access my 403b retirement account o pay back bills. My plan would be to find a surgery center or clinic that I like- but I have a strong feeling I will just end up back at the hospital within a few months.

I have always wanted to work in the NICU or nursery, but I have heard some say mother- unit is hard ( the visitors and pts being demanding and rude). NICU would be more my style I think, although I might enjoy L+D.

If not in one of those areas, I'd like to be in an ICU. Then, if I did go back to the float pool, I would say I wanted to be placed in the ICU division ( although I forsee her saying that I would have to accept med-surg or ICU assignments.) There aren't any openings in any of those units, though. There are some cardiac cath lab openings. There are only a few positions outside of the hospital advertised that I would desire.

I appreciate any comments or suggestions.

Thanks!

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Dear Cutiedear--

Hi, I am an L&D nurse and I have been a NICU nurse and have done some motherbaby. After working in med-surg, you would love mother-baby. It would seem like a vacation--almost no meds to give out compared to med-surg. People are young and healthy (generally) and the babies are so cute. L&D is a lot of work, and depending on your unit, can be non-stop running around and emergencies--you also have to circulate in the OR. Many days I can not get to the bathroom when I need to or eat. I also have a health condition that is aggravated by the stresses of 12-hour shifts so I am interviewing for a home health position. Maybe you could consider that? Go to the home health specialty board to read up on that.

Take care

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I love PP and well baby nursery. Usually the mom's can wipe their own butts and i hand out percocet and colace like candy. Very few meds compared to med surg. I am currently doing mostly L&D. Its ok but the stress level is crazy sometimes. Some nights we sit around doing nothing and other nights I am scared to how we will handle things if one more laboring PT walks through the door. It all depends on what interests you and the stress level that you want. NICU and L&D being towards the higher end on the stress scale and PP being less stressful.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Mother-baby and postpartum are great areas to start when you have no L/D experience. You can always try L/D after going into these areas. And your med-surg experience would be a HUGE plus in any area. I know my unit would welcome someone like you. Good luck.

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Thank you all for your help. I changed my username while I am now looking for a new position. I talked with the nurse retention specialist at my hospital today, who suggested I talk to my manager first and see if she would be willing to accomadate my desire to start into Mother-baby or NICU. After that, I will have the retention spec. send out an email to the units I am looking into, then take a tour of the units. There is another great NICU about an hour away, but I don't think I could take the drive. Right now there is an opening in L+D and MBU. (couplet care).

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wow, y'all have a rentention specialist? i did not even know they existed. wish they had one where i worked.

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Just an update.

L+D filled their position before they ever posted it- with a nursing student. That won't graduate until May. That was a little irritating.

NICU sort of 'interviewed' me today- and it went well, I think. I really want to work there, night shift or whatever. SHe is encouraging me to try limbo there while having a position somewhere else in the hospital, as they have no openings.

MBU mgr called me tonight, after I spoke with the retention nurse again ( yes, it is great we have one). We have an interview set up for Friday. She asked me on the phone if I was a night shift person- I was honest, and said no, but told her that I understand that there is a starting point on every unit. She said there would be 5 people ahead of me waiting on day shift ( I didn't ask) and that if I wasn't a night shift person I would basically not work out. I feel like I have been turned down from the start. I could manage night shift for a while- no I don't think I am built for nights- and it would be a struggle, and for childcare too. If it's the right unit, with the right staff, I think night shift could be great- once my body gets adjusted ( if ever). I have to get in the door somewhere, and there are no other options for me at this hospital other than taking a position on a unit outside OB-neonatal and still working limbo for NICU, working my way in the door there. A hospital about 1/2 an hour away is wanting me to interview for an ICU position, and another larger hospital an hour away has NICU positions open but haven't called me.

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Wow, 18 months later, and here I am again.

First, the good news. My new manager (18 months ago) turned out to be awesome. Really, a great leader, and if she were not my boss, a friend.

Now, the more interesting stuff. I never changed my jobs that I spoke of 18 months ago. I began my RN to BSN program and will be able to finish it up this December, or next May at the latest. I've been doing school full time because I can work on my homework at my office position (between pts).

In November 2009, YAZ (BEWARE!) caused massive bilat pulmonary emboli, cor pulmonale and a minor MI. Knocked me to the ground. By the grace of the Lord I survived 4 months with very little pay, no sick or vacation or disability pay... (on the float team we don't get those benefits). Several people helped me financially with gifts and donations. In the mean time, as I was starting to work enough hours to come near the minimum bill payments, my family life has been turned upside down and my daughter is living with her dad 5 hours away.

I want to be able to see my daughter, and the float pool gives me the flexibility to make quick trips or even long weekends. I have considered going right into my MSN (possibly in education tract or FNP), as I have a chance to do it now FT (and possibly get it mostly paid for through a grant). I still really dislike/hate working on the med-surg units, but there is give and take in every job.

A FT nights position (with Every other weekend) just opened up on NICU. Historically, very rarely does a position come open in this unit. While my daughter is no longer here for me to worry about her being alone, I still don't think I could do nights easily, if at all. My health is not fully recovered, although all the VS look good, the echo results, etc. I know that there are things I could do last year, and can't this year. I am afraid that the night shift and the potential for high stress in the NICU could be difficult with my health (plus the fibro). However, Med-surg feels like it is going to kill me most days. (this is not just me, but most of my med-surg float team friends). If only I could magically jump into the Mother-Baby division of the float pool- then I'd have my flexible hours, my kind of pts, and my great manager.

I have some friends that say I need the benefits, take the job- and some say that seeing my daughter and school are more important- keep what I've got.

I'm leaning towards sticking with what I've got right now. I'm praying God will give me a clear answer, but I thought I'd retry asking some experts (aka ya'll.... lol).

Thanks :)

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Specializes in Cardiac.

wow, what a unexpected outcome! Glad your feeling better!

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Specializes in Med/Surg, Surgery, Post Partum, GYN.

What a busy year you have had! I have worked in med/surg and surgery for a long time, then last winter took a night shift position on a mother/baby and gyn unit. This is the first time I have ever worked night shift and I absolutely love it! I was afraid I was going to be bored, but there are nights when I wonder why the patients don't sleep. Granted, it has NEVER been as busy as I ever was on med/surg - it does feel like a vacation. We never have more than 4 patients (combination of couplets/gyns), and all of our gyns go home the next day after surgery. The patients are almost always 100% self care and we mainly administer colace, prenatal vitamins, iron, pain medications, and tDap vaccines. I find my job relaxing and rewarding. I get to do a lot of teaching, assist with breastfeeding, and best of all, hold new babies - who wouldn't love to do that?

I would totally recommend a mother/baby unit - totally different atmosphere than anywhere else in the hospital. Very quiet and rewarding. Night shift has also given me ample time to work on my master's. We recently had three float/agency nurses join our unit full time because they wanted stability, a guaranteed schedule, full paychecks, and benefits.

Best of luck to you if you decide to pursue this area of nursing. And good luck as you complete your BSN!

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Loveanurse and Scrubcap, thank you :dancgrp:That just looked like a fun emoticon to throw in there.

ScrubCap, your advice is helpful. I thought a while about this, and if I did take night shift it would need to be lower stress. I am waiting for the right Mother-Baby position to come open. Until then, I will work on my BSN. Yesterday I found out I can take up to 9 grad level courses while in my last 9 undergrad course requirements... at the undergrad rate and with undergrad fin aid. So, I feel like this is the direction to take at this point in time. I appreciate this site and everyone's input so much.

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Here I am, again. Looking back, I wish that I would have gone for that night shift in NICU, but at that time I guess I really wasn't ready for it (physically). There has not been an opening since, and I recently called the (retiring) manager who said that the hospital is so tight (I believe it) that they aren't letting her hire anyone else.

I have an interview for a night shift 70 bed level 3 NICU. My daughter remains living with her dad, so I am going for it. I think I will like a change in hospitals, but the drive is concerning to me. I have an interview for both intermediate nursery and intensive care nursery. I'm not sure which one (if either) would allow some downtime during night shift? I also would be sad to give up on my second part time local office job since it does allow me to do schoolwork in between pts.

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