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Kittypower123, ADN, BSN, RN 4,977 Views

Joined: Feb 13, '09; Posts: 144 (65% Liked) ; Likes: 288

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  • Dec 2 '17

    As we walked around the track together, my friend shared some of her nursing job frustrations with me. She had been in her current position for a little over 2 years. Long enough, she felt, to know whether it would be a long term good fit. "It's getting harder and harder to give my patients the care that I want to give them." She went on to vent about some other more minor concerns and then said, "But there is a job that looks good on another unit. Do you think I should consider switching?"

    A recently published study sponsored by the Robert Wood Johnson Foundation shows that "an estimated 17.5 percent of newly-licensed RNs leave their first nursing job within the first year, and one in three (33.5%) leave within two years." (Nearly One in Five New Nurses Leaves First Job Within a Year, According to Survey of Newly-Licensed Registered Nurses - RWJF). High turnovers are hard on the hospitals and hard on the nurses. Although stressful for all involved, job changes within the profession seem to be a very common occurrence.

    So, if you are not currently satisfied with your job, is it time to jump ship or should you just sit tight? The answer is, of course, it depends. Here are some things to think about; questions to ask yourself as you consider.

    1. The grass is always going to be greener.

    It is simply human nature to feel like we are missing out on something wonderful, just down the hall, on that other team, or maybe across town at the fancy, new hospital. Most of us struggle to be content in other areas of our lives, as well. We want things that are just out of reach: the better car, the bigger home, more stuff from our etsy-fueled dreams. However, if we are honest with ourselves and with others, we soon realize that sometimes our desire for change and newness is simply that: restlessness for the elusive perfection-that job where everything will be good and we will be fulfilled as nurses. Bottom line: sometimes we are the ones that need to change, not the job.

    2. Toxicity varies, but most jobs have stuff we strongly dislike.

    I can remember struggling to adjust to my first nurse manager and her style. She was abrupt and often came across as unfeeling. Many times, I cried after my shift. But gradually I came to realize that her military training occasionally clashed with civilian life and my 20 something tender heart. Over time, I came to respect her vast knowledge and value her judgment. In a case like that, staying the course paid off huge dividends. I learned a lot. But environments that support bullying, that allow verbal abuse, that condone rudeness, should not be tolerated. Out of self-respect, it is important to be able to identify unprofessional behavior and draw the line, leaving that work behind and washing your scrubs in extra hot water before heading to a new position. Bottom line: know how to identify a truly toxic job.

    3. Boredom is not a good reason to go.

    I cringe when I hear someone say, "This work just isn't challenging enough for me." It is painful to hear because every job out there-if it involves nursing-can be challenging. There is always room to go above and beyond; to be and do more than is expected; to learn and create improvements. Every patient has something to teach us-people are a never-ending story and we have much to learn from one another. The daily practice of being a great listener can renew our flagging energies. When we get discouraged, we can listen more carefully to those around us and find new reasons for curiosity and gratitude. I remember meeting an older gentleman who was caring for his wife in the nursing home. She was our primary focus and the center of our conversation. I didn't really get to know him until years later, after she had passed and he became the patient. His stories of being injured in the Pacific during WW2 shook me because I thought about how I almost missed knowing him, and hearing all he had done. Bottom line: Boredom says more about us than about the job.

    4. Some of the long-term job satisfaction comes from long-term work

    Developing relationships and becoming an expert in the field can both contribute greatly to job satisfaction. Working relationships with other nurses, physicians on staff, ancillary providers and environmental workers can take years to develop. Those relationships tend to build and progress through experiences together, bonding the team even as expertise develops. It is an earned recognition that makes someone "the best stick" on the floor or the "go to" person for wound care or "the best diabetes teacher ever." This potential source of professional satisfaction suffers when we change jobs. While we can still be an expert, it takes time for people to learn to trust us and for those working relationships to develop-again. Bottom line: Life is all about relationships.

    5. Change happens.

    If a position was good and things got bad, then chances are it will circle back around-eventually-and be good again. Meanwhile,we can all be agents for change, helping to make difficult situations better. We can influence the culture of our floor or unit or office for the good. We can work has the superior professionals that we are, holding ourselves and others to a higher standard, working always to provide the most excellent patient care. Bottom line: Change is the only constant.

    My friend ended up staying with her job-for now. What about you? As you consider your options or talk with other nurses, what are some of the things you think are important to consider? What is your bottom line?

  • Dec 18 '16
  • Jul 2 '16

    The Dark Side of Hope
    By Joelle Yanick Jean, RN

    About a year ago, I witnessed hope in the worst way. It wasn't the hope that in the back of your mind you prayed was going to come true and it actually did. This hope was malicious; a menace. It was taunting, a bully, a liar. Being a nurse, you are often faced with this type of hope. The hope you know is not going to end well because of your experience and medical knowledge. It's the hope that parents, patients, family members, even staff members have; the hope their loved ones or their patient is going to live despite a poor prognosis.

    One evening, as the charge nurse, I received a phone call from a hospice nurse who was calling in her patient to the ER because her NG tube fell out. She was calling me directly because she wanted to warn me. The patient was very sick, and the parents did not want any interventions other than replacing the NG tube, and once replaced, the patient was to go right back home.

    The young girl was twelve, and had end stage cancer. The parents were in denial about her illness. They refused to sign a DNI/DNR. They were hoping she was going to get better. They were hoping she was going to be cured from the cancer. The hospice nurse cautioned me the patient looked very ill and probably should be in a hospital, but the parents understandably wanted her home.

    When the patient arrived in the ER, I was immediately aware of the situation. Hope had wrapped its ugly hands around this family. It had taken over their lives, just as the cancer had taken over this young girls' body.

    The young girl was fully conscious, on a bipap machine, frightened and suffering. When we placed her in a room, I introduced myself and touched her hand. She had skin breakdown around her nose and eyes. Her eyes were puffy from the pressure of the bipap machine which was helping her breath. A foley catheter was placed to catch her urine because she could not urinate on her own. A fentanyl patch was placed on her arm for pain control. All interventions used to prolong her life because Hope had said so.

    According to the Oncologist, the family was counseled many times on the prognosis of the young girl's disease, but the parents just could not accept it. They hoped through prayer and faith, this young girl was going to walk again, play again, laugh again. They prayed loudly around her and with conviction as we replaced the NG tube.

    Hope allowed this girl to suffer, to be in pain. Maybe their hope had seeped into us as well, allowing the medical team to honor this family's wishes. Where was the ethical team? Where was the person who says, this is enough, let her die in peace. Hope had not allowed them to be present.

    That night, I wanted a different hope for this young girl and her family; a hope that I often wish would come sooner than later for some families. I wanted a forgiving hope, the hope that kept its promise. I wanted the hope to take over that doesn't let you down. I hoped for the suffering to end for this young girl; I hoped she would die a peaceful and painless death. I hoped this young girl's family would come to the realization she was suffering and the God they prayed to wanted her to come to his home not theirs.

    As nurses, we are often faced with the uglier side of hope. However, I believe that through experiences and knowledge we can and should educate our families about a hope that allows one to let go and to grieve appropriately. I know it is extremely difficult to let someone go, and not everyone has the strength, but I believe since we are nurses we are better equipped to deal with these types of situations.

    Sometimes it's the nurse's role to be the voice of reason. Families listen to us and value our opinions. I wish I had had the courage to tell this young girl's family that she is dying, and to please let her go, but I'm hoping, hope finally came to its senses and told the family the truth.

  • Jun 3 '16

    When a staff member says "here comes the death lady" or "palliative care kills people" or "I am not going to take morphine because everybody knows that once you are on it you are basically dead" --- pointing to misinformation, bias, and uninformed populist announcements.
    I like to say that while everything centers somewhat around end-of-life and serious illness, it is more about quality of life, how to deal with serious illness and how to take control over your life and the time left.

  • Jan 10 '16

    Yes! Casa de la Luz is fantastic. Hospice family care I've also worked with but not as impressed. Emblem is also good.

  • Aug 22 '15
  • Jun 6 '13

    Man....I gotta tell you by the end of a 12 hour shift this thing weighs a TON!!!!!!!!!!!!!!

  • Mar 17 '13

    Don't worry. With all the body fluids we encounter, they'll be colorful soon enough.

  • Feb 6 '13

    I never understand questions about weaknesses and "where will you be in 10 years?" If I were an interviewer I would know these questions are unfair and will almost never yield a truthful (truly) response.

    If I were to answer this question I would say I will come in every day and work very hard, but I am not going to suck up to you/coworkers, I will probably not add you/coworkers on facebook, and I will probably never go out with you/coworkers outside of work.

    I personally don't view this as a weakness, but it sure has given me a lot of flack over the years I've been working.

  • Dec 12 '12

    All I want for Christmas is a New Elf Care System

  • Nov 14 '12

    It's time to quit arguing about who gets to be the Indian next, you can trade places tomorrow. Now please, lets go back to your room so I can finish my med pass.

  • Nov 7 '12

    What do you call someone that craves HIPAA policy.

    Hungry, Hungry, HIPAA

  • Oct 23 '12

    You don't want to know where they found Dr. Smith's stethoscope this time!

  • Jul 5 '12

    when you believe every patient needs tlc: thorazine, lorazepam and compazine

  • Jul 5 '12

    eating microwave popcorn out of a new bedpan is perfectly natural