Need some career advice

[PAnurse94]

Hi everyone,

I am a 1st year RN. I graduated with my associate's in August 2017. In December, I got a job on a med/surg/telemetry/PCU overflow/stroke unit (obviously, they are in the process of reorganizing the units! Haha). I am learning a TON there, and I'm really happy to be getting this kind of experience on my resume. The people are nice for the most part. A lot of nurses recently quit (we went from 50 to 16 in the month that I was hired, and I was one of 12 hired...since then about 15 more have been hired). The hospital restructured a lot due to a merge with a big company and that's why many nurses quit. Unfortunately, there are hardly ever nursing assistants, and the nurse:patient ratio is 5 or 6. It has even been as high as 8 (with some patients being critical if they are PCU). Needless to say, it's stressful.

A little about me: I just turned 24, getting married in about a year and a half, planning to have kids, super family oriented, have always, always, always struggled highly with anxiety. I am on medication daily to control my anxiety and getting through nursing school and this job has been quite the challenge. I am so proud of myself for my accomplishments so far, but I need your advice/input on the plan I am creating for my future career and more importantly my work/life balance.

Money has always been important to me, I am materialistic and I like to be seen as "important" so I always wanted a job like this where I would be able to say "I save lives." When I started nursing it became more than that - I love the skills, I love the people. However, I do not love it to the point where it makes me forget about the anxiety and overwhelming feeling constantly. That part makes me hate it, to the point where I don't even care about the people (and that isn't me). I understand the first year of nursing is tough, and I understand from experienced long-term staff on my unit that these changes have made it unbearable but it isn't usually like that. I feel like if I stick it out, things will be okay. I'm okay where I am for now, as hard as it is. But I am trying to figure out where I want to go from here.

Obviously, I want out as soon as possible from this unit. I was hoping to leave after 1 full year (December 2018) or possibly 2, depending on what I realistically need on my resume to get another job after this. I think a lot about where I want my nursing career to go in terms of how I want to spend my days at work. I'm not lazy, I don't mind pouring effort and passion into things. I pour time, effort and passion into hobbies, favors for family members, etc etc etc constantly and I love it. That is a strength and gift of mine - and I want to take FULL advantage of it to thrive in my career. But I need a job that I don't hate and that I'm not so, so afraid of. It's awful (not to sound dramatic). I get anxiety about it to the point where physical symptoms manifest such as diarrhea, panic attacks, heart palpitations, night sweats, nightmares, and lashing out at my loved ones. I'm not enjoying the things outside of work - I can't get work off of my mind. I don't enjoy time with my family anymore, or my dog, or my boyfriend. I am house hunting, a process I was so excited for, and I have no desire to get dressed or leave my apartment on my days off. I basically hide and hope that the clock will freeze so I don't have to go back.

I only work part time (24 hours a week) which is nice. At first I picked up extra hours, and then they started automatically scheduling me full time and tried to argue with me when I asked them not to give me extra hours. I stood up for myself and now I don't take any extra hours, for now. That is helping. I am also doing my BSN online, and I'm taking my time with it. I'll be done August 2019. It only takes about 5-10 hours a week and isn't too stressful. I have been trying to exercise, meditate, practice my hobbies more often, go out (movies, shopping, visitng friends, dog park), exercise like going for walks, going to the gym, doing a yoga video in the livingroom. I've been trying to learn new healthy recipes and organize different parts of my life at home. All of this has helped me feel more relaxed and in control of things. I feel good about the progress I am slowly making.

When I think about the "dream job" that I want to ultimately end up with, I want the obvious - I know this probably sounds cliche, and bratty - I want off on the weekends, the holidays, the snow days. When I have kids, I want to be home when they're home. I want to work part time when I have kids, and I want to take a year off with each baby. I possibly want to take summers off. Family time is so important to me (as it is to everyone, of course) but my point is - it's not worth it to me to work super hard and make lots of money. my boyfriend is extremely supportive and he doesn't make a ton but we worked it out and we will manage if he works full time and i work part time, or switch between part and full time.

I have researched jobs where nurses work in office settings Monday-Friday with paid holidays off, weekends off, and work from home on snow days or days when their kids are sick. Perfect for me in the future, I think. The only downside is I would miss hands-on with patients.

I was also thinking something like same-day procedure or pre-op nurse. I kind of like repetitive stuff. Putting in IV's or whatever all day I feel like would be lower stress because it's less management and more just performing skills.

Something I've really been considering, hear me out, is getting my NP. I would love to get my NP in cardiology and work full time, in an office or something, seeing patients. I could have the ideal schedule that I want, and my day-to-day would be a lot of work I'm sure, but it would be a different kind of stress and I feel like I'd like it better. It would be a little more repetitive/routine and maybe that would work nicely for me. Even if I switch to part time later as a NP, I would still make more money than RN so it's not like its a waste to go to NP school then go to part time. I might make the same part time NP as I would full time RN. This would allow me to have more of a balance between home and work, and also make the money that I would like to make. I think becoming an NP is a good compromise - but I need your advice and opinions.

I obviously don't fully know how the nursing world works yet. I need experienced nurses who have been there, done that to guide me. I try researching online - nothing helps. I also get very stressed from school, but I was thinking if I continue part time then I can handle getting my MSN simultaneously? I'm willing to put in the work, I jsut don't want to push myself super hard if its not even worth it.

My current plan is:

1) Stay on my unit (part time) while doing my BSN until I reach 1 or 2 complete years

2) Transfer to a slower paced job, like pre-op, telenurse, or maybe home health

3) Complete my MSN while working in my lower stress job

4) Work as a NP and be done school! Work full time, or part time to balance with family if I have kids by then.

Do you guys think I'm totally delusional/stupid or do you think my plan is smart for me? I'm welcoming all advice with open arms!

Also - does anyone have tips for getting through work. Any at all.

Thank you!

PA Nurse xo

[WestCoastSunRN, MSN, CNS]

You are young and still figuring a lot of things out about yourself. Given that ahead of you are some pretty huge life changes: marriage, kids, career trajectory... I would SLOW DOWN in the department of future planning regarding nursing. You are doing a great job of taking inventory of how things are going for you right now given the challenges you face right now. It sounds like you need to stay focused on the here and now. Your unit sounds chaotic, though. Because of this you need a very strong support base. You may benefit from counseling, also, to help deal with the anxiety issues you are facing.

I would hesitate to point you in the direction of NP -- thinking you are going to get a cush schedule or part-time hours. I think you may find the reality of that very different from what you may hope. Not to mention -- cardiac NP -- this is acute care/specialty focused and it would behoove you to stay in acute care -- indeed gaining cardiac and even critical care cardiac experience if this is your intention. That type of position and what it takes to get there may seem very stressful to you. At least right now -- you can learn (with the help of others such as trusted friends and counselors) how to cope with your anxiety and what you can and really want to accomplish in light of that and all the other things you have going on in life.

I'd try to stick it out (if you can sufficiently manage your anxiety) where you're at -- as seems to be your intention -- for at least a year. If management is decent, things might improve with proper staffing. And then I wouldn't make any changes until you feel a clear draw to something else. You're pretty new at this -- I think things will become much more clear for you just with some more time.

Best wishes to you!

[Been there,done that, ASN, RN]

That ratio is unsafe, especially for a newbie. Transferring might be possible after 6 months, but that would take god knows how long. Definitely only work your 24 hours.

Working on your BSN/ NP will take years.

Materialism and nursing don't mix.

Best wishes.

[GeminiNurse29]

Sounds harsh but if you want $$ don't stay in nursing. You'll be comfortable but not rich.

I worked night shift to a clinic position now and I have to say, not only do I miss the money (took a $6 cut), I miss the teamwork and not having clinical people there all the time breathing on my neck or demanding XYZ.

24 hours, assuming you work at a hospital, means what..2 shifts? I have 3 little ones under 5, and let me tell you, it does not get easier. If I were you, I'd work 3 12s a week (it's essentially one more shift), get full time experience, and save $$. Daycare is not cheap either. You might decide to work a later shift to save on daycare, that's what I did.

It's gonna be hard to get an office/clinic position without experience even though they pay less than where you have to work nights/weekends/holidays.

Not gonna lie, it's nice having weekends off now, but I also feel sometimes like I'm wasting my time. This past holiday, I worked Christmas Eve, day, New Year's Eve, and NY day by virtue of how my schedule rotation fell. The holiday pay was nice.

The school journey, well, you're young. Again, it's a heck of a lot easier to do school and work without kids. Kids also get sick, need to leave daycare early, and go for checkups a ton (I seriously didn't know how often little ones go to the doc until I had my own...)

That's just my two cents. Good luck on your journey.

[RNperdiem, RN]

It sounds like you are at a crossroads of a sort and need to make a choice. Do you want nursing to be a job or a career?

If nursing is a job, family can come first, hours can be prn or part-time. You can resign and take time off after each baby and resume the job search. There are trade-offs to be made, of course. A stable second income is required too.

If nursing is a career, then you can make more money, advance to positions of more responsibility and get more of the jobs in high demand. A career requires more care and feeding, and full-time hours (and beyond sometimes) are expected.