Need help..hate my job :(

NotAllWhoWandeRN, ASN, RN · May 29, 2017

My story is a little different because I initially LOVED my unit (neuro med/surg) and 4 years later I HATE IT. I caught on really quickly because I was a UC/CNA on my unit for 1 1/2 years and did all my clinicals in my hospital, but over the years the unit and hospital have changed and my unit has changed directors. These changes caused a mass exodus to different units and now my floor is all new grads. Every night is crazy and its such an unsupportive environment for new grads and for the more experienced nurses like myself who find it unacceptable.
I am leaving the hospital altogether for an opportunity outside of direct patient care and maybe thats the answer for you, although I do think you should wait until a year has passed first.

May I ask what your non-direct care adventure will be? I'm needing some sort of career shift, probably in 1-1.5 years once I complete my BSN, but not sure which direction I want to go. I'm all ears about non-acute care options.

To OP, I feel for you. My highest acuity assignments were in LTACH, though I never had the "ICU" (e.g. on critical drips, repeat coders) ones, and bad days tore me up. Unfortunately, lower acuity units, in my experience, only mean that you have even more patients and get pulled more directions, not that you have more time with each person. It may still be less stressful to have your prioritization between assessments, PRN pain meds, and who still needs a snack and a glass of water. Your higher acuity training will help you when the more urgent situations do arise.

I do not think it will hurt to start looking for jobs now, as it takes some time to apply, interview, screen, and onboard anyway. Spend a shift shadowing on any unit where you might like to work. If a year comes around and you have not taken another position, go to your manager and say you don't think the unit is a good fit for you and ask about transferring.

Do not worry about loyalty to the unit or hospital; respecting their investment in you is a nice thought but no one else is carrying all that baggage home with you. The hospital will not usually be loyal to you when you are in a bind. Do not worry about the day nurses fussing that you missed something non-critical because a patient was tanking. You do the best you can and that's that; a hospital is a 24-hour facility.

Remember to take care of yourself by finding completely NON-NURSING things to do in your time off.

butters9812 · May 29, 2017

I have thought about home health and am going to look into it but I know a lot of places want a year experience? It's an option though!

brandy1017, ASN, RN · May 29, 2017

Your experiences and feelings are pretty typical for most nurses, especially new grads. Since you have cardiac experience check out Dr offices especially cardiac, clinics, cardiac rehab or consider working in the cardiac cath lab. You don't have to stay where you are. Take care of yourself, possibly consider seeing your Dr for meds to help cope in the meantime. Good luck with whatever you do.

BrnEyedGirl, BSN, MSN, RN, APRN · May 30, 2017

Have you ever considered actual ICU? I don't mean to downplay your particular department. I just mean that perhaps if you were a unit for critical care, you'd be able to devote yourself to two very sick patients vs. five who could turn that way at any moment.
I did floor nursing and ICU, but I never ever did stepdown. My hat's always been off to stepdown nurses. Half of those patients probably do need the ICU but the ICU is full or they "technically" don't meet sepsis criteria or just barely get by without pressors.
I think since you have your assessment skills and experience with very sick people, the ICU may be a good fit. I know several nurses who felt that ICU was less stressful than stepdown. It's much easier to split yourself in two than five. And the resources available in the ICU tend to be closer at hand.

^^^^ THIS!!

I started fresh out of school on a step down/tele unit. I ended up spending 8 years there and transferred to the ED. I left my unit angry, frustrated and overwhelmed. My coworkers thought I was crazy to "jump from the frying pan into the fire" as they put it. ED is busy and crazy, but I had resources, We were the rapid response team, we were the code team. I didn't have to worry that one of my patients might crash and I would not have the experience or resources to take care of them! In the ED I was surrounded by fabulous nurses, RT's, doctors, etc all the time! Stepdown is rough, you are always taking care of pt's that really need ICU care but you don't have the resources of an ICU. Hang out your three more months and ask around, maybe shadow in the ICU. Do you think you could take care of one or two of these patients a night? Hang in there, you will find your niche!!

futuremidwifee · May 30, 2017

If i was in your position I would look into other Nursing fields! There are so many options- high stress, low stress. You can even be a nurse in a private setting. Or you can further your education and become a practitioner. Start looking into other fields:)

ProperlySeasoned · May 30, 2017

What stands out to me the most in your post is lack of a robust life outside of work. I would work on this - first. Eat well, get your sleep situated, work out, make friends (and hang out with them). It can be really hard to adjust to the night shift, and I can't help but to think there might be elements of depression that are making the anxiety so much worse.

CKAYTHOMAS · May 30, 2017

Stay for 3 more months to have a year of acute care experience and maybe apply to an urgent care or an observation unit if your hospital has one. Nursing is for you, you sound like a great nurse. Not everyone was built for high stress situations and adrenaline rushes back to back. There is nothing wrong with that.

MrNurse(x2), ADN · May 30, 2017

I feel for you. Sounds like I may know you, as that sounds like my old university based floor. I left after 28 years, and will never look at another hospital position again unless things change a lot. I, however would recommend to step back and look a bit differently. I am constantly telling new nurses that this is a career, not a job. You will not feel confident until you have at least three years (read 6,000 hours +/-) under your belt. The current attitude to discipline instead of teach encourages most new nurses to put on the air of fake it til you make it, that is why other new nurses "seem" more on top of things, news flash, they aren't. I would recommend looking for other options, but would steer you in a hospital based position. The critical thinking skills learned there are invaluable in ever other aspect of nursing and will make you the best nurse you can be, IMHO. Another aspect you may want to consider, as it helped me immensely, is your attitude before a shift. Go in positive your night is going to be the most awesome you have ever had. I always told my coworkers I had the best patients on the floor. Guess what? They all believed I did, because I wasn't going to have anything less than the best patients and the best night. Sounds corny, but it really does affect how your night will be. Good luck in your endeavors and I hope you can return to that excitement you felt when you first started nursing school.

sunshine539 · May 30, 2017

As I was reading your post..I kept saying to myself this is totally me 3 years ago! My first job was on a IMCU/stepdown/tele unit. And I was feeling the same way you were--I wanted OUT of bedside... I was working night shifts feeling OK during the night but then the day shift nurses would walk in and give me such hell in the morning that I always felt like I was doing a terrible job/stupid. I left many mornings crying while driving home I was so upset all the time. I would also be so hard on myself when I made mistakes. I never slept because I couldn't stop beating myself up. I was miserable (or so I thought).

So, I left bedside altogether after 1 year.. I ran to a nursing office that was going to offer me to stay in the office for a few months and then would train me in endoscopy... Long story short, they never held to the promise -keeping me in the office for an entire year and (lost all of my clinical skills) and office nursing was not any better to me (and you get paid way less). It was less stressful yes, but I felt like I was no longer a "nurse" anymore. I had no more fun stories to tell my friends and my life felt boring.

Fast forward--I ended up leaving to go back to bedside at an LTACH (day shift!). I have been here for a year and I wish I never left bedside. I lucked out here because the nurses here are always helping out if I'm behind and there's a "help everyone" attitude as opposed to a "nurses eat their young" atmosphere as I had been in.. I wish I had stuck it out and maybe asked HR to try a new unit or stuck it out to get on day shift..I didn't realize how much bedside nursing taught me and how I wish I had found out that the grass was not greener on the other side. I often find myself saying..why did I ever leave? I wish I stuck it out longer because it actually wasn't that bad. Its crazy and hectic every day of where currently work-- But with time I have learned to appreciate everything I learned in that stepdown unit.

In conclusion, OP--I stress the grass is not only greener. I suggest if you have a good team stick it out for a little longer.

Remember it takes a new nurse a little longer to really feel comfortable. but also it may be helpful to change your thinking a bit. When crazy things are happening. accept it, and realize EVERYTHING is a learning experience. If your day feels crazier than other nurses- say thank you because you will be a way stronger nurse after all of it. And when another patient has the same thing happen you will be a pro and know what to do.

Another tip--take care of yourself OP! Be sure to eat well and get your rest!

Also, you may be like me where night shift is not for you.. (you have more chances of getting to day shift if you stay).

If you are absolutely miserable- then start interviewing elsewhere!! There's nothing wrong with interviews and you don't have to take a job if you get it. And do not feel bad for the manager--this is your life and your nursing experience and he/she will understand. Everyplace is different. And perhaps this isn't your "niche". Theres so many places for you to go, OP. and you are luckier than most having 9 months in a step down as a base! Don't give up!!

Ruby Vee, BSN · May 30, 2017

I'm going to offer a different perspective. I may be way off base, and if so, please feel free to let me know that, but I would like you to consider this:
I think you are doing just fine, clinically speaking. You sound like a highly conscientious professional working in a reasonably supportive, albeit challenging environment. I believe you may have had unrealistic expectations about the ease of settling into a routine in your first nursing job. Very few basic nursing programs have access to sufficient clinical instructors and placements to allow students to fully experience the role of a staff nurse prior to graduation. Most new grads have never had to manage (independently or with minimal assistance) a full patient load providing direct care and coordinating with other disciplines, family, clergy, etc. Most have mastered care of 2-3 patients, at best, often without juggling the responsibilities other than direct care. While this is often the maximum that the academic setting can offer, it is not realistic preparation for the workplace.
New grads have a lot to master in their first 2 years: Specific knowledge of the pathophysiology, pharmacology, etc. of their patient population, clinical skills specific to that population, organization and time management skills, politics and social environment of their unit and facility, networking with peers and other disciplines, etc. It takes time and patience with one's self to accomplish all of this. I believe your manager and co-worker understand this and are pleased with your progress. I believe you are suffering anxiety and stress largely because you don't grasp this and are measuring yourself against an in-attainable standard.
Please consider this in deciding whether you would be better served by staying on your unit a while longer to continue to master these important skills, or whether you would prefer to seek out another area of care, where I believe you are likely to begin the process all over again.
Also, my most important suggestion to you is to seek professional guidance from a counselor or therapist who can help you manage stress and anxiety, whichever career decision you make. It will serve you well in your personal and professional life. My very best to you. I would be pleased to be your employer.

THIS!

In just three months, you'll have been on your unit for a year. Use these three months to polish up your resume, do some networking and figure out what you'd like to do next. Believe me, it will pass quickly.

guest52816 · May 31, 2017

There are tons of options available to you, as far as nursing jobs with a slower,
less stressful pace. Psych nursing is one option. I loved going from a post
surgery/ortho floor to an adult psych unit. I worked night shift on the psych
unit. Very low stress!

This just ISN'T true. I know because I recently left a psychiatric nursing position. One night, I was the only nurse for 17 adult psych patients. Do you consider that to be low stress? Adult psych patients can be borderlines, and they require attention every 20-30 minutes. They include people who self-harm while on the unit (and try suicide while on the unit).

My last night at the facility was this past Saturday. I was ALONE on the locked unit with two highly psychotic patients for over 30 minutes (one had thrown furniture at staff the night before and had to medicated via IM injection

, while the other was a paranoid schizophrenic who thought Abraham Lincoln was after him. The previous night, he was eating his own feces.

Anybody who tells you psych is low stress is lying. It is simply a different kind of stress. I traded in it for med-surg stress.

The lowest stress is probably detoxing addicts at a psych facility.

When you are responsible for people's lives, it is going to be stressful. I empathize with you, really I do. Do you have counseling resources available to you? Some kind of talk therapy would probably help you.

Good luck!

I figure if I can handle 17 patients, I can surely handle six or seven med-surg patients.

butters9812 · Jun 2, 2017

I think that's half the problem is the lack of resources! I work nights as well so there is ONE doctor on who doesn't even know anything about the patient..ONE. It's so stressful not having any resources to help a patient in need.