Need help..hate my job :(

pixierose, BSN, RN · Jun 5, 2017

I see I've gotten a lot of flack for this post. I do apologize. Wasn't
thinking too clearly.
Yes, psych can be VERY stressful, in fact I never even said that my worst,
most stressful nursing job thus far was on a pediatric psych unit.
I guess I was coming from the point of view that psych, at least on some
units and at certain times of the day, does tend to be much slower paced
and allowing for more one-on-one patient contact. But then again, there
are also med surge units that are like that as well. I currently work on one.
But some psych units can again, be very stressful. Especially on evening
shift when all the groups and activities are over and there's not as much
for the patients to do, and they are awake.
Again, my apologies. Didn't think that one through.

No apologies needed, NurseCard. I get where you're going with this now :up: .

Psych is my niche and I enjoy it. I'd probably be miserable in the ICU or step-down or whatnot because I just wouldn't be good at it. And you're correct, at least in my case: I do get to talk to patients more, allowing for that 1:1 patient contact for a few minutes. Sometimes it's not as long as I'd like, but I still HAVE to make time for it (i.e. determine moods, SI/HI, auditory/visual hallucinations). My head-to-toes include that thorough mental assessment, meaning that I absolutely need to make that connection (or attempt to).

I think it rankled me a bit, seeing pp's in the past on AN go "psych is so easy!" But I always enjoy reading your posts, and I get it now.

pixierose, BSN, RN · Jun 5, 2017

I've thought about going down this path. Do the patients you surround yourself around ever get to your head? I don't mean the ones in there for suicidal thoughts or depression, but ones in psychosis... Seeing things, lashing out, etc that have been in and out of your ward the whole time you been there? If I was in your shoes, I think it would just be depressing watching that all day

I've only just come off orientation, having been here for 3 months.

But ... no. I clock out, and go home to my family. Probably like any other job in nursing? I have seen many frequent fliers in the short time I've been here, d/c one week and back two weeks later again in full blown psychosis. It's sad, and can be a little overwhelming at times ... but I think many things in life are depressing. The dad of two in the ICU, the mother in with a sick child in peds or the NICU...

I'm not sure I could do what my best friend does as an oncology nurse in a peds hospital. You just have to know your limits.

AZ New Nurse · Jun 5, 2017

Dear Butters,

Sounds like you are very stressed out for a variety of reasons. Is there someone who has or could be a mentor to you on the unit? Ask if you can contact them outside of work. If not, maybe a retired nurse friend who has been there and understands the new nurse environment.

I recently resigned from my first RN job at the end of orientation after being told there would not be a position for me on our busy tele unit. My manager ignored all attempts at conversations, higher ups were never available (constant meetings) and my numerous preceptors provided no feedback at all, good or bad. It was rather a sink or swim situation. Honestly think they wanted to see how far I would sweat and if I could handle being on overload all the time. That said, I received constant compliments from patients and families for taking time with them, even for simple comfort tasks.

SO, now looking for another position outside the hospital, realizngi I don't want so many high acuity patients. Do you more experienced nurses find a great resume format I should consider? Have reviewed all the comments posted here and plan to disclose my recent acute care experience since I only have student clinicals before that. Welcome comments and feedback on how to turn this into a positive during interviews.

Shanua · Jun 6, 2017

I think you're feeling normal for a new grad. That being said this job is not your job for ever. There are lots of other options. But every unit/job has a learning curve. You may be stress for the first part of any job. I do recommend vacations. I recommend taking classes - My patient coded my first shift, my response was to sign up for ACLS. Talk to your manager and see if they have recommendations or thoughts. Shadow on another unit. Find a mentor. Find ways to destress - yoga, exercise, etc. Every job has some level of stress but it varies and how you can handled it varies.

nlb0101 · Jun 6, 2017

Forgive me if I'm overstepping my bounds, but it sounds like you have anxiety in general. You stress out just going into work and carry anxiety with you even when you're not at work. I will tell you this is exactly my personality and I know I have issues with my anxiety. You seem to like your profession. Here is my honest opinion and I apologize if it insults you, but I feel like you should look into therapy or something similar to deal with your mindset before making any rash decisions. If you can get in a better place mentally, you may find that you really enjoy your job, or at least nursing in general.

Perhaps a new environment would benefit you as well. For instance, I hated working in nursing homes for the usual reasons. I stumbled on a facility for people with developmental disabilities and I actually really enjoy it. That had never crossed my mind as an option for my nursing career, but it's much more laid back than where I've worked before.

Just my two cents. Feel free to disregard them as rubbish if you don't agree with me. I hope you find what you're looking for in life. Good luck :)

NurseDbsn · Jun 8, 2017

Hi, I just left a pre-post op orthopedics floor and am going back to LTC, but I would really like a position in plastic surgery or aesthetics, any advice?

maji2002 · Jun 8, 2017

It sounds like classic "reality shock" common to nearly all new nurses. Be sure you are taking care of yourself, eating right, exercising regularly and engaging in a hobby or sport you are passionate about. Those all help to control anxiety, promote sleep etc. Find a support network of other nurses. Every area in nursing has its stresses. I hated floor nursing, but loved critical care for the reason someone already cited, only having 2 patients vs. 5-6 "time bombs". I was able to feel more control in that situation and didn't have to rely on CNA's (who at that place were awful, but have also since worked with great ones). Make a list of what you love and what about your job you hate. Talk to other RN's in areas you may be interested in also. It does get better! I survived 35 years and counting, but those first few were rough and like you, I wanted out! Best of luck.

kalycat, BSN, RN · Jun 8, 2017

A couple of thoughts to add to the great info you've received...

If you think that resources are a major component of your stress, perhaps dayshift on your unit would be a better fit? We staff very lean at night on my busy cardiac transplant and mechanical heart unit, and several of our new grads have gone to days as soon as possible -- reporting much less stress -- even though the shift is busier. You have multiple disciplines around during day shift, leadership, attendings, etc. But you can get orders when you need them, additional specialists are around, and our day crew even has a helper nurse. Just something to consider if you have day shifts opening up with any regularity. I love nightshift because I love the challenge and the autonomy... and I'm a natural night owl. The unpredictability of a sick cardiac patient or an evolving stemi is what makes me fire on all cylinders, so it's a good fit for me.

I work at a large teaching hospital and am supplemental at a well respected/established critical access hospital. I feel like small community hospitals are occasionally overlooked. While it can be busy, the stress is much different, the patients are no where near as sick, and the staffing ratios are better. I work med-surg and ED there. I wouldn't recommend ED at a critical access facility if you're not very comfortable with your skills, but med-surg can be very nice and the patient contact is wonderful. You see some variety, you invest in your community.

If you like cardiac and are in a metro area, perhaps look at clinic nursing for your heart institute, mechanical heart program, or in pre/post cath lab areas. (We have a dedicated pre-op and pacu for our cath lab and EP patients during the day). While it can be busy, these patients are typically there for a scheduled, pre-planned procedure and are stable outpatients -- Not the same as working in the cath lab itself. I have several friends who work with our mechanical heart program and love it. You truly get to know your patients well and the skills tend to be more technical in nature. Pre/post cath lab and EP can be busy but as I said, stable outpatients and your cardiologists and cath lab team is right there. Can't get much better in the resource department!

Good luck!

brandy1017, ASN, RN · Jun 8, 2017

Hey everyone,
I'm coming here because I need advice and i'm starting to question why I even went into nursing to begin with. Anyone I talk to about this who isn't a nurse just does not understand
I'm a nurse on a really busy stepdown/telemetry unit at a hospital, I have been there for about 9 months right out of school. I was so happy to be hired on a critical care floor right out of school and extremely thankful for the opportunity, but I am extremely unhappy. Although I feel more comfortable now than I did first off orientation, I'm starting to think I either chose the wrong profession or I am in the wrong place.
I love my patients and I love taking care of people, my manager told me I am doing great, but I HATE my job. I dread going to work every single day. I work night shift. I have had really really bad nights. I feel like I am the only nurse who keeps having horrible nights where patients are in super critical condition and I need to call the rapid response team. The other nurses on my floor are awesome and so is my manager, but these horrible nights stay with me for months and I have such anxiety about it. On my days off all I do is worry about when I have to work next. I had a really bad night recently which I will not get into but it was horrible and involved a patient screaming in pain. I do not even want to go back into work because i felt so horrible about this one patient. We have 5 patients at night and they are all usually very critical. I feel like i have no time to even spend with my patients because i have so much work to do. I feel guilty about not doing enough for my patients. I get flap from the day team if one stupid thing isn't done even if I explain that my night was horrible and i spent all night with one patient who was very critical. I give props to all the RN's out there who can handle high stress situations. I don't want to do it. I know every RN job out there has its pros and cons. I am hoping i can find a job where I am happier than i am now.
I don't mean to rant but I need to get out. I need to know what else i can do. I would love a job where I can spend more time with patients, where is it slower pace. I think some nurses are great in critical care, but i am sensitive and cannot handle the stress over and over and over.
I haven't even been at my job for a year which is why if i leave now i think it will be hard to find another job, and i know my manager would be really disappointed if i left now. With that being said, I do not feel like myself and I just want to be happy.
Thank you for anyone who read this horribly long post, ANY advice is appreciated.

I totally understand the stress but remember you are doing a good job and you are catching issues before a patient codes. The RRT is a wonderful resource for the floor nurse. Many have protocols so they can start ordering tests and treatments before a Dr is called. If you have a house Dr or hospitalist even better, but in the old days we were left waiting on a Dr to call back and hoping the patient didn't code. Once in a while the supervisor would have your back and place a patient in ICU without a Dr order as they recognized how critical the patient was. I have witnessed codes that didn't have to take place before the RRT and they make a critical difference in patient's outcomes. Also you are right some patients are unstable and they may be on the floor due to lack of beds or ICU staff to care for them. Patient acuity has only risen over the years!

You are being vigilant and remember it is better to be over vigilant than to be lackadaisical. The RRT should be supporting you and mentoring you and in time you'll better know if its a real emergency or not. I used to call the Dr's all the time just to be on the safe side as a new nurse and believe or not I felt supported and even thanked by the Dr for calling. Very rare was a Dr irate or ungrateful. Over time I realized patients were more stable than I first thought and didn't call the Dr as much as when I was a new grad. It was hard for me to get used to the RRT because I was used to handling everything myself, but I was encouraged to call them anyway to validate their need and because they had protocols for treatment as you know Dr's don't always call back quickly. These teams are one of the few resources the corporate overlords haven't taken away where I work. I don't think they dare to cut them because they have national support from the IHI Institute for Healthcare Improvement!

Tippyrn · Jun 9, 2017

Right psych is very stressful, almost no lifting though and minimal wound care. You should really research a psych unit first, some are better than others.

tyvin, BSN, RN · Jun 11, 2017

Do a search on this site for independent nurse consults, opening up your own business, be your own boss...there're tons of posts to read with good info.