New Grad switching from ICU to Health Department internal conflicts

[LiveHappyLiveHealthy]

Hello! I was just needing a few second opinions about some new-grad internal conflicts. It's a little long, so please bear with me!

I have been working at a large teaching hospital for the past 6 months in their ICU. I chose to stay at this institution because I had gone to school here and did my practicum on the unit, so I was familiar with policies, procedures, charting, and the overall environment (or so I thought). I didn't have a specific goal at the time that I took this job, just that I knew that someday (probably many years from now) I would like to potentially go back to school, yadda yadda yadda.

My ICU experience has really pushed my passion for health promotion, preventative medicine, and patient education further into the light. Taking care of critical patients with preventable or unmanaged chronic diseases on a daily basis is what's doing it for me. I realized quickly that I had an unrealistic idea of the amount of patient education that is actually done (or could be done in the case of the critically ill) in the hospital "real-nursing world." I'm looking for jobs where education and health promotion are components of what I would be doing every day. I'm also really interested in epidemiology and addressing health disparities. I had an awesome public health clinical experience during nursing school, and I recently went to a small informational public health nursing conference. I know public health is where I'd like to grow my nursing career in.

Anyway!

With this realization, I was fortunate enough to stumble upon a public health nurse job opening at a local health department near my hometown, applied, interviewed, and am anxiously waiting to hear back! I'm looking to move closer to home because I've also found I'm no longer happy in this city. My major supportive network of friends has dispersed and moved away, and I find myself making the roadtrip home to my family and LDR boyfriend more frequently than I thought I would need to (basically any chance I get).

Are these valid enough reasons to leave my current job should I get the new position? I feel bad for leaving with less than a year under my belt and with staffing being TIGHT. Our unit is also staffed with a ton of newer nurses due to a huge turnover event that occurred a couple years ago. Since I've started, I've seen 6 nurses move on and know of 3 who will be leaving in the next few months.

I guess I'm just wondering if it's okay that my happiness, goals, and wellness take precedence over this staffing situation? Or if I should suck it up and stick it out until staffing gets better (but will it..?). Public health nurse jobs are harder to come by than hospital jobs, so I'm not sure when the next time I'd be able to find an opening near home.

[Laurie52]

How long was your orientation?

[guest464345]

If you get the job offer, take it - are you kidding me? Negotiate a start date at the new job that allows you to give appropriate notice, cheerfully work your notice period, be professional....and run like hell for the exit when the time comes.

I went from the ED to public health (I work in epidemiology, an office job). I remember exactly the day I realized that I wasn't going to be happy in acute care. I got a young guy with abdominal pain and other hard-to-pin-down complaints - he was angry and defensive, but mellowed out a little while I was getting his line, labs, etc. He finally mentioned that he'd been diagnosed recently with HIV right after coming out to his family as gay, and then he skipped out on his followup care for several months. I lingered maybe 10 minutes in his room doing some education. I made sure an LGBT-friendly, HIV-knowledgeable resident was seeing him. I felt really good about it.

Except when I walked out, two new patients had been put in my other rooms without anyone telling me; my from-the-door assessments revealed one guy with a heart rate in the 170's and the other guy a recent kidney transplant who was grey, diaphoretic, and panting. I cursed myself for the next three hours for taking that 10 minutes in the young guy's room.

I mostly talk to my patients on the phone now (which is not usual in public health), but I have the luxury of taking ALL the time I need to do education. It's my favorite part of the job. People thank me almost every day at work, and I hear over and over again that "no one really explained this at the hospital," or "my doctor never told me any of that." I spent forty minutes answering questions for a mom of a baby diagnosed with pertussis last week - I never once had the luxury of 40 minutes to talk to a patient in the hospital.

You're not responsible for the hospital's staffing problem. You're responsible for showing up for your shifts and doing a good job while you're there; that's it. If there is huge turnover in your ICU, and rare turnover in your public health department, there's probably a reason.

Good luck with your decision.

[SiwanRN]

If public health is where you want to be and you get offered the job, go for it! Just make sure to take laflaca's excellent advice and transition professionally out of your current position with however much notice is required at that job so that you leave in good standing. It's exciting to open new doors, but don't anger your current employer with a sloppy exit and get a bad reference later or marked ineligible for rehire.

[Momma1RN, MSN, RN, APRN]

I'm considering a move from ER to PH because i've always loved the teaching part of my job my favorite. Your post really resonates with me because it's SO true. I'm actually a little emotional thinking about it. So thank you :)

[Momma1RN, MSN, RN, APRN]

If you get the job offer, take it - are you kidding me? Negotiate a start date at the new job that allows you to give appropriate notice, cheerfully work your notice period, be professional....and run like hell for the exit when the time comes.

I went from the ED to public health (I work in epidemiology, an office job). I remember exactly the day I realized that I wasn't going to be happy in acute care. I got a young guy with abdominal pain and other hard-to-pin-down complaints - he was angry and defensive, but mellowed out a little while I was getting his line, labs, etc. He finally mentioned that he'd been diagnosed recently with HIV right after coming out to his family as gay, and then he skipped out on his followup care for several months. I lingered maybe 10 minutes in his room doing some education. I made sure an LGBT-friendly, HIV-knowledgeable resident was seeing him. I felt really good about it.

Except when I walked out, two new patients had been put in my other rooms without anyone telling me; my from-the-door assessments revealed one guy with a heart rate in the 170's and the other guy a recent kidney transplant who was grey, diaphoretic, and panting. I cursed myself for the next three hours for taking that 10 minutes in the young guy's room.

I mostly talk to my patients on the phone now (which is not usual in public health), but I have the luxury of taking ALL the time I need to do education. It's my favorite part of the job. People thank me almost every day at work, and I hear over and over again that "no one really explained this at the hospital," or "my doctor never told me any of that." I spent forty minutes answering questions for a mom of a baby diagnosed with pertussis last week - I never once had the luxury of 40 minutes to talk to a patient in the hospital.

You're not responsible for the hospital's staffing problem. You're responsible for showing up for your shifts and doing a good job while you're there; that's it. If there is huge turnover in your ICU, and rare turnover in your public health department, there's probably a reason.

Good luck with your decision.

I'm considering a move from ER to PH because i've always loved the teaching part of my job my favorite. Your post really resonates with me because it's SO true. I'm actually a little emotional thinking about it. So thank you :)

[guest464345]

Your post really resonates with me because it's SO true. I'm actually a little emotional thinking about it. So thank you :)

Glad it was helpful. You know, a year later I think I'm *still* trying to make sense of my experiences in acute care....until I got out of there, I did not realized how much it was messing me up. But, different nurses love different things!