Not Sure What Direction To Go From Here...

[Aliceozwalker]

Hi everyone. I'm curious to hear people's thoughts from different areas of nursing about what direction they would recommend to me as I am a bit stuck.

I currently am working two part-time jobs, one at a hospice and the other on a busy medical unit. I have been working as a nurse for a year and a half now. I don't like my job in the medical unit at all. The position has a high turnover (in the past year 10 nurses has left) and is constantly understaffed especially recently.  Honestly, 90% of the nurses who work there have told me they want to leave the unit eventually due to the high acuity of care and short staff issues. This is made all the worse due to the fact that I do have a history of mental illness; specifically diagnosed moderate social anxiety and severe generalized anxiety with mild depression. I do have a psychologist and she flat out told me to quit the hospital job due to my symptoms until I explained my reasoning for being there. My goal has always been to make it to two years, at which point I have been told that a lot more doors open up. If I worked at just the hospice, I wouldn't have access to several specific skills such as IVs. 

I have definitely been in worse health the past year and a half due to the job and am finally starting to see the light at the end of the tunnel. The issue is I'm not really 100% sure where to take my career from here.

I am strongly considering becoming a nurse practitioner as it encompasses mostly what seems to be ideal for me; 9-5 (within reason), higher pay and while still bedside has less direct contact with patients. However, in my country you are required to have a minimum of 3 years of clinical experience before you can apply to be a NP. Factoring that in along with the university time and you are looking at another three years before I could begin practising as an NP. So I would need to do something else until then.

I sort of see three main areas of nursing frequently come up; Hospital, community and LTC. LTC is immediately out for me due to several issues that would take too long to get into. Hospital is an option, but I am a bit concerned as to how much I have disliked bedside nursing on my current unit due to the feeling of dread on not knowing what I am walking into each shift, patient acuity and stress. I have put on an alarming amount of weight since starting the job and constantly feel sick (Also have diagnosed IBS) from the changing of days to nights and other stressors. Community is also an option, with the main concern being paid less and going into people's houses. 

I have actually found a community job I was considering but heard that it required lots of visits to patient homes which has always made me a bit nervous. I once went with a nurse to a home and the situation got a little...dangerous. The patient was being quite aggressive and normally you would be alone in their home. The whole experience kind of turned me off community nursing but I am considering it again. 

To all the nurses who have done both, or like one more than the other, what were your experiences with community nursing versus the hospital? For those RNs who have social anxiety (or anxiety in general), which roles worked best for you? Any help or insights would be much appreciated. ? 

[gere7404, BSN, RN]

Our gen med unit has the reputation of being one of the hardest units to work... maybe a different department might be a better fit? Infusion services and wound care also seems like pretty chill gigs.

[SmilingBluEyes]

On becoming an NP:  Just check out the area you are living in/plan to live because around here, the market is saturated.  I know 2 NPs who are working in the hospital for *more* money than they could earn in an office and because there are no full time opportunities for them. NP is not the be-all, end-all solution to  every situation where a nurse feels the need to escape the bedside and its woes.

The NPs I know who are in the office are not there from 9-5; they are there later, just catching up their charting and see patients every 10 minutes all day. It's very stressful in and of itself. The ones who are not there late like that only work part time in the office.

Try another unit/specialty/hospital first, and then go back to school if you are so inclined. Just be sure you want to go into debt to be an NP and can afford to pay it back (not all work places pay sufficiently for grad school).

Not trying to be a wet blanket,  but realistic for you before you jump in that direction. You are not the first to think this is the solution and certainly not alone.

[SmilingBluEyes]

Also I have social anxiety. Get help with that. (therapy and meds, if indicated).  I did and I cope fine. No area of nursing is  necessarily suitable for someone overcome with social anxiety.

[mmc51264, BSN, MSN, RN]

What is interesting about having social anxiety and being an introvert (I am both), I have no issues with patients-my issues are with colleagues. I don't feel comfortable sharing with them, I feel socially awkward, etc. It's really odd. 

I work on a busy ortho/trauma unit. I love my job, I just struggle with my peers. 

I hope you can find a place that feels comfortable for you. 

oh-I agree with Smiling Blue Eyes-NPs have it rough. It is hard to find a job, the loads that they are required to carry has increased and I am not sure the pay is worth it. 

[jobellestarr]

I’m just throwing this out there as I have no idea what the market is like but would working in psych be a better fit for you? Would this be less stressful for you?  And maybe get your psych NP? ❤️

[Aliceozwalker]

14 hours ago, gere7404 said:

Our gen med unit has the reputation of being one of the hardest units to work... maybe a different department might be a better fit? Infusion services and wound care also seems like pretty chill gigs.

I actually did look into a wound clinic that I had a placement at. ? Unfortunately, they are not hiring right now, but maybe that will change. I think it does really depends on the clinic. I got to spend a week at a chemotherapy clinic at the hospital while taking my chemotherapy certificate and while they work technically 9-5, they never take their breaks and often stay late. 

[Aliceozwalker]

@SmilingBluEyes

It almost does seem to be the general consensus to become an NP to get away from the bedside, so thank you for being realistic with me. On my unit alone there are four of us who want to get away from bedside by becoming an NP. On the plus side, the area I wanted to focus in for my NP (palliative care) does seem to have a lot of openings right now due to the baby boomers ageing. I have seen several postings in the community and the hospital. I am in therapy working on my social anxiety. I have had it ever since I was a child but started to go recently. Unfortunately, I can only afford to go once a month as nothing is covered at either of my jobs. I guess what I need to think long and hard about is whether I should be looking into switching careers altogether or pursuing a NP. Because I honestly feel that I can't continue to do shift work down the line. Some people do fine with it, but I have always been a person of routine and tend to overeat, get insomnia and have had numerous bowel issues since starting the job. I did look into being a physiotherapist when I first started school but the pay for a master's degree is surprisingly low. My family thinks I would do well in forensics, as I have a strong interest in finding the identity of remains but I have heard the job market is limited. It does make my path kind of difficult to figure out...

[Aliceozwalker]

9 hours ago, mmc51264 said:

What is interesting about having social anxiety and being an introvert (I am both), I have no issues with patients-my issues are with colleagues. I don't feel comfortable sharing with them, I feel socially awkward, etc. It's really odd. 

I work on a busy ortho/trauma unit. I love my job, I just struggle with my peers. 

I hope you can find a place that feels comfortable for you. 

oh-I agree with Smiling Blue Eyes-NPs have it rough. It is hard to find a job, the loads that they are required to carry has increased and I am not sure the pay is worth it. 

I would agree that my issues lie partially with my colleagues as well. They are honestly a good group of people, some of them have just stated to me that I am super quiet and shy around them.  It's a pretty known fact as well to them that I have anxiety. When I was first starting the job, I had a patient that was super anxious themselves and just built up my own anxiety. They were saying things such as "Do you know what you're doing? How many years have you been a nurse? If I die it's going to be all your fault." Long story short, I had a massive panic attack with hyperventilation in front of 5 co-workers and my charge nurse. My manager pushed me to go onto short-term disability and get some help for a few weeks. But since then, it's super awkward around the management staff all around. I also get nervous about not meeting patient's expectations or the families. Night shifts are a bit better but on day shifts I often get super nauseous and dry heave. Of course this leads to the co-workers saying I "look sick" which makes me more anxious and it becomes a cycle. It's hard to enjoy work when I'm always feeling sick every time I go in due to IBS which is set off by anxiety.  My other job I am often symptomless which makes me know it is due to the hospital job in particular. I do like seeing patients for a shorter period of time as there aren't the same worries of letting them down each day which being an NP provides. But your right that the workload does seem intense. ? IDK, it's hard to know what to do. 

[Aliceozwalker]

46 minutes ago, jobellestarr said:

I’m just throwing this out there as I have no idea what the market is like but would working in psych be a better fit for you? Would this be less stressful for you?  And maybe get your psych NP? ❤️

Unfortunately, I think that psych isn't a good choice for me as I personalize things too much. My family has a history of mental illness including bipolar disorder and when I see psych patients I tend to see parts of my family or myself in them which can freak me out a bit. 

[jobellestarr]

I see. Well, it sounds like something away from the bedside might be best for you. Good options for you from other posters and I wish you luck and peace ❤️

[Nunya, BSN]

On 5/11/2021 at 8:30 AM, SmilingBluEyes said:

On becoming an NP:  Just check out the area you are living in/plan to live because around here, the market is saturated.  I know 2 NPs who are working in the hospital for *more* money than they could earn in an office and because there are no full time opportunities for them. NP is not the be-all, end-all solution to  every situation where a nurse feels the need to escape the bedside and its woes.

The NPs I know who are in the office are not there from 9-5; they are there later, just catching up their charting and see patients every 10 minutes all day. It's very stressful in and of itself. The ones who are not there late like that only work part time in the office.

Try another unit/specialty/hospital first, and then go back to school if you are so inclined. Just be sure you want to go into debt to be an NP and can afford to pay it back (not all work places pay sufficiently for grad school).

Not trying to be a wet blanket,  but realistic for you before you jump in that direction. You are not the first to think this is the solution and certainly not alone.

Yes, I think you'll have the same if not more direct contact with patients as a NP.  Have you thought about trying to do something like case mgmt, infection control, research?  Edit: or a work from home job?