Struggling: Losing my high-acuity skills

Career Columnist / Author · Aug 7, 2017

Nurse Beth,

Fear of losing my skills:

I'm a new (14 months out) grad from a fast track nursing program (2 years, but you still come out with a BN). I spent my first year in a high-acuity med-surg environment as a casual, split between two units. I found it really stressful and exhausting. My coworkers were mostly nice, with a few that made a night shift or a busy afternoon hellish. Then...my partner got transferred to another post across the country, and I find myself working in home and community care--wounds, palliative patients, and delegation of task for elderly folks and their medications. I love it in many ways; I love being able to be connected with my patients in a way that I couldn't in the hospital, but I'm struggling with the notion that I'm "losing" my higher acuity skills. I haven't put an IV in someone since October. I don't see CVPs or PICCs on a daily basis anymore. I don't have anyone on TPN. In some ways it's like a dream, but in other ways I'm worried that I'd be unable to transition back to working on a unit if I ever decided I wanted to do so. I know I'm building a new skill set, but I'm not sure I'm ready to let go of the old(er) one yet. Any advice?

Dear Struggling,

Congrats on finding a job where you feel connected. You are doing something you love, whereas acute care was stressful and exhausting. So you are fortunate.

What you are feeling is normal when you leave the bedside- you are experiencing a loss.

It's not so much that you wouldn't be able to pick up your acute care skills again- it's that the longer you are away from acute care, the harder it is to get back in. A few years fly by, and you can no longer easily land a job.

If you plan to stay in the community, that's not a concern. If you're not yet sure, then you will need to keep your foot in the door by working a weekend shift occasionally, or some other arrangement.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!