Out of My Element Again

[SilverBells, BSN]

A while back, I had posted about my discomfort of being assigned to work the COVID unit.   My main thing was that the COVID unit didn’t bring out my strengths, but sure highlighted my weaknesses. 

Now, again, I am in a similar position.  Because there are not enough patients to fill 2 rehab units...in other words, my normal unit is closed...I have now been reassigned to help on the LTC unit.  

I find myself in a similar position in which working this unit does not highlight or emphasize my strengths.  Just as a background, my strongest skills as a manager and nurse include documentation, writing SBARs and completing admissions.  However, with it being a LTC unit, we don’t accept nearly as many admissions.  Mainly, we accept “leftover” patients from the rehab unit who are transitioning to LTC.   This also means there aren’t as many things to follow up on, and therefore, not as many SBARs to write or as many assessments to complete or orders to put in.  Instead, the work is mostly on hands on skills which, while I can perform, I am not as efficient with and don’t enjoy as much.   We also have a patient who has medical needs that I am not familiar with or comfortable meeting.  

In other words, this is another change I am not thrilled with because tasks I am being asked to complete are not my areas of strength and I am being given fewer opportunities to complete the activities I do well at.  Once again, I feel I would do a much better job in the admissions role, which I have offered to learn, but continue to be denied that role because for some reason they’d rather assign me elsewhere.   

Anyway, any suggestions appreciated.  It seems that they do not realize that by assigning me to these other tasks, I may lose my skills in writing SBARs and even my ability to write in complete sentences. 

[mmc51264, BSN, MSN, RN]

My first job was on an ortho rehab unit that was part of a LTC center and at times, I needed to work LTC side. 

It was not my forte, but it really helped me with time management. I am of the belief that we can adapt and do anything for a short time and there is always something to learn from each experience. One thing I learned was how caring LTC nurses and aides are. They are amazing. I am not sure whether I was just lucky, but the nurses, mostly LPNs, and aides, had been at this facility for many years and treated their residents as family. It was an amazong experience. 

[JKL33]

6 minutes ago, SilverBells said:

I may lose my skills in writing SBARs and even my ability to write in complete sentences. 

I admit I just perused the emojis to see if there was one that looked like "Oh, come on, now." I will hope your last statement was an attempt at humor.  I don't wish to be mean, but you are not going to lose the ability to write in complete sentences by providing direct care to patients.

Your performance in the roles that you say you want may very well be enhanced with increased direct care experience. I know there are exceptions, but if I had to pick a side I would be on the side saying that you don't need to be in charge of all the SBARs and care planning when there are patient medical needs that you aren't familiar or comfortable with. Your peers might not be most familiar with them either. But we have to figure things out; learn, grow. Help the patient. We don't get to just say we should get a non-direct care role.

It's pretty possible that your superiors have recognized your weaknesses and your hesitation/refusal to put strong efforts toward some of these things. If they think that avoidance is part of your desire for different roles then you're really facing an uphill battle I think.

[Sour Lemon]

54 minutes ago, SilverBells said:

In other words, this is another change I am not thrilled with because tasks I am being asked to complete are not my areas of strength and I am being given fewer opportunities to complete the activities I do well at.  Once again, I feel I would do a much better job in the admissions role, which I have offered to learn, but continue to be denied that role because for some reason they’d rather assign me elsewhere.  

I think it would be fun to create a position just for you ...like maybe riding a pony down the halls and tossing flowers into each patient's room. I think I'd be amused by your reasons for not liking it ...and amused by any proposed alternative(s). ?

[0.9%NormalSarah, BSN, RN]

Looking back on your posts you seem so super humble. You get a lot of great but very blunt advice from seasoned nurses here and seem to take it in stride. But then you make another post that says basically the same thing packaged a different way. It’s bad everywhere for everyone right now, none of us are getting everything we want out of our jobs. You can change jobs, but you may find yourself in another situation where your role changes to meet the changing needs in a crazy time. 

[SmilingBluEyes]

I was an LTC nurse and I guarantee you, I did not forget about SBARs and complete sentences.

If you think about it, that is insulting to LTC nurses.

The skillset is different, not inferior.

It may not be "fun" all the time, but no job ever is.

Good luck to you. Try to keep it on the sunny side and have a sense of humor. That is what got me by, day by day, in LTC. Seniors can be so amazing to work with, even the ones with dementia.

[Hoosier_RN, MSN]

1 hour ago, Sour Lemon said:

I think it would be fun to create a position just for you ...like maybe riding a pony down the halls and tossing flowers into each patient's room. I think I'd be amused by your reasons for not liking it ...and amused by any proposed alternative(s). ?

OMG! The visual in my head...@DaveyDo, we need a cartoon!

[nursej22, MSN, RN]

Can someone clarify for me what is the skill in writing an SBAR? I thought it was tool for organizing a communique, but for the OP it seems to be something more complicated?

When I worked in acute care SBAR was encouraged when contacting providers, "I am calling you about Joe Blow who is having acute chest pain, 2/10. He was admitted 2 hours ago for r/o MI, his current VS are pulse 110, resp. 24 and BP 130/80 and SaO2 is 95% on RA. Current 12 lead shows NSR with elevated T waves in the anterior leads. I have given him sublingual nitro with minimal relief of pain.  I recommend you see him ASAP or shall I call a rapid response? " 

[caliotter3]

If they keep assigning you to areas in which you can not utilize your strengths in spite of your protracted discussion of same with them, perhaps you are being given a message about your standing with the organization.

[Wuzzie]

Silverbells, you can’t cherry-pick what nursing tasks you will do based on what you like best or feel is your strongpoint. This has been a consistent theme throughout your various posts. We all do things that we aren’t good at, bore us, find difficult/gross or just plain hate to do. It’s part of the job. It’s called being a nurse. It’s also part of being an adult.  I’m beginning to think you don’t like nursing at all. At the core it’s all about patient care but you seem to only want to do paperwork. You need to find a job that allows you to do that. Also, I’m beginning to think that after 6 years your inability to efficiently manage your patients is a choice not because you can’t. I’ll throw you a bone here and give it the possibility that it’s an unconscious choice but here we are. 

[TheMoonisMyLantern, ADN, LPN, RN]

Hi silverbells, 

So, sometimes especially when we are new to a facility or even position whether it's clinical or managerial , we have to prove that they made the right decision in hiring us. A lot of times the work is not what we would like or envision doing but rather the work that just needs to get done that no one wants to do. The past few weeks I've been working every shift and my overtime on the covid unit not because I just love covid but because it keeps one less person from being exposed, it's been stressful, it's been demoralizing due to all the deaths, but I've not complained about being there simply because it has to be done. Now that doesn't make me special, I'm just doing what so many of us have to do right now in this crazy pandemic.

If I remember right you are a unit manager, correct? The managers I have will certainly help with admissions, but they're more involved with running the floor both clinically and of course administratively. They're make sure labs are done, results are called, meds are ordered, physical/behavioral issues called to the doc, talking to family members over the phone, doing the assignments for the nurses and CNA's, helping nurses troubleshoot situations that arise. All of these things happen even on an LTC floor and it's a very busy job. Is that what you're supposed to be doing? Does that sound like what you want to do? It sounds to me like you might would've done better taking an Admission Nurse position versus a management position.

I would not make anymore noise about what you want to do right now, because either you're still having to prove your worth, OR they're trying to tell you that what you want isn't going to be happening.

You might want to start thinking about whether this job is for you.

Good luck.

[Jedrnurse, BSN, RN]

The only way to make your "weaknesses" less...weak is to get more experience doing those things that challenge you.

No offense, but your writing makes it seem like you just want to give up because you're not starting at a place of high competence. 

Nobody does.