klaRN01

i posted this under general nursing but i thought why not ask the pacu nurses...thanks in advance! as a new grad i went to cardiac imcu/med-surg floor and have been there 2 years. for about the last 9 months ive been feeling burned out and that it just isnt for me. i returned to school in oct 2011 and since then my level of stress and burn out has only increased. some of the factors that make me think floor nursing isn't for me are: scheduling (hired for day/night rotation but until recently usually worked 3- 12 hr 7a-7ps/wk not a big fan of nights), staffing and ratios (5:1 & 6:1 for days and eves; 6:1 and 7:1 for nites...some consider that good but i dont when taking care of cardiac drips cardio/vas surgicals), too many extra duties (i only get 1 payrate but you want me to be a secretary, mind reader, waitress, janitor, brown noser to families, provide scripted customer service, delve into pt personal lives for + hosptial survey responses, oh and keep everyone alive...really). anyway i finally decided i would give another area a shot...which is big for me because i dont like change and the unknown. i analyze and then reanalzye before i make decisions. so i decided to go for a endoscopy/specialty health position that was posted assuming the hours would be better (basically weekdays occasional short saturdays and rare to no holidays...umm thats my dream job!!). so i call to talk to the manager of the dept today and it's already filled but she looked me up in the system and saw that i currently worked cardiac imcu and suggested her pacu opening. the shifts are 7-3, 9-5, 10-7, 2-1030, every 3rd-5th sat , 1 day/wk oncall. the only problem is i like 12s so i can be at work less days and im a 0.8 shes offering a 0.6 with the possibility of extra hours. fellow nurses whats your opinion? is pacu better than the floor and a less stress? how is it working oncall? what about going to a lower fte with only verbal assurance you can pickup extra hours? im kind of hesitant to continue pursuing a transfer now that i know my dream job is gone...but i tell myself maybe that wasnt the one for me. i had considered pacu before but thought the scheduling inconsistency and stress level might be just as big a problem for me as the floor is so i never pursued it. i would definitely shadow 1st if i was leaning toward pursuing the transfer but would you first officially interview and shadow before deciding not to pursue the transfer? thanks all...your replies are appreciated!

As a new grad i went to cardiac imcu/med-surg floor and have been there 2 years. For about the last 9 months ive been feeling burned out and that it just isnt for me. I returned to school in Oct 2011 and since then my level of stress and burn out has only increased. Some of the factors that make me think floor nursing isn't for me are: scheduling (hired for day/night rotation but until recently usually worked 3- 12 hr 7a-7ps/wk NOT A BIG FAN OF NIGHTS), staffing and ratios (5:1 & 6:1 for days and eves; 6:1 and 7:1 for nites...some consider that good but i dont when taking care of cardiac drips cardio/vas surgicals), too many extra duties (i only get 1 payrate but you want me to be a secretary, mind reader, waitress, janitor, brown noser to families, provide scripted customer service, delve into pt personal lives for + hosptial survey responses, OH AND KEEP EVERYONE ALIVE...REALLY). Anyway I finally decided I would give another area a shot...which is big for me because I dont like change and the unknown. I analyze and then reanalzye before i make decisions. So I decided to go for a endoscopy/specialty health position that was posted assuming the hours would be better (basically weekdays occasional short Saturdays and rare to no holidays...umm thats my dream job!!). So I call to talk to the manager of the dept today and it's already filled but she looked me up in the system and saw that i currently worked cardiac imcu and suggested her PACU opening. The shifts are 7-3, 9-5, 10-7, 2-1030, every 3rd-5th sat , 1 day/wk oncall. The only problem is i like 12s so i can be at work less days and im a 0.8 shes offering a 0.6 with the possibility of extra hours. Fellow nurses whats your opinion? Is PACU better than the floor and a less stress? How is it working oncall? What about going to a lower fte with only verbal assurance you can pickup extra hours? Im kind of hesitant to continue pursuing a transfer now that i know my dream job is gone...but i tell myself maybe that wasnt the one for me. I had considered PACU before but thought the scheduling inconsistency and stress level might be just as big a problem for me as the floor is so i never pursued it. I would definitely shadow 1st if I was leaning toward pursuing the transfer but would you first officially interview and shadow before deciding not to pursue the transfer? Thanks all...your replies are appreciated!

I work on a cardiac imcu; I started on the unit when I graduated and have been there a little over 2 years. I must say I am completely burned out and get very little satisfaction and a lot of stress from my job for the past 6 or so months I have been thinking about transferring. Recently an endoscopy position was posted and I was hesistant to apply for it at first because I kind of feel I might be cheating myself by leaving the floor and not giving myself a chance to get more experience and see more stuff. However after heavy thought this week I decided to go for it. I'd rather try a less stressful area with consistent hours where I might actually not dread going to work everyday versus staying somewhere that i have become burned out on constantly flipping between day/night shifts and dealing with other inconsistencies just for the sake of experience.

@ Mindlor Sounds like you have it tough, but i guarantee you my job is FAR from a dream job. No i dont work for the VA. I am thankful to have a job but BS is still BS. As far as ratios 4:1 5:1 in my opinion it is not good when you have cardiovascular surgery patients (i.e. open hearts), cardiac drips, when neuro is full new and evolving CVAs "stable" enough to not need neuro-icu, monitored transports for diagnostics, frequent vitals with drip titrations and returning surgicals, insulin drips with q2hr one touches and etc. Im no stranger to patients with a tube from every orifice and demanding families. On my unit the discharges, admits, and transfers are constant as well. I guess its just less than idea conditions everywhere. Until there are stricter laws r/t nursing staffing and conditions we're going to continue to get screwed i guess.

Kasmus For acute dialysis how long are the hours in the hospital setting does it involve alot of weekends and holidays and offshifts? It sounds like its a lighter load than the outpatient dialysis setting. I am currently a floor nurse on a cardiac imcu/med surg unit, i've been there for 2 years, and im BURNED OUT already. Im sick of the workload, the staffing, all those things you named in your post, having a schedule thats all over the place and etc. I thought about trying dialysis but had always leaned toward the clinic setting because in the acute setting I was worried about being there alone if something were to go wrong with a patient or if there was a situation where i needed help. However after reading your post it doesnt sound like it would be as hard as i thought. Did your training prepare you well for the position and once on your own how long did it take you to feel comfortable?

Kasmus For acute dialysis how long are the hours in the hospital setting does it involve alot of weekends and holidays and offshifts? It sounds like its a lighter load than the outpatient dialysis setting. I am currently a floor nurse on a cardiac imcu/med surg unit, i've been there for 2 years, and im BURNED OUT already. Im sick of the workload, the staffing, all those things you named in your post, having a schedule thats all over the place and etc. I thought about trying dialysis but had always leaned toward the clinic setting because in the acute setting I was worried about being there alone if something were to go wrong with a patient or if there was a situation where i needed help. However after reading your post it doesnt sound like it would be as hard as i thought. Did your training prepare you well for the position and once on your own how long did it take you to feel comfortable?

MJB2010, Im glad to read your perspective on the chronic dialysis setting. Currently I work in acute care and was considering chronic dialysis because I thought the work would be a little less stressful but from reading your post it doesnt seem that way. Another reason I was considering was because I hate hospital hours Im sick of flipping between day and nights and working weekends and holidays. I know the chronic setting does involve Saturdays and holidays arent totally eliminated I just thought it would give me a bit more of a structured schedule and more family time.

@ sapphire18, While in nursing school I became interested in nursing education and wanted to eventually pursue it. But I feel I would need to get more experience first as I have only been a RN for 2 years (i was an lpn in LTC for 1 year while getting my RN). Currently I am working on my BSN and i do plan on pursuing an advanced degree. Im just in need of a more satisfying position while im working toward my degrees. Thank you for your response.

Thank you for your response. I've been thinking about transferring to another unit for a few months now im just one of those people who are cautious when it comes to change. But I definitely have to try to find an area of nursing that is a better fit for me. Your insights are appreciated.

I've been an RN for a little over 2 years on a cardiac imcu/med surg unit. Previously I worked LTC as an LPN for about a year while pursuing my ASN. I am now in school for my BSN. Before even earning my LPN, I knew I didn't want to work in LTC and I was right. I hated it. So, after I got my LPN license, I rushed right back to school to earn my RN. Once I obtained my RN license, I thought I would finally be content working in acute care. I started as a new grad on the cardiac imcu/med surg unit and (as is for all new grads), it was tough. But about 6 months in, I started feeling more comfortable. After about a year I was pretty comfortable and confident in my abilities. The unit I work on has very knowledgable and supportive veteran nurses so I am lucky in that aspect. Now a little over 2 years in I am close to miserable, but not just at work. It carries over to my outside life as well. I don't expect to love my job (that's why it called a job), but should I really dislike it this much? I've become increasingly stressed, impatient, fatigued, have more health complaints, no energy, and etc... I cant believe I put the time and money into a earning a degree to be this unhappy with my career. Some of my issues are: staffing ratios (job was pitched as 4:1 day/evening ratio but it's usually 5:1, and at times lately its been 6:1); rotating shifts (Hired as day/nights but as the older RNs left, I moved up to mostly to days. But now that staff is leaving or new hires decide they don't like nights, I get thrown back to them. I hate nights); time taken away from my child & home life; being scheduled over my FTE (im a 0.8 get, but frequently am scheduled 0.9 or 1); and heavy workloads; constantly added inconvenient extra duties. As far as scheduling is concerned, I have never been a person who can tolerate a 5 day work week. I like to work as few days as possible. Currently I am a 0.8 (32 hrs/wk). I like to do 12 hour shifts so I can work 3 versus 4 days a week. When I first started working, I was told people with seniority got the 12 hr shifts first which is understandable. But since then, multiple senior people have left and the majority of the nurses have less seniority than me and I still don't have the schedule consistency that I would like. Maybe the inconsistency is just something that goes along with acute care since it's 365 days 24 hours. Since I like a more structured schedule, maybe the hospital setting isn't for me. As far as extra duties, it's not just about patient care anymore. A licensed nurse on my floor may have to be a secretary, janitor, or even doctors (take on responsibilities that aren't a nurse's job). Since reimbursement is changing, there is increased focus on scripted customer service. You cant just go in and be genuinely nice to a patient, but you have to ask key questions and say key phrases so the hospital gets + survey responses. Currently, I'm pursuing my BSN because I would like to be more marketable and have more options. Even though school is adding to my workload and stress, I feel I have to stick with it. I am currently trying to decide if after completeing my BSN, I should pursue an advanced nursing degree or try to obtain a minor or certificate in another field or flat out pursue another degree. I like nursing theory and the educational aspect of it, but I really want a lot less to do with the hands on aspect. Job attributes I am looking for is: decreased manual and floor work, but still enough contact to maintain and enhance my nursing knowledge; and no offshifts and rare to no weekend or holiday obligations. Overall I would be content with a job in the healthcare industry, but a desk type job. I even think I would be OK with being an NP. In nursing school they told us that there are so many career possibilities/paths for nurses. I'm just trying to find an educational path that will get me to a job that is more tolerable for me. Any insights or suggestions as far as educational paths and career options are much appreciated. Are any of you nurses who returned to school to pursue an entirely different major and if so, what did you major in and what career did it lead to?