jj16

I started my career in 2020 as a second degree nurse. It was a bumpy start to say the least. I was on an IMCU/Stepdown in a level one trauma center. We lost 22 nurses in the 15 months that I worked there. I loved the critical thinking, the autonomy, the care, but the environment was unsustainable for me so I took a step away because I was afraid that I’d leave the profession altogether if I didn’t. I’ve now been at an outpatient ophthalmic surgery center for almost a year and while I love my boss, the hours, the team environment and my coworkers, I desperately miss the autonomy, and the critical thinking. I feel like I’m basically a CNA, which is fine if that’s what I wanted to do, but I’m not even close to working to the scope of my license and it bothers me. I know that I like educating my patients, I like a team environment, I like using my skills and I like having a somewhat stable schedule that works for my family (I have four kids). I have been looking into outpatient oncology, home care, IR and Cath lab (although I don’t think I have enough experience for the last two). Any other jobs that will allow me to critically think - have some autonomy and still offer good home/work balance in terms of hours? I would love any advice!

I spent my first 15 months as a nurse on a very busy IMCU in a level 1 trauma center in Boston. I graduated in the height of COVID and our floor was 99% COVID through my entire orientation. Once it switched back to a mix of patients I was on my own and our floor was a mess of nurses leaving constantly - prob the same everywhere but was tough while trying to learn with very sick patients. I left because I wasn’t sleeping at night and I took a job as a pre/post nurse in an outpatient surgery center. The hours are wonderful, wonderful coworkers, amazing supportive manager - super busy but low stress. I’ve been there for 9 months and will stay there forever in some capacity even if per diem because it’s just a wonderful place to work. That said, I miss caring for “sick patients”. I miss really looking at a patient and helping formulate a plan of care and comforting patients who are sick. Maybe that sounds weird, but I miss it. I’ve realized my biggest strengths are patient education (I’m a 2nd degree former teacher so I think maybe that helps), compassionate care/bedside manner and attention to detail - I’m also really good at caring for patients others have deemed “difficult”. I have small children and a husband who works overnights so outpatient or a flexible schedule appeals to me. I think that I would love outpatient oncology as (at least how I envision it), I could get to know my patients, spend time with them, provide education and compassionate care and use my assessment and nursing skills. I also think that working as a VNA nurse might allow me to schedule my days to meet the needs of my family while also being able to care for the needs of the entire patient - navigating the challenges that they face in their environment. I def think there would be a great deal of patient education, compassionate care and assessing/skills. This is so long but my bottom line is I don’t want to look like an unstable employee jumping from specialty to specialty and before I apply to either of these positions, I’m hoping to hear from someone who has done either and tell me what you love and don’t love - maybe even someone who has done both and can compare! Thank you lovely nurses for any advice ❤️

I started as a 2nd degree nurse last year - graduating in May 2020 and starting my career on a medical stepdown in a level 1 trauma center in major city. I was part of a new grad program but my floor was a mess - my manager was never ever there - never once checked on me - my preceptor was amazing but was forced to play manager so I was doing everything on my own pretty much from day 2 of my orientation. I came off orientation early and while I have done okay and learned a LOT, I just feel anxious all the time when I have to work there. I had to start taking medication to sleep before shifts - starting 2 nights before and I could only think of work on my days off. I recently cut down to per diem and started a separate per diem job at an outpatient ophthalmology surgery center. It’s amazing - I have 4 young kids and they’re super active so the schedule has allowed me to feel a real sense of work life balance. My manager is incredible - checks on me all the time to be sure I’m comfortable and happy. It’s the polar opposite of my other position. I pick up extra - I don’t need meds to sleep at night. It’s a dream. Except that I don’t feel like a nurse. I don’t have much autonomy - for no other reason than that’s not really the role of the nurse there. I don’t do much assessing. I do love the educating, but it’s a very small part of my day. I am definitely staying on for a while but I’m curious if there is such a job where I could marry these experiences. Somewhere where I can critically think, assess, use skills, but in a team environment where I can have some work/life balance. Does such a unicorn career exist?

Thank you! Do you feel that this type of experience with my 1 year of stepdown could put me into a PACU position?

I’m considering making the leap from a level 1 trauma center working on a very busy stepdown to an outpatient ambulatory eye surgery center. We have had a mass exodus on my floor, leaving only a tiny handful of nurses who have been on the floor for more than a year or 2. We were the main Covid floor for pts with high acuity over the Winter as we transitioned patients away from intubation and onto high flow as a preferred tx option and I think everyone is just burnt out. This job sounds amazing - nurses stay long term, they work as a team, great manager (according to someone who works there) who invests in her employees, tons of training and support and the hours are 3 days a week - 6:30-4:30 - no holidays no weekends. I have small kids and this would be huge. My long term career goal was MICU, Cath Lab or PACU. Am I shooting myself in the foot if I take this position? Will I be able to get back to the bedside in the future if I want to? Help!

I work at a BUSY IMCU in a major city/level 1 trauma center for 1 year and have already begun to experience burnout. I am a newish grad, but a second career nurse. My initial goal was ICU, but I’m now at the point where I just don’t know if I want that kind or stress. My floor is a revolving door of nurses, so I know this is likely a common feeling. I would like to plan to move within the next 6 months to 1 year but honestly do not know where I would like to go. What I love about my job - complexity of the patients, dealing with multiple comorbidities, figuring out what’s going on, caring for the families when they’re scared - I know many people hate this but I LOVE it. What I hate - feeling like I am overwhelmed by how sick my 3 patients are and that I’m going to miss something because I just don’t have enough time to fully know everything about them - honestly the 13 hours at work - I am so exhausted that I have nothing left for my kids on my days off. I have been thinking that a PACU, hospice nurse, cath lab might be a good spot for me but I don’t know how to get from here to there. I guess I’m just looking for general advice or thoughts on types of bedside nursing that are a bit more sustainable and how to get there.

Hi! I’m a second career nurse - former special education teacher with a master in education/developmental delays. I became a nurse after one of my children developed a severe childhood epilepsy (Doose syndrome) and we spent the better part of a year trying to get his horribly uncontrolled seizures under control. I was so inspired by the incredible nurses who literally saved his life (and ours truly). My motivation to become a nurse was 10000% pediatrics. I’m a mom to four amazing kids and kids are just my favorite. At some point in nursing school though I started to worry about how my heart could handle kiddos who have poor outcomes. I’ve spent my first year as a nurse in this pandemic in a busy city hospital IMCU. I had mostly super sick COVID Patients at first and the rest are complex adults with tons of comorbidities. I love the challenge and the complexity but I keep thinking I would love to be in peds - I thinj my disposition/endless compassion and experiences would make me good at it. I am just not sure if my heart can handle it. Sorry for the long post. Has anyone else felt this way? Help!

I am a career changer who just finished orientation at a busy city hospital on an IMCU that was the primary COVID step down and I am struggling with feeling like COVID patients are the only patients I know how to care for. I don’t want to keep asking other nurses a million questions and wonder if there are any good books or podcasts for new grads. I feel like I spend so much of my day just getting tasks completed that I’m not seeing the big picture until I get home and process the day or sometimes not at all. I’m on a medical floor and our patients have so many comorbidities. It’s like I don’t get a great handle on the big picture in the morning and struggle to hone in on the the relevant labs off the bat and then my whole day I’m playing catch up. For a COVID pt I know to check their WBC, D Dimer, Lactate, ABG, their CXR, their Fio2 and O2 requirements. And I do this quickly and can respond to things quickly. I want to be able to do this with other patients - at least the quick and dirty - what should I know for each “type” of patient. I also still have many skills that I’ve never had the chance to do. Any books, podcasts, Youtube’s, words of wisdom for new grads who constantly feel incompetent?

Thank you! I’m not young hahaha. I’m 42. I’ve been home with my children for 10 years but my youngest is only 5 (oldest 12) so I do appreciate how important time spent with them is. I completely agree that I may not get this position. It is very competitive. However the timeline is so tight that I do feel I have to really consider whether it’s something I even want. Thank you for the advice!

I am a recent graduate of nursing school. I am a second degree student with a young family. I applied to almost 100 jobs leading up to graduating and then right after. Our job market (Boston area) was hit with hiring freezes due to COVID. A neighbor handed in my resume to a small community hospital landing me an interview and I was hired on a med surg floor which is set to begin mid-September. In the meantime, I received an email that I was selected to interview for a highly competitive slot in a critical care residency in a large Boston hospital. The interview is 2 weeks before I am set to begin working at the small community hospital. The residency would lead me directly where I want to be - critical care. However, the smaller hospital offered me the choice of evenings vs overnights to help accommodate my family which I think is huge as a new graduate. My question is - do I go for the big city hospital which would feed directly into my long term goal - making me a very small fish in a very big pond or choose a smaller hospital that pays less, would require me to jump through more hoops to reach my goal but that may offer more flexibility for my young family. And how will the small hospital perceive me leaving them before I even begin with such short notice.

Good question and something I would not have even known to ask or consider! I am grateful you brought that up!

Thank you so much! It is chemo administration. This is very helpful information!

Hi, I am a recent grad (2nd career) and have a couple of questions. I spoke with a recruiter yesterday, for a position at a private oncology clinic. I really loved my clinical time in critical care because I loved spending a lot of time with one patient. Definitely not easier by any stretch of the imagination but different and in my mind (could be totally off base), oncology is similar where you really get to know a patient and are caring for their needs in a different way. Am I being naive or is this a fair assessment? Can you tell me what you like and don't like about oncology nursing and also, if I started in a clinic, would I be pigeon holed into this environment? My long term goal would be to move into the hospital setting. Any advice would be very much appreciated! ?

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Thank you!!! Both are very good. That's how I chose them in terms of applying, but I sort of figured I would get into one and not the other and have my decision made for me. Ha! It's a good problem to have I suppose!