Quitting first RN job

[wideyedfreedom, LPN, RN]

Hi, I am an RN who will have 1 year of experience come August in the ICU. I was an LPN for 3 years before working as an RN. I did my clinicals in ICU and thought it was going to be the place for me. My clinicals and practicum were in a smaller medical ICU, which now looking back is much different than where I work now. I work in a mixed Trauma, medical/surgical, and Neuro ICU with 40 beds. We also had a COVID ICU which I worked as well. 

I don’t hate the ICU, I love the learning and providing care to the ICU patient. I hate the stress, the anxiety, and the drama. My stress and anxiety is getting to the point where I dread going to work. I am constantly second guessing myself and my judgement. I hate when a patient has poor outcomes after my three days and constantly wondering if it’s something I did or didn’t do. 

My prior experience was working in a rehab for a year and a half and home health for a year and a half as an LPN. I really didn’t enjoy rehab, I didn’t mind home health and now looking back - I miss it. I miss being able to educate patients who were responsive and relationships I had with patients and families. 

I’ve been looking at other positions now that I’m coming to my 1 year mark- such as utilization review, case management for home health/hospice. 

I’m scared to quit and move on. ICU was my dream and I thought it was going to be my dream job. There are still parts of it that I really love and I feel like I am going to throw the opportunity away. Everyone says 1 year - it will be easier. But here I am at 1 year and I feel dumber than ever. it’s like the more I work and the more I learn the more I realize what I don’t know and it terrifies me. It stresses me out and makes my anxiety worse. I am in a two year new grad contract as well, so I will be breaking my contract and not sure if this hospital system would ever hire me back. I talked to my managers about going PRN and they said absolutely not, said I need to work on my mental health. I also worry that they wouldn’t give me a good reference either if I quit. We are always so short staffed and people are constantly coming and going on the unit. 

I also feel like I’ve jumped around a lot since becoming a nurse and I don’t want to look like a job hopper. Sometimes I wonder if nursing is even for me and I should do something else. 

The anxiety is driving me through the roof. I don’t know whether to stick it out longer or to jump ship. I just hope whatever I do, I really love and can stay for years. 

Any advice would be helpful.. thanks

[freesia29, ASN, RN]

I can totally relate.  I always wanted ED.  But my own health is not good enough for me to do it ..  I am so bored by all the non hospital jobs.  Almost 1 year as an RN, was an LPN for 8 years before.  Just in a funk.  I desperately want to work in hospital.  Just wish my body would hold up.  ?

Stick out the 2 years if you can.  Can you take a couple weeks off to destress?

[wideyedfreedom, LPN, RN]

On 7/18/2021 at 10:11 PM, freesia29 said:

I can totally relate.  I always wanted ED.  But my own health is not good enough for me to do it ..  I am so bored by all the non hospital jobs.  Almost 1 year as an RN, was an LPN for 8 years before.  Just in a funk.  I desperately want to work in hospital.  Just wish my body would hold up.  ?

stick out the 2 years if you can.  Can you take a couple weeks off to destress?

I’m taking two weeks off now, but my anxiety about going back is just unreal. I really want to stick out the two years, but mentally I’m not sure if I can. My main concern is ruining future opportunities or having difficultly getting another job if I leave now. 

[TriciaJ, RN]

Sounds to me like you love your work but hate your job.  When I started reading your post my first thought was that you aren't getting enough support.

Then I got to the part about the manager telling you "you need to work on your mental health".  That is incredibly callous.

My only advice is to put your own oxygen mask on first.  That means prioritize your own health, then career.  Good luck.

[JBMmom, MSN, NP]

Yes, at the one year may have an increased comfort level with your ability, however, that doesn't mean you will necessarily find your particular job easier. It sounds like you may have a fine set of nursing skills after your year of experience, but your particular set up is not conducive to nursing at all, much less nurses that are still new in their practice. You have to do what's best for you and your health, no one else can really dictate what that course will be. Good luck with your decisions!

[JKL33]

19 hours ago, wideyedfreedom said:

I don’t hate the ICU, I love the learning and providing care to the ICU patient. I hate the stress, the anxiety, and the drama. My stress and anxiety is getting to the point where I dread going to work. I am constantly second guessing myself and my judgement. I hate when a patient has poor outcomes after my three days and constantly wondering if it’s something I did or didn’t do. 

A few of very important questions:

1. Are your assignments (or any other significant thing about your unit) objectively unsafe? Like, would most knowledgeable RNs hear the details and advise you that your setting is generally operating in an unsafe manner?

2. Are you being nitpicked: unreasonably written up and/or criticized for not perfectly performing beyond human capacity

3. Are you being otherwise treated poorly? Try to be objective in answering. Examples: Chronic mandatory OT, denied basic time off, any other underhanded malarkey (regularly lied to, reneging on agreements, etc.)

[JKL33]

19 hours ago, wideyedfreedom said:

Everyone says 1 year - it will be easier. But here I am at 1 year and I feel dumber than ever.

Yes, well, at the 1-year mark it should be slightly easier (as far as tasking, housekeeping items, knowing protocols, knowing charting mechanisms, etc.). But it would be a mistake to think that the 1 year mark is some magical line of going from officially being a beginner to an expert or going from being extremely difficult to easy. I'm not even sure that 1 year is a great marker. It may be an emotional milestone but I'm not sure what it actually signifies beyond that.

You are describing the feeling of having learned enough to recognize that there is quite a bit more that you don't know. That shouldn't necessarily freak you out.

[wideyedfreedom, LPN, RN]

2 hours ago, JKL33 said:

A few of very important questions:

1. Are your assignments (or any other significant thing about your unit) objectively unsafe? Like, would most knowledgeable RNs hear the details and advise you that your setting is generally operating in an unsafe manner?

2. Are you being nitpicked: unreasonably written up and/or criticized for not perfectly performing beyond human capacity

3. Are you being otherwise treated poorly? Try to be objective in answering. Examples: Chronic mandatory OT, denied basic time off, any other underhanded malarkey (regularly lied to, reneging on agreements, etc.)

1 - I wouldn’t say my assignments are unsafe. I am never tripled thankfully because charges knows I am new, but sometimes up to 7-8 nurses will be tripled on the unit if we are very short. Lots of the nurses are new as well (less than 1 -2years of ICU ex).  But there have been times when I am given a very very sick patient with something new I’ve never experienced like a patient with multiple sheaths and ECKOs machine that needs to be set up from IR (for example). In this instance I try my best to look up in our protocols, ask my charge, and the most experienced nurse near me to help. But if we are short staffed getting the help I need can be difficult with our charge nurse being pulled in 20 different directions and other nurses busy. 
 

2.  I’ve talked to my manager about issues I’ve had, they say I am a good nurse and they have no complaints about my work. My charges say I do a good job. My managers have told me everything I am feeling is normal. But it doesn’t change the fact that this feeling is making me miserable. 
 

3. Besides only getting 6 weeks of training when I was told I would get more when I started. And it being difficult to request PTO and get it approved - nothing like that.

 

thanks for the response  

[wideyedfreedom, LPN, RN]

19 hours ago, TriciaJ said:

Sounds to me like you love your work but hate your job.  When I started reading your post my first thought was that you aren't getting enough support.

Then I got to the part about the manager telling you "you need to work on your mental health".  That is incredibly callous.

My only advice is to put your own oxygen mask on first.  That means prioritize your own health, then career.  Good luck.

Thank you for the response. And I know, it’s been a tough decision for me. 

[wideyedfreedom, LPN, RN]

2 hours ago, JKL33 said:

Yes, well, at the 1-year mark it should be slightly easier (as far as tasking, housekeeping items, knowing protocols, knowing charting mechanisms, etc.). But it would be a mistake to think that the 1 year mark is some magical line of going from officially being a beginner to an expert or going from being extremely difficult to easy. I'm not even sure that 1 year is a great marker. It may be an emotional milestone but I'm not sure what it actually signifies beyond that.

You are describing the feeling of having learned enough to recognize that there is quite a bit more that you don't know. That shouldn't necessarily freak you out.

I guess the reason why it “freaks” me out is because these patients are so so sick and it’s just the constant feeling of wondering if I am making them worse. Or maybe I am missing something and I don’t even know that I am.  I talk to nurses who are working the same amount of time as me in other units and they seem to be thriving or so they say. Super confident and ready to progress onto other units. Some are charges of their units. Where I feel like I have barely touched the surface of what I need to know and be confident with. I could never be charge of my unit. No way. 

[JKL33]

Thank you for providing thoughtful answers.

I was asking these things because the answers can help you understand the likelihood of the grass being greener elsewhere, as in--if you're being treated significantly poorly or are being regularly asked to take objectively unsafe assignments then there's a decent chance you can do better than that. But if you have decent coworkers and are being given fair assignments for the most part and not being messed with by management, then there's a decent chance that a move will be a downhill move, even if the area of nursing or the type of work sounds easier.

Two things: Obviously I/we don't know you. Also, I am not against whatever you think you really must do for your personal health and well-being.

But: It does sound like there is a component of this possibly having to do with you feeling worse than your actual performance would indicate. So then the question is should you take steps to remove yourself from the situation or take steps to see if you can improve how you perceive it/feel about it. A decision only you can make, but it's worth thinking it through.

I suspect you are doing better than you think you are. Pretty much if you're holding your own then you are probably aren't doing too bad at all...and time usually does allow people to feel more comfortable/confident. With the amount of critical care stuff that you have to learn this will take longer than a year.

> Don't compare yourself to how your peers seem to be doing. There are a lot of confident people out there who wouldn't be so confident if they had half a clue about what they don't know.

All of this is just food for thought.

Take care ~

[TriciaJ, RN]

1 hour ago, wideyedfreedom said:

I guess the reason why it “freaks” me out is because these patients are so so sick and it’s just the constant feeling of wondering if I am making them worse. Or maybe I am missing something and I don’t even know that I am.  I talk to nurses who are working the same amount of time as me in other units and they seem to be thriving or so they say. Super confident and ready to progress onto other units. Some are charges of their units. Where I feel like I have barely touched the surface of what I need to know and be confident with. I could never be charge of my unit. No way. 

Yes you could.  You will surprise yourself one day.  I don't see it as necessarily bad that you currently lack confidence.  It just shows that you take your work seriously and are aware that you don't know everything.

I agree that the one year mark looks impressive on paper, but you will continue to learn a lot going into your second year.  Your confidence will grow gradually.