Ready to leave bedside after only 1 year?

[Corpsman2OncRN]

I'm an inpatient oncology RN working in NYC and just had my one-year anniversary in December (first nursing job).  I love oncology, I love my patients (well...most of the time, anyway :p), and I love almost all of the RN's and PCA's I work with.  However, over the past several weeks I have grown increasingly worn out and truly dread walking into work.  I have so much anxiety now about how short-staffed we will be (repeated staff "high-risk" exposures leading to two-week quarantines have left those of us picking up the slack exhausted and often having to work 24-hour shifts).

I'm an anxious person by nature, but it has been so much worse lately to the point where it's hard for me to even find the bright spots during a shift or for me to find that "why I'm doing this" feeling that can usually carry me through.

I feel that I still have so much to learn working bedside, but so many of my coworkers are leaving and it's making me feel like I want to do the same as things just seem to be getting worse and worse and more responsibilities dumped on us to the point that I feel like my license, and worse, my patients' safety, are all in jeopardy because of unsafe ratios and new policies like not allowing patients to be on a one-to-one unless they are suicidal (not that we often have one-to-ones, but delusional/non-redirectable patients can't be managed by a camera especially when half the time the camera operators don't even alert us when something is happening, and Q20min checks are just unrealistic for one person to keep up with all day while still trying to take care of the rest of their patients).

I feel like if I leave the bedside now, I won't ever come back, and so I am hesitant to do so and miss out on increasing my knowledge and skills when I'm a still relatively new nurse.  I also feel awful when I look at the nurses who have been working bedside for like 30 years and think to myself that I can't even make it to two years before needing a break.  But I can't even enjoy my free time anymore; I'm either exhausted from work and sleeping it off or spending the day dreading going back and seeing what kind of nightmare awaits me.

I am currently in counseling (not specifically because of this, just for general depression/anxiety), just as an FYI if anyone wanted to suggest that.

I don't even really know what I'm asking here but I guess I am wondering what people's thoughts are and whether it would be a mistake for me to leave the bedside now, so early in my career, just because I am feeling stressed?  Just to reiterate, I *do* enjoy being a bedside nurse, it's just that this whole year has been so hard with COVID and getting inappropriate-for-our-floor admissions and policy changes that throw more work on the nurses and staffing shortages etc. etc. etc... I know many of these problems are just the realities of working inpatient but I feel like I'm at my wits end here.

Any advice would be so appreciated!  Thanks for reading.

[Hannahbanana, BSN, MSN]

Your state Division of Wages and Employment (or whatever it’s called) can address this. There are federal rules about who can unionize, what activities are permissible, under what circumstances. For example, you may not be allowed to discuss unionization at work, with patients, or on a work email, but you certainly can elsewhere. Such a threat is illegal. Take a photo of it and submit it to the folks above and/or the civil rights folks at the atty general’s office. Keep a copy next to your excellent annual reviews so if all of a sudden they start dinging you, you take them to a good employment atty to proceed. 

[TheMoonisMyLantern, ADN, LPN, RN]

3 hours ago, Hannahbanana said:

Your state Division of Wages and Employment (or whatever it’s called) can address this. There are federal rules about who can unionize, what activities are permissible, under what circumstances. For example, you may not be allowed to discuss unionization at work, with patients, or on a work email, but you certainly can elsewhere. Such a threat is illegal. Take a photo of it and submit it to the folks above and/or the civil rights folks at the atty general’s office. Keep a copy next to your excellent annual reviews so if all of a sudden they start dinging you, you take them to a good employment atty to proceed. 

Thanks for the info. It's obvious you have a lot of experience with this. It would make for an awesome article or thread discussion if you have the time and desire to share your wisdom.

[martymoose, BSN, RN]

Union is very frowned upon where I am (it will never happen) and they get away with the staffing thing cause they know theres some slobs like e who have everything at stake if they lose this job . Like lose your house , your insurance, your ability to get rehired if youre old but too young to retire. 
 

[nurseMR2020]

Hello my friend. I am a newgrad nurse as well. I graduated in May of 2020. I started on a PCU in a level two trauma center. I also have anxiety/depression and it affects me in a terrible way because of the stress of nursing. Lots of my coworkers are also leaving.. The pandemic has changed nursing so much. The senior nurses at my job always tell me that they feel bad for me since I came in at such a bad time in nursing. I feel the most important thing is that you are afraid of something happening that will affect your license. That is NOT a good situation to be in. If you feel comfortable talking to a fellow nurse/charge nurse, possibly even management about how you feel, I would!! Utilize your resources as much as possible. I also dread going in to work. I get so anxious before a shift I want to throw up. Our staffing ratios are terrible and we are stretched as thin as possible. Also ask yourself, is your unit right now a place you could see yourself staying for a while? I asked myself that same question and the answer was no. So I accepted a job in OR which is less stressful and more manageable. I start soon. Your mental health is absolutely the priority, this is a career. It is not our identity. It is hard because nursing school consumes you and you get so used to it, you forget that you are a person, not just a nurse. This is your only life. Do you want to spend any part of it being stressed and anxious constantly? Everyone convinces you that you need to do this or that for nursing but you need to do what you love and what is sustainable. I hope this helps you even a bit. Hang in there. You've got this. I hope it will turn out well for you. ? 

[JKL33]

On 2/25/2021 at 3:16 PM, Corpsman2OncRN said:

 I have so much anxiety now about how short-staffed we will be (repeated staff "high-risk" exposures leading to two-week quarantines have left those of us picking up the slack exhausted and often having to work 24-hour shifts).

I will assume this is not an exaggeration. Working a 24-hr shift in acute care (and probably just about any other typical nursing job) is not appropriate. It isn't okay. And it is not a situation in which the logical thing to do is find fault with yourself because you aren't tolerating it well.

On 2/25/2021 at 3:16 PM, Corpsman2OncRN said:

I feel like if I leave the bedside now, I won't ever come back, and so I am hesitant to do so and miss out on increasing my knowledge and skills when I'm a still relatively new nurse.

Consider other options; you likely have more than two. This doesn't boil down to "work 24 hr shifts or else leave the bedside."

On 2/25/2021 at 3:16 PM, Corpsman2OncRN said:

I also feel awful when I look at the nurses who have been working bedside for like 30 years and think to myself that I can't even make it to two years before needing a break.

Yes, there are a lot of people who have given a lot of time to this profession; their individual motivations for having done so range from noble to apathy and everything in between. While nursing seems like it probably has never been an easy profession and every generation has faced some serious difficulties in nursing, the 30 years you're talking about were not today's scene and everything it includes (not to mention the pandemic and the significant stressors it has introduced).

Stop being self-deprecating about this situation. Nurses need to stop with the self-deprecating guilt routine in response to their own feelings about  unacceptable conditions. You are neither deficient nor a failure for not enjoying very stressful conditions and 24-hr shifts and all of the stressful possibilities constantly hanging over your head. You are essentially lying to yourself about yourself, here. You will feel better when you find the power to accept that your feelings are a natural reaction to the situation and find the power to be proactive with regard to what you are going to do about it.

Take control of this situation. You don't have to accept it. Figure out your options, consider them carefully, and move on/move forward.

Best of luck ~

[Corpsman2OncRN, BSN, RN]

Thanks everyone for the responses! I will try to respond to the questions on my next day off, but I appreciate everyone’s input and suggestions 

[SchoolNurseK, BSN, RN]

I am going on my 20th year as an RN (how is that even possible?!) and I left bedside nursing after my first year.  (I went back PRN for one year and confirmed it isn't a good fit for me.)  Explore your other options.  You don't have to do bedside nursing to be a great nurse!  I realized it was important for me to have time to get to know my patients and see them through their illness.  I went into geriatric home health where I could take my time, build relationships with the patient and family, do a lot of teaching and see improvement or gently usher them into end of life care.  Now I am in school nursing and it is very similar in respect to building relationships and doing a ton of patient teaching.  There are so many great options, so don't put yourself in a position where you feel unsafe or dread going to work.  Identify what you love about being a nurse and find a position that fits your personality and provides you a healthy work-life balance.  Hugs from this old nurse that's been there and understands how you are feeling.  ❤️ 

[Robmoo, ADN, BSN, RN]

You don't need to leave the bedside.  You need better working conditions.  In Texas when a nurse is given an assignment that they deem unsafe that nurse can file paperwork for "Safe Harbor."  Most states have a similar rules.  Every time that you are given an impossible assignment especially 24 hours shifts file the paperwork.  Get you colleagues to do the safe.  If you all hang together than administration will be forced to do something about the situation.  You don't gain any sort of whistle blower protection until you report to a regulatory agency.  It sounds like it is about time that someone at your institution reports.  It is too bad that you and the other staff members couldn't gather together and bargain collectively for better work conditions.  Using a pandemic as an excuse to increase profits it pretty low.

If you aren't in a place where you can take this sort of action then it is probably time to quit and find employment elsewhere.  If you enjoy working at the bedside then find a new job at the bedside.  With your years experience you will find getting a job elsewhere much easier and likely more profitable then where you currently work.  In fact this might be helpful to your friends.  Employers often listen when nurses begin "voting with their feet."

[ErikRN2011]

I’m sure many others have already responded and given you food for thought. I’m sorry you’re struggling. Nursing (especially inpatient) is a hard job. It’s backbreaking work really. I’ve been an inpatient nurse for 9 years and I recently became a flight nurse. I’m again overwhelmed with a learning curve, but I don’t see myself returning to the bedside.

I see you’ve been in oncology for 2 years, yes?  I was in oncology my first two years also!  It’s VERY difficult. The patients are sick, in pain, vomiting, diarrhea, and they have the weight of a life-threatening diagnosis on their mind every single day. The combination of these things can make them behaviorally challenging also. And then there’s their family members. After doing nursing in many other venues I can confidently say that oncology nursing weighed most heavily on my mind and body. So don’t beat yourself up!  ?

Nursing is SUCH a broad field, so think of other inpatient departments you might like to try. I suggest working toward something where you don’t care for the same patients your entire shift, such as ED or PACU. I found the flow of just having these patients for a couple hours to be easier to manage. 
 

One excellent way to dabble a bit is travel nursing. After I became an ICU nurse I traveled for a couple years. I was looking for a job that felt right to me. It gave me the chance to check out several hospitals and even different job sites. I did some ICU travel assignments, but also pre- and post-procedure for the cath lab and even advice nursing. It was really fun to explore possibilities!  Travel nursing companies usually only require you to have one year of experience, so you’d definitely qualify. 
 

Bottom line:  don’t lose hope. You’ll most likely find your niche in nursing, even if it’s ultimately away from the bedside. I encourage you to try to identify what about your current job makes you want to step away from bedside and then look for an inpatient department that features important differences in patient population etc. If you try one or two of those without feeling much different, step away from the bedside with a smile. Become a clinic nurse or case manager or advice nurse...or even school nurse!  There are so many possibilities. ?

[Lovethenurse2b25, ASN, BSN, CNA, LPN, RN]

I feel the same way after 2 years of critical care nursing and continuous short staffing. I have also worked in long term care facilities and I realized the grass hasn’t gotten any greener. But the good thing about nursing is that their are many other specialties to choose from whether it be working in a clinic, home health, insurance etc. 

Hang in there. And don’t be afraid of stepping out of your comfort zone. We didn’t work this hard to earn a license to be unhappy. However I do believe the coronavirus has seriously impacted healthcare in a way that I would have never imagined. I also couldn’t imagine 30 years of bedside for what it is today. 

[Yetty-MBA]

Sometimes when I read things on this page. I don't know whether to cry or scream. Seriously, when u signed up for a job, do u not have an agreement in place that spells out what the job entails? 

Because if it is, the question then becomes, do u agree to it or not? See, life is a choice; we must not make a nursing job look like a do or die because it is not. I have worked in many facilities and all floors for years to ensure I have all the experiences needed to survive ANYWHERE IN THE WORLD. 

Therefore, I tell you how the job goin' go down, not you. I have worked all my life, get all the degree I needed, NOT to be a pushover. 

Therefore, Dear nurses, the bottom line is this. U are NOT supposed to work in any facility on a 24hrs shift. This is illegal. You need to defend your license.  Aiight?

[Hannahbanana, BSN, MSN]

When through a series of events beyond my control I left my hospital clinical job (20+ years in critical care, MN, teaching, clinical specialist) for what I thought would be a temporary placeholder doing worker's comp case management, I felt bereft. I felt unmoored, adrift in a sea where I had no landmarks to guide my next steps, unable to even think about what to do next. My entire self-image was gone, vanished. I had no idea about what case mgmt involved, knew nothing about the insurance and finance part of health care, never worked c an attorney, never worked in an office or independently.

But to my vast astonishment I found that 1) I didn't know how much hospital politics and general constraints had been wearing on me and 2) it was really interesting learning an entire new specialty and industry where my nursing knowledge and inclinations were valued! Nothing was wasted except my white lab coat and scrubs, LOL.

And it opened up a wide, wide world of professional opportunities I had no idea existed. While sometimes I look back with fondness on my awesome critical care life, it was a long time ago. Critical care work isn't what it was now that COVID is on, healthcare finance is tougher, patient loads and nurse abuse are on the rise ... and parking costs more. I have exactly zero regrets and nothing but gratitude for the terrific career I've had since then.

There are a LOT of things open to you. Don't be afraid to try any of them. There are people out there who will hire you not because of what you have done in the past (although if you want to do something related, that might be useful) but because as a nurse you have already demonstrated a lot of transferrable skills that can be applied in new ways, like willingness to learn, experience with talking to people you don't know, ability to deal with stressed out people (seriously, if you can stay cool when a jerk surgeon is having a temper tantrum, there's 90% of life right there), observation, documentation, decision-making, and more. It's not just that you can DO it, it's that YOU can do it.

Good luck!