I've been a nurse for about a year and I just passed my 1-year mark on a highly specialized post-surgical unit. I love who I work with, but my unit has had some serious growing pains. We don't keep experienced nurses long, and brand new nurses are pressured into being charge at 6 months of experience. Through sheer dumb luck I have ducked that one. CNA coverage is patchy during the day and non-existent at night. Management oversight is a joke as our manager is also over another much larger and much higher acuity unit. In the year that I have worked here, I have never had a one-on-one conversation with any of the management. Our unit is on paper a step-down unit, but we work with Med-Surg ratios, and we are held to ICU standards. This all creates a great deal of stress among all the employees. I can't think of a single coworker that is not in management that has not either dropped to part-time or PRN or voiced that they are job-hunting. These issues have accelerated in the past year.
I'm also dealing with another problem that is exacerbated by the stress in this unit. I work nights, and I love the flow, the teamwork, the slightly different focus from days, and the managed chaos that comes from surprise ED admits in the middle of the night. Unfortunately, my body doesn't love it. Case in point, I'm writing this at 10 AM local, between shifts, and I really should be asleep. I have teenagers at home and one is special needs and struggling with highschool. Although I attempt to cluster my work days so I can have longer stretches of days off, I have never managed to switch well from being awake at night to being awake during the day, and back. I have this perpetual haze and overall sick feeling that lasts the entire time I'm off and doesn't get better until I'm working, but then I work myself into the ground trying to do it all over again. I was able to cope for a while, but I just can't keep it up. If not for the rest of my life, I would just stay on one sleep schedule days on and off, but as a parent, I can't do that, and I end up not even having a rest of my life. I recently had 8 days in a row off and I didn't sleep more than 4 hours in any given 24 hour period. This is taking a significant toll on my health and family relationships.
Reluctantly, I asked to switch to day shift. I know this shouldn't be a problem since the unit just lost over half the experienced day shift nurses. Not only are the positions open, they are desperate for them, while night shift is usually in better shape for staffing. At 1 year, I still consider myself new, but I don't need hand-holding and I get it done. I'm a little slow at charting, but I rarely leave late, and when I do, it is always a patient safety issue that came up near shift change. Most of what I need from more experienced nurses are a little guidance when I'm doing something for the first time and a quick check to see if I'm the right track when I get a curve ball. Now I've not been on day shift since my new grad orientation at just over a year ago, so I don't remember how to discharge a patient and I'm a little fuzzy on some of the standards expected of day shift nurses, but with a little direction from my coworkers I'm sure I'll get there, even if it is a little awkward at first.
I never got a reply from my manager. She just ghosted me. This morning, a few days after my request, I caught her when she did her 2-3 times/week check in with the unit which is always early in the morning. She spends the rest of the day on the other, larger unit and is generally much less accessible. She told me she got my email, but didn't think I had the right time-management skills to work day shift. I was completely flabbergasted and I didn't even know how to respond. I haven't had problems getting things done on time since orientation, over a year ago. Sure I'm not as confident or as smooth as some of the newer nurses, and I'm not as good as "faking it until I make it". I do think that I am right where I should be in my judgment, nursing skills, and yes, time management for a 1 year nurse. She made some vague comment about how maybe a position would open up by January, but I may have to wait until March. We'll see. Meanwhile, we have 2 nurses scheduled a couple of days this week to care for a floor that averages 18 patients. She didn't wait for an answer from me.
This unit is a good place to learn because we have our own surgical patients and a good deal of med-surg overflow, so I feel like I can really get good at something while still constantly learning new things. But I don't see myself working here forever. My 20+ year vision of my nursing career culminates with being an in-patient palliative care nurse, likely requiring an NP by the time I get there. I don't think I'm ready for hospice nursing, though that's on my short list, and I don't want to do general med-surg, though I do enjoy the med-surg that I get. I would love to do oncology, and the ideal place for that where I live is in the "other" hospital system from where I work. That gets into a few hairy details as to how much of the 401K employer match I get to keep, but I don't have any contractual agreements to work a certain number of years in my current job. There's a few other nursing specialties I've been drawn to, but oncology keeps coming to the top of the list.
If you made it this far, I apologize for the book, and the length is likely due to stress and lack of sleep. I suppose what I'm asking for is impressions from anyone who has read this thing as to what I should do next. Is it too early to restart the job search? I'm halfway through my BSN, and at only a year experience I'm not sure what I bring to the table beyond enthusiasm. My unit's management is likely to get a shake-up soon, but right now all we have is rumors, and I'm not convinced that a management change would make a difference. I already feel like my current manager doesn't know me and hasn't made any attempt to get to know me. As long as I don't screw up (I haven't, beyond the usual new nurse goofs) or kill anyone (I haven't), I'm not only not on her radar, I just don't exist. I would rather put my energy and efforts into a purpose that at least knows my name. I'm open to all suggestions, insights, and comments. What would you suggest I do?
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I've been a nurse for about a year and I just passed my 1-year mark on a highly specialized post-surgical unit. I love who I work with, but my unit has had some serious growing pains. We don't keep experienced nurses long, and brand new nurses are pressured into being charge at 6 months of experience. Through sheer dumb luck I have ducked that one. CNA coverage is patchy during the day and non-existent at night. Management oversight is a joke as our manager is also over another much larger and much higher acuity unit. In the year that I have worked here, I have never had a one-on-one conversation with any of the management. Our unit is on paper a step-down unit, but we work with Med-Surg ratios, and we are held to ICU standards. This all creates a great deal of stress among all the employees. I can't think of a single coworker that is not in management that has not either dropped to part-time or PRN or voiced that they are job-hunting. These issues have accelerated in the past year.
I'm also dealing with another problem that is exacerbated by the stress in this unit. I work nights, and I love the flow, the teamwork, the slightly different focus from days, and the managed chaos that comes from surprise ED admits in the middle of the night. Unfortunately, my body doesn't love it. Case in point, I'm writing this at 10 AM local, between shifts, and I really should be asleep. I have teenagers at home and one is special needs and struggling with highschool. Although I attempt to cluster my work days so I can have longer stretches of days off, I have never managed to switch well from being awake at night to being awake during the day, and back. I have this perpetual haze and overall sick feeling that lasts the entire time I'm off and doesn't get better until I'm working, but then I work myself into the ground trying to do it all over again. I was able to cope for a while, but I just can't keep it up. If not for the rest of my life, I would just stay on one sleep schedule days on and off, but as a parent, I can't do that, and I end up not even having a rest of my life. I recently had 8 days in a row off and I didn't sleep more than 4 hours in any given 24 hour period. This is taking a significant toll on my health and family relationships.
Reluctantly, I asked to switch to day shift. I know this shouldn't be a problem since the unit just lost over half the experienced day shift nurses. Not only are the positions open, they are desperate for them, while night shift is usually in better shape for staffing. At 1 year, I still consider myself new, but I don't need hand-holding and I get it done. I'm a little slow at charting, but I rarely leave late, and when I do, it is always a patient safety issue that came up near shift change. Most of what I need from more experienced nurses are a little guidance when I'm doing something for the first time and a quick check to see if I'm the right track when I get a curve ball. Now I've not been on day shift since my new grad orientation at just over a year ago, so I don't remember how to discharge a patient and I'm a little fuzzy on some of the standards expected of day shift nurses, but with a little direction from my coworkers I'm sure I'll get there, even if it is a little awkward at first.
I never got a reply from my manager. She just ghosted me. This morning, a few days after my request, I caught her when she did her 2-3 times/week check in with the unit which is always early in the morning. She spends the rest of the day on the other, larger unit and is generally much less accessible. She told me she got my email, but didn't think I had the right time-management skills to work day shift. I was completely flabbergasted and I didn't even know how to respond. I haven't had problems getting things done on time since orientation, over a year ago. Sure I'm not as confident or as smooth as some of the newer nurses, and I'm not as good as "faking it until I make it". I do think that I am right where I should be in my judgment, nursing skills, and yes, time management for a 1 year nurse. She made some vague comment about how maybe a position would open up by January, but I may have to wait until March. We'll see. Meanwhile, we have 2 nurses scheduled a couple of days this week to care for a floor that averages 18 patients. She didn't wait for an answer from me.
This unit is a good place to learn because we have our own surgical patients and a good deal of med-surg overflow, so I feel like I can really get good at something while still constantly learning new things. But I don't see myself working here forever. My 20+ year vision of my nursing career culminates with being an in-patient palliative care nurse, likely requiring an NP by the time I get there. I don't think I'm ready for hospice nursing, though that's on my short list, and I don't want to do general med-surg, though I do enjoy the med-surg that I get. I would love to do oncology, and the ideal place for that where I live is in the "other" hospital system from where I work. That gets into a few hairy details as to how much of the 401K employer match I get to keep, but I don't have any contractual agreements to work a certain number of years in my current job. There's a few other nursing specialties I've been drawn to, but oncology keeps coming to the top of the list.
If you made it this far, I apologize for the book, and the length is likely due to stress and lack of sleep. I suppose what I'm asking for is impressions from anyone who has read this thing as to what I should do next. Is it too early to restart the job search? I'm halfway through my BSN, and at only a year experience I'm not sure what I bring to the table beyond enthusiasm. My unit's management is likely to get a shake-up soon, but right now all we have is rumors, and I'm not convinced that a management change would make a difference. I already feel like my current manager doesn't know me and hasn't made any attempt to get to know me. As long as I don't screw up (I haven't, beyond the usual new nurse goofs) or kill anyone (I haven't), I'm not only not on her radar, I just don't exist. I would rather put my energy and efforts into a purpose that at least knows my name. I'm open to all suggestions, insights, and comments. What would you suggest I do?