Should I leave nursing?

[CRNAorBust]

Hi everyone,

I've been doing med surg nursing for almost a year and a half and have noticed I'm not very good with critical thinking. The fast pace of Med Surg work is also hurting me physically and pyschologically.

I would like to move to some other type of nursing but EVERYTHING seems to involve critical thinking skills which as I said is not my forte.

I am good at teaching but then there would be the need to do clinicals. I am good at troubleshooting technology (use to work in computers), and at interfacing with patients/families etc.

I'm also a very good team player.

I'm really in need of getting out of my med / surg state soon before things go REALLY badly (already had one med error that was due to a very stupid thing on my part).

Any feedback would be greatly appreciated...

[Mommy TeleRN, RN]

Do you think you'd do better in an area where you only have to focus on one patient at a time perhaps? How many patients are you taking on the medsurg floor?

Maybe you would enjoy being a patient educator in a certain area?

I notice you are in your 50s...what kind of work did you do before nursing that you felt successful in? Maybe that would help you find your strong points to think about that.

[pagandeva2000, LPN]

Hard to say, research, or education maybe? Or, if you are looking for a clinical setting maybe ambulatory care.

[chachh, BSN, RN]

Have you thought about hospice care through a home health agency? One visit at a time. There is some clinical care with the patient but you also educate and are supportive with the families of the dying patient. This would/could involve spiritual care depending upon needs of the family, but you would also have a resource/interdisciplinary team to help provide care. It can be a very fulfilling area of nursing.

[CRNAorBust]

Hi everyone and thanks a bunch for taking the time to reply.....

Regarding the question about how many patients we have.....it's 5 to 6 and that of course doesn't take into account the acuity of the patients, and or the number of times they have you in and out of the rooms.

So yes, perhaps one at a time would work. Where do you do that type of nursing?

And what's it like in hospice? Is that one on one? Is that in people's homes?

Thanks again everyone.......

[CaLLaCoDe, BSN, RN]

Have you considered becoming a discharge planner. One who arranges for placement at home, placement at rehab hospital, finishes up loose ends needed for discharge by the physician/staff nurse. You wouldn't be having to stress out if you should give or hold the Dilauded and you'd -- if you worked at my hospital -- only work week days.

How about an infection control nurse; also not required to run a code or be a direct care provider. Just make sure those that are on isolation still need to be and make sure people are washing their hands lol

Both of these titles are teaching oriented. Good Luck!

And of course there's always becoming a clinical instructor for a college or university.

The list goes on and on I'm sure.

[Mommy TeleRN, RN]

Some areas where you do one patient at a time:

Surgery

Radiology (think arteriograms, vascaths, etc)

Cardiology (stress tests, echos)

Cath lab (nurses take turns circulating, recording procedure, or scrubbing)

There is also case management (not sure how much experience they require) but here you are mostly working with charts and helping with discharge planning.

Wound care - you go around and assess wounds and write orders for wound care, change out dressings, wound vacs, etc.

PICC team - would probably need a lot of IV experience for this. You have to become PICC certified. But you go from patient to patient and do the procedure at the bedside. They also do the hard IV sticks (they can use the doppler to help locate deeper veins), change dressings on PICCs weekly, etc.

There is also ICU where you have less patients to juggle, but you are working with more critical meds so if you are really concerned about pt "harm" then that may not be the area for you if you think you are going to be prone to making a serious error.

Pt educator: you edcuate pt on new diagnoses or if they have not been compliant, educators usually specialize in one area ie diabetes or cardiac.

That is all I can think of for right now. Hopefully doing the med surg now for one year will open up to an area you feel more comfortable with. Med surg just isn't for everyone. Juggling so many patients might be your main problem and make it hard for you to keep things straight. Have you thought about what you can to do more effectively manage your time? I know it's hard as I am learning this myself as I'm in orientation. Right now I'm taking 4 patients and eventually it will be 6. Perhaps you didn't really have enough orientation to really get down your time management. Personally I feel much more organized when I use a sheet I created for myself that is more suited to how my mind works and helps me stay organized. I keep a running to do list on it for each patient so that I can grab everything at once like when I'm in the supply room or up at the front desk.

[Mommy TeleRN, RN]

TeleRNer - those are great tips. I'd be leery about clinical instructor though. Talk about juggling...you not only have to worry about YOU making mistakes but also up to 10 students...eek! I don't think I could handle it lol...the more I think about it esp in my last semester when we had more autonomy the more I appreciated how much my teacher was putting upon her license... there was many more than one occasion where she kept us from giving a med that we needed to hold - ie a beta when the HR was low, or PRN Tylenol when pt already had narcotic with tylenol...etc. I don't know HOW they keep everyone's pt straight! But I know there are teachers who strictly do the lab supervision..that might be fun teaching skills to the students :)

[CRNAorBust]

Alot of these suggestions are great.....I think in the long run I'd probably feel better about doing Research. But the one program I have found which has an MS - PhD program is expensive and would require me to do it full time and spend alot of time trying to put funding in place to ameliorate the debt load. So that won't be possible for a few more years i would love to do teaching but as you all realize that requires also doing clinicals which i would not feel comfortable with.

My actual organizational skills are really not that terrible. It's just at the end of the day we often get hit with additional orders that we can't always get done PLUS things tend to go wrong and a patient may lose their IV access and there goes the chance to give the IV meds that were just ordered OR I don't have alot of time to ask for help to have someone else put in an IV on a tough patient who's a hard stick. Then the nite shift gets short shifted with more work that I couldn't finish up. It's a very unsatsifying situation.

I will definitely look into Hospice care. Is this done at people's homes? Or is this done in a hospital? I'm not so thrilled about going to someone's home. You just never know how clean the situation will be and how likely it might be you'd catch something in the field. Also you might run into someone whose got psych issues. I know of a texas woman who does home health care a few days a month and she needs to bring the marshal with her for one patient who has psych issues and also has guns in the house (EEK).....

And finally, what i use to do before nursing is work as a computer consultant with hardware and software issues. That was satisfying since i did teaching and loved working with technology. I know about informatics but that's not so easy to get into. Not a big demand. Also requires alot of networking to get a foot in the door. Plus you don't interact with people as much.

Thanks again for all the feedback.....

[grammyr]

My actual organizational skills are really not that terrible. It's just at the end of the day we often get hit with additional orders that we can't always get done PLUS things tend to go wrong and a patient may lose their IV access and there goes the chance to give the IV meds that were just ordered OR I don't have alot of time to ask for help to have someone else put in an IV on a tough patient who's a hard stick. Then the nite shift gets short shifted with more work that I couldn't finish up. It's a very unsatsifying situation.

What you have described here is a typical day as a med-surg nurse. One can never predict when these things will happen, but you can bet your butt that it WILL happen toward the end of the shift and when you have another patient going bad and will happen to at least 2 of your patients at one time.

[RNperdiem, RN]

If you enjoy teaching, look into that. The catch is that you will need enough hands on experience beyond book learning to really be an effective teacher. How much is enough? That is hard to judge.

[Quickbeam, BSN, RN]

What about case management? It does require critical thinking but in a far less stressful environment, without the crisis component. You'd be amazed at how sharp you really are away from the chaos. Not everyone thinks their best in a tornado. CM is also far kinder physically and tends to have normal hours. I found the pay equal to hospitals in my area. Best wishes to you!