Sick of floor nursing, what now?

[r0seRN]

I'm getting tired of floor nursing. And I'm getting burnt out on night shift.

I've only been nursing for a year and a half. We're always told that med-surg is where you should start to get your experience. I just don't know where to go from here. What do you do when you don't WANT to advance to another area (within the hospital)? I don't want ICU/ED/L&D/Mother/baby/PACU/OR/Charge nursing/Case management.

I love everything about the job of night shift, but it's killing my body. I miss sleeping normal human hours, and being awake for the day. I miss the sun. However, it's not as simple as switch to days”. No way in HELL I would work dayshift on the floor. Less pay, more stress, more families and doctors and discharges. No thanks.

The only non-hospital options I can come up with are all ones that include a paycut, but I'm seriously at the point to where the money isn't worth the physical and mental exhaustion anymore. I'm considering home care, clinics, doctors offices, or one of those work from home insurance approval positions.

I don't need the excitement or challenge that drive some people. I like stable, steady, routine. I want to do my job, know that I helped someone in some way, and go home. I don't want to feel like I'm spread so thin that I barely get the tasks done, not able to give a patient quality care because I have to rush off to another, walking on eggshells, and sit here on my days off dreading the next day.

I feel stuck.

I would appreciate advice from those like me who have made the change from floor nursing to other positions, and how it turned out for you.

[Oh'Ello, BSN, RN]

I'm confused. You say that you don't know what to do, but you don't want to go to another area. So do you want to go or not? You say you've come up with other options that involve a paycut...what were those options?

[r0seRN]

I did say I don't know where to go from here. I meant that we are told to start in med surg (where I currently am) and change to another position when you get the experience. However, every other position within the hospital that I could transfer to, I'm not interested in.

All the other options (non-hospital) are the ones that would involve a pay cut, include home care, clinics, doctors offices, etc.

[Oh'Ello, BSN, RN]

What about a different kind of floor and not a different level of care. Working on the floor and working med-surg floor are two different beasts. I used to work oncology (Heme maligancies and SCT) and loved it (for the most part). Our sister unit was a gen med floor and it was a horrible nightmare being pulled there. In one shift you could have a geriatric stemi, a fracture repair, a post-trauma and a gi bleed as your assignment and it would be mayhem. Is there a particular kind of patient you like more than others? Are there any pathologies that particular interest you? Does your hospital have specialized floors with different populations? What kind of tasks are you good at? What aspects of nursing care really interest you? These are the kinds o questions you should ask your self in figuring out where to go.

Doing a specialized floor would be my only advice. It would help you keep the routine aspect that you crave, as most of the patient's would have the same problems, the same doctors, your probably only dealing with a handful of medical services

[r0seRN]

When my unit is over staffed I have been sent to other units such as oncology and ortho, and it is the same feeling. I'm looking for more information from people who have left the floor for non-hospital positions. I just don't want it to be one of those instances where the grass looks greener on the other side.

[Mr. Nightingale]

I suggest taking a couple months off work under FMLA or stress leave to reflect on your life as well as your career and what you really want.

I know this sounds probably unreaslistic however im sure it will help.

[r0seRN]

That is a wonderful thought, but not doable at this point in my life (bills, etc). I know I need a change, I'm just scared to make the jump and put myself out there. I've become comfortable at doing the job. It's the environment, schedule, and stress of the hospital/acute setting that is getting to me. I wish I could hear from someone who has been there, made the change, and give me some kind of hope that there are better options out there that are worth making the change. I just can't see myself doing this forever.

[nutella, MSN, RN]

I worked in a variety of areas - one position I really liked a lot was acute dialysis - which is dialysis in the hospital. I dialyzed patients in all critical care areas, in a hospital acute dialysis room, did CVVH and was getting trained in apheresis. BUT this might not be for you as it typically requires some more experience, preferably critical care or similar and you work long days and frequent on call - which is one of the reasons I left.

Supervisor and clinical manager - besides the fact that I feel most manager positions seem to just suck life out of people (middle management ...) I enjoyed clinical management but not the financial aspect and was pushed to agree on things that I feel are not right - so I left. However, also not for you - you need experience.

Community care - home palliative care/ home hospice care - I really liked that a lot as well. Home care is not for everybody though. I enjoyed the 1:1 but documentation can kill you. If you are very organized, focused, fast with computers and have good nursing skills perhaps home care is something you would enjoy. I liked palliative and hospice care as opposed to regular home care. Pro is usually daytime work, independent, make your own schedule, more time off - cons usually less pay, a lot of driving, no space in the trunk of your car, documentation is crazy and many nurses do not get it done within their allowed time when they are salaried ( most places will pay you salaried - the title is usually case manager but that is not a desk job - it is community based). I liked that I felt I had real impact plus see what is actually going on at home. If you do not like one case - fine - most likely they will be discharged soon anyways or in hospice they pass. Community based care is very different from hospital care and I have seen nurses come and go - they think that it is "easier" than hospital work but in fact it is not easier - it is different. If you are interested find a reputable agency that is large and connected and takes patients from local hospitals - you see very sick patients in home care. I also did home chemo and accessed ports , tube feed teaching ....

You do not have much experience,which will limit your choices but there are other areas of nursing - they might not pay as well. I did evening shift in a teaching hospital for years and enjoyed those but of course you start in the afternoon and have discharges and admissions as well.

I liked critical care as well - there are different critical care areas that are all slightly different.

If you do not have a BSN perhaps you want to go back to school - a BSN will probably increase your chances of getting a different job.

[OrganizedChaos, LVN]

Have you looked into corrections? I have never worked in a hospital but it was easily the funniest & more relaxed jobs I had. But you have to be the right person for it since you are working with criminals.

[roser13, ASN, RN]

How about ambulatory surgery center? Still hospital-type nursing (slower paced but still challenging), M-F, no weekends, no holidays. As a result, often hard to get into, but worth the wait. And if the ASC is connected to a hospital system, the pay scale is the same as the hospital's.

[LovingLife123]

I can understand your feelings to an extent. I love the flow of nightshift but I miss the sun and not being so tired all the time. It messes with your total mindset and maybe you are not thinking clearly about other positions right now.

Im in an ICU. No more than two patients, ever. I think ICU is way better than medsurg to start. People have this steadfast belief that all nurses need medsurg experience. No. Having anywhere from 4-6 for a new grad is crazy. How you get meds passed and do assessments and chart all of that is crazy. They don't get enough experience to see when things are starting to go bad with a patient and we expect to foresee all these things with no experience. Then, the pt ends right back in the ICU.

In the ICU, you only have two patients and you are constantly assessing. Full head to toe assessments every 4 hours. Your patients are always hooked up to monitors. You can see heart rates, blood pressures. You can see when things are going south. I feel it gives you the best experience to start out. Plus, a couple of years in ICU, you can get that non-acute job you are craving.

Just think about it. I'm sorry nightshift is messing up your body. It has been for me as well. I miss my family terribly because even on my off days, I'm sleeping.

I just think telling new grads, oh you need to work medsurg to start and you must do nights there as well is wrong. Getting some experience in ICU I think would help you greatly. And yes, there are families and more docs on days, but you get that experience working with the physicians and with families, sometimes, you just gotta be firm, but kind, and let them know you are in charge, not them.

[Ruby Vee, BSN]

I did say I don't know where to go from here. I meant that we are told to start in med surg (where I currently am) and change to another position when you get the experience. However, every other position within the hospital that I could transfer to, I'm not interested in.

All the other options (non-hospital) are the ones that would involve a pay cut, include home care, clinics, doctors offices, etc.

If you like where you are, then stay!