Still don't know where I belong :/

theRNJedi · Feb 24, 2015

Hi. I'm going to give you some of my thoughts on your questions.

1. Congrats on completing your first year...IMHO it is best (for you) to stay where you are and gain another year or two in the same position before changing specialties. There's a lot of reasons I recommend that but in short, for your situation, you're somewhat still a 'new grad' and you would feel so much more confident and be more marketable with one or two more years in the same job and specialty. If you were lucky enough to land a residency - be grateful because many new grads are struggling. You have a whole career ahead of you to change specialties, now's the time to get really grounded as a nurse. And here's a tip...nursing can burn you out wherever you go...it's hard work and healthcare is imperfect...so the grass is never perfectly green on the other side.

2. I would recommend you stay 12 hours while you can with a kid - you have two extra days off each week (totaling 4 whole days from work)...do you know how many parents would die for such an opportunity to work 3-12hr shifts a week!? ...if you go to 5 days a week, yeah you get home earlier, but it can be more exhausting to do the work routine 5 days a week than just 3. Having said that, this is a personal call for your life. Some people prioritize being home for dinner and others prioritize having the extra days (which could be used to work prn in other jobs like HH, or participate in your kids school, etc...). Plus, there are jobs that are 4-10hr shifts...have you considered those options?

3. Pursue your BSN and make it a priority. ADNs are competent, qualified, and wonderful nurses...but healthcare is evolving and organizations more and more are giving preferential consideration to BSN/MSN nurses. Don't be held back...get your BSN to optimize your qualifications and expand your marketability.

4. I would also aim to become certified in your specialty. Possessing a specialty certification is a very big deal.

-TheRNJedi

nurse.j., ASN, BSN, MSN · Feb 24, 2015

Hi. I'm going to give you some of my thoughts on your questions.
1. Congrats on completing your first year...IMHO it is best (for you) to stay where you are and gain another year or two in the same position before changing specialties. There's a lot of reasons I recommend that but in short, for your situation, you're somewhat still a 'new grad' and you would feel so much more confident and be more marketable with one or two more years in the same job and specialty. If you were lucky enough to land a residency - be grateful because many new grads are struggling. You have a whole career ahead of you to change specialties, now's the time to get really grounded as a nurse. And here's a tip...nursing can burn you out wherever you go...it's hard work and healthcare is imperfect...so the grass is never perfectly green on the other side.
2. I would recommend you stay 12 hours while you can with a kid - you have two extra days off each week (totaling 4 whole days from work)...do you know how many parents would die for such an opportunity to work 3-12hr shifts a week!? ...if you go to 5 days a week, yeah you get home earlier, but it can be more exhausting to do the work routine 5 days a week than just 3. Having said that, this is a personal call for your life. Some people prioritize being home for dinner and others prioritize having the extra days (which could be used to work prn in other jobs like HH, or participate in your kids school, etc...). Plus, there are jobs that are 4-10hr shifts...have you considered those options?
3. Pursue your BSN and make it a priority. ADNs are competent, qualified, and wonderful nurses...but healthcare is evolving and organizations more and more are giving preferential consideration to BSN/MSN nurses. Don't be held back...get your BSN to optimize your qualifications and expand your marketability.
4. I would also aim to become certified in your specialty. Possessing a specialty certification is a very big deal.
-TheRNJedi

Thank you so much for taking the time to share your thoughts. I kinda have had a little intuition that says 'hold out a little longer...enjoy the extra time off and get your BSN'. I think I've been so focused on how to get out of my unorganized unit, that I am expecting things to be magically easier if I go somewhere else. AND that going to 'normal hours' will also be so great. Perhaps I should wait to worry about regular hours once my son is in full-time school? (Which won't be until Fall 2016...that's a ways a way). So how do I keep my spirits up at my current job? I love my coworkers...but the unit is poorly managed, extremely short staffed and unorganized which makes for really long hard shifts most days. Other days...it's not so terrible and I really enjoy being a nurse. Appreciate your thoughts and time. And good idea about additional accreditations!!! :)

paulinejoyRN · Feb 24, 2015

Your replies. spot on. RN Jedi indeed, *bows*

paulinejoyRN · Feb 24, 2015

I agree with the first reply. To answer your questions myself:

1. Stay in the hospital but different unit?

- Stay where you are. You're learning a lot, and yes, it is stressful, but you're also learning a lot from your everyday challenges. Like the RNJedi commented, all nursing jobs come with similar stress and the need to juggle work/life/rest. You've already got 1 year of experience in your unit, why not continue to improve your practice there. I'm sure you'll feel more confident, slightly less stressed, and more marketable when you decide to look for a new job. Jobs for new grads are rare, and having a resume that proves you can commit to a unit/facility for more than the required contract term is a good sign for future employers. You will continue to learn and master your skills on your current unit.. then almost every other unit after will be easier. If you want to try other units, why not stay at your current unit, but offer to be part of the float team so you can moonlight on other units and see how you like them. The grass is always greener on the other side, but not always that great once you're on that other side.

2. 8's or 12's?

- 12's all the way. If you think you're tired from working 3-12's, think about working 5-8 hour shifts. By 12-1pm you'll be struggling to catch up on charting, completing afternoon tasks, and next thing you know.. change of shift.

Some ways my colleagues have made 12 hour shifts work better for them and their lifestyles:

- switch to NOCs.. you still get to see your kids in the AM and take them to school. Then sleep while they're away.

- OR-- stick with a consistent wake up time, even when you're not working, and a regular workout schedule. It'll make a huge difference for your body and mind.

3. Try something all together different with 'normal hours' in something like clinic or HH?

-- HH may seem like it has "normal" hours, but trust me, you will be charting after 5pm at home. You will be performing follow up phone calls that don't necessarily fall in normal hours. Also, having more acute care experience will benefit you for when you decide that you want to try home health or outpatient care. One of my previous colleagues even told me that she spends so much time charting at home that her kids barely see her face. Something to think about.

Opportunities like the one you're in (working 12s in the PCU) are harder to come by without your BSN. Nursing is evolving, and many initiatives encourage nurses with their ADNs to pursue their BSN. Many hospitals here in CA won't even hire applicants without their BSN.

You're on the right track. Don't question yourself too much, Nursing is stressful, but you're gaining the experience to eventual gain mastery over your practice. Believe in yourself! I believe in you!

theRNJedi · Feb 24, 2015

Nurse.j., ADN - you may not realize that your challenging shift work is teaching you something, but it is. To keep your spirits up just do your best to see the silver lining of the experience, focus on the good things, and just fall back on the fact that this is just for a season; a stepping stone for yourself professionally. It's OK to get upset and irritated at the things that are wrong, bad, and unfair...but rise above those moments and maintain a professional composure and work through things diplomatically. You will garner the respect of your peers, patients, physicians, and leaders. It's hard I know; we've all been there, but it will pay off. In the meantime, be the nurse that stays the course.

-TheRNJedi

nurse.j., ASN, BSN, MSN · Feb 24, 2015

I agree with the first reply. To answer your questions myself:
1. Stay in the hospital but different unit?
- Stay where you are. You're learning a lot, and yes, it is stressful, but you're also learning a lot from your everyday challenges. Like the RNJedi commented, all nursing jobs come with similar stress and the need to juggle work/life/rest. You've already got 1 year of experience in your unit, why not continue to improve your practice there. I'm sure you'll feel more confident, slightly less stressed, and more marketable when you decide to look for a new job. Jobs for new grads are rare, and having a resume that proves you can commit to a unit/facility for more than the required contract term is a good sign for future employers. You will continue to learn and master your skills on your current unit.. then almost every other unit after will be easier. If you want to try other units, why not stay at your current unit, but offer to be part of the float team so you can moonlight on other units and see how you like them. The grass is always greener on the other side, but not always that great once you're on that other side.
2. 8's or 12's?
- 12's all the way. If you think you're tired from working 3-12's, think about working 5-8 hour shifts. By 12-1pm you'll be struggling to catch up on charting, completing afternoon tasks, and next thing you know.. change of shift.
Some ways my colleagues have made 12 hour shifts work better for them and their lifestyles:
- switch to NOCs.. you still get to see your kids in the AM and take them to school. Then sleep while they're away.
- OR-- stick with a consistent wake up time, even when you're not working, and a regular workout schedule. It'll make a huge difference for your body and mind.
3. Try something all together different with 'normal hours' in something like clinic or HH?
-- HH may seem like it has "normal" hours, but trust me, you will be charting after 5pm at home. You will be performing follow up phone calls that don't necessarily fall in normal hours. Also, having more acute care experience will benefit you for when you decide that you want to try home health or outpatient care. One of my previous colleagues even told me that she spends so much time charting at home that her kids barely see her face. Something to think about.
Opportunities like the one you're in (working 12s in the PCU) are harder to come by without your BSN. Nursing is evolving, and many initiatives encourage nurses with their ADNs to pursue their BSN. Many hospitals here in CA won't even hire applicants without their BSN.
You're on the right track. Don't question yourself too much, Nursing is stressful, but you're gaining the experience to eventual gain mastery over your practice. Believe in yourself! I believe in you!

Wow, thank you so much for your support as well! It's so nice to hear from experienced nurses that understand. I have a ride along scheduled tomorrow with a HH company and I'm going to go just to see what it's like...maybe actually seeing what it's really like, I'll appreciate the 3-12's I work and time I get at home with my son. But I won't be making any decisions just yet. I made it over a year, I can do another and be even more marketable once my 2 years comes. Should I start on my BSN then in the meantime? Thank you again :)

iluvivt, BSN, RN · Feb 24, 2015

I agree with the others. You do not want to be trying to learn a new speciality as well as start a new job AND work on your BSN. Secure your future by starting on that BSN.Even the one programs move quickly with papers and assignments coming at you at a fast pace.

Libby1987 · Feb 24, 2015

I've been a career HH nurse and I love it. It's been family friendly with my flex schedule but I've been doing it forever. The first year for any nurse is rough and more so for a newer nurse, though newer nurses often have an easier time with the charting having come from care planning and more than likely are computer literate. The newer nurse will have less experience and confidence in assessments and decision making, the more you bring with the better the learning curve.

Re tomorrow's ride along, those are a good idea, I've taken many with me but unless you spend the week with someone or go home or back to the office with them you won't see the whole picture. What it will give you is an idea of the patient care and interaction which most love and can see themselves doing. That part is great, it's the hours spent learning your resources, reimbursement and regulations, time mgmt and planning for driving a different route everyday and then the

PAPERWORK that you won't get a realistic view.

Home health, depending on how you make it, can be incredibly rewarding and worth all the paperwork to me, which I can do anywhere including sitting in my car waiting for baseball practice to end and not have to miss hardly anything.

But research it and prepare for the first year to consist of long stressful days until you get the hang of it.

paulinejoyRN · Feb 24, 2015

Right on!!! I love home health. It's a different beast, but sooo awesome

paulinejoyRN · Feb 24, 2015

Honestly, if I were you-- your contract ended, focus on getting a permanent position. Focus on that, and when it's less stressful and you feel more comfortable due to your competence, then add the BSN. Focus on one big learning adventure at a time so you can give yourself the most energy and time to really get the most out of each experience. You'll do well, just remember to make time for self care!

nurse.j., ASN, BSN, MSN · Feb 24, 2015

Thank you ladies!! I will go to my ride along today and get a feel and ask lots of questions and then if they offer the job to me and the pay is right, I'll give it a go. But either way, I'll go with my gut. I still have a permanent position at my hospital (I meant my residency contract ended...we had to commit a full year after residency)...if I do decide to take the HH job, I'll see if I can keep on call status to not lose my seniority, benefits, etc. And if for whatever reason HH doesn't work out, I can always go back.

Libby1987, the schedule of HH and the theory behind it all is what really drew me to the profession. I have struggled with 12 hour hospital shifts as a single mom and finding care for my 4 year old...I like knowing I can flex my schedule to be off in time to pick him up from school/daycare, take him to an appt or whatever I need to do. I am a little nervous about charting at home, because I'm afraid that will take time away from him, but I can always do it after he's gone to bed and my weekends will be free to spend QT with him. Is HH a single mom friendly schedule? I'll let you know how to today goes!