stress and needing to go back

Hey!

I have been a nurse in Long Term Care for 15 years. Over the past three years, I have job-hopped, searching in vain for the kind of environment I started in so long ago, but I fear that it is slowly disappearing. I am an LPN, on the front lines at the nursing homes. There arent enough RNs to do the supervision. The last job I had, I very nearly cracked up, with fifteen skilled residents and another twenty or so intermediate care residents. I could have done even that, and I did a fair job of it, until the one night I had a man with sudden onset severe SOB, cyanotic, poor air movement....and the first thing I thought was PE. I had seem them before and he just had "that look" about him. We were required to call the DON prior to any dishcharges to hospital, because the facility was losing census. Natually the DON wanted the man treated in-house (no RN available to get a line in this guy, he's got o2 cranked up as high as it will go and he is satting at 85%.

I got a little huffy with the DON, finally telling her that I was going to send the man out because that was what the daughter wanted and we did not have a DNR form in his chart. In the meantime, I seriously lost my temper, sent my little guy out, where his DDimer was elevated and they were going to send him for an MRI to rule out PE. I finished my work and left, said I would never go back to nursing.

I dont think I am a burned out nurse, in the sense of having apathy toward my patients or not caring what happens to them or to my fellow staff. I am sick and tired of the system that places the staff in un-winnable situations and will not let us do our jobs. I keep looking for a place that will truly put the Residents first. And since I have been not nursing for two months, I am finding a lot of baggage coming out in my dreams. Dreams of being overwhelmed with Trauma patients, or being at a job where the patient load is impossible. I get shaky when I think about going back....and yet, I want to.

My mom keeps telling me I need to get in on a Hospital and see if that makes any difference. I just dont feel ready to give this up. Any thoughts, explanations, advice? Many Thanks!

SJ