Switching specialties and leaving ICU- will I be bored?

[smokeoverfire]

Has anyone switched departments to a specialty? I’ve been in the ICU since I graduated undergrad, and it’s always been my passion. Even when I was in Nurse Practitioner school, all of my clinicals I completed within the ICU setting.  I’m getting ready to switch roles, and it’s a little scary. I for sure want to leave where I’m at. I am not sure if I want to leave the ICU setting altogether and try something new, or if I want to continue in the ICU within a different institution. 

Where I’m working now, the culture is very toxic. I’ve never had this problem before with upper management, it’s only at this hospital as an advanced practitioner.  I work here as a nurse at the bedside for over five years, and I’ve never had this issue with management. The job that I had before this and my advanced roll, I did not have this problem with upper management either. However, I have been to two departments within this institution, within the ICU setting. In both departments, I am experiencing the same exact issues with upper management. I honestly feel that they had already made their opinion about me before I even started within the second apartment. It seems as though they talk to my old boss, I have not been heard, and they usually make a decision about a situation before they haven’t even spoken to me about it to get the pertinent details from my perspective. I keep getting called in to discuss minor things that I feel could have been explored in a non-official meeting. I received my first write up before I was even taken off orientation, which I thought was really weird, especially since it was over something that I had not been properly trained on how to do, and was a minor thing and did not result in any harm to the patient. It just resulted in an inconvenience for a consulted team. It’s been a downward spiral from there, and constant interrogations and accusations where I have not been heard. Overall a very toxic environment, and it’s time for me to leave. However, I love the ICU. I have always love the ICU, and I’m not sure if I want to leave it. 
 

My question is, is this what I have to look forward to within Annie ICU department as a provider? Is this the general culture when you’re in an advanced role in a high intensity setting? 
 

I have been verbally abused, yelled at, and I have been held to a different standard and presented with policies that do not exist. I do not feel it’s going to change and so that’s why I’m leaving. But is this the way that it is across the country within the critical care setting for advanced providers? 

Has anyone switched departments to a specialty like cardiology, onc, nephrology, surgery, etc.?  How was your transition? Did you get bored and your new role, or did you appreciate the comfort in knowing that she had better worklife balance?  All advice and input is greatly appreciated.

[JBMmom, MSN, NP]

I can only imagine that some of what you're dealing with is specific to the organization, otherwise there would likely be far more openings for ICU APRNs. The hospital I'm at is a teaching hospital and I can already sense a MD/APRN/PA hierarchy, but I don't know of anything like the toxic situations you describe.

As far as whether you'll be bored, hard for anyone else to know what's best for you. There are interesting and boring aspects to almost any job, so basically you have to weigh the positives and negatives and decide what's worth it for you. Good luck!

[ghillbert, MSN, NP]

I'm a supervisor of APPs in an ICU, and this is not usual in any ICU in my institution, or any local ones that I have heard of. I've actually only had to have 1-2 official meetings with someone who was just not improving after a year of training. Otherwise, the APPs do their thing, and I arrange trainings and orientation, and bug them about doing competencies that are hospital-required, but otherwise leave them alone. I have worked outside the ICU and I certainly missed the pace and went back to ICU, as have several APPs that I have hired from other settings who wanted to get back to ICU.