Thinking of leaving ED after 6 months

[NicoletheRN]

Hey there fellow nurses,

I got my first RN job in the Emergency Department at a great hospital here in California back in December of 2014. I love the hospital and I signed a 2 year work agreement to stay within the hospital system for 2 years. I always thought the ED would be "fun" and exciting as a nurse and was super stoked to be offered the job from 500 other applicants. I was an LVN for 4 years prior to becoming an RN and I worked in a nursing home; learning how to interact with doctors and families and learning some time management as well. Fast forward to today, 6 months in the ED and I am a complete nervous wreck. I'm a pretty calm and collected person and have never had anxiety issues in the past but now I can't eat, sleep or function properly outside of work. I tried to be logical and thought that I was just adjusting to the new nurse role; but it's been 6 months and It seems to only be getting worse. I'm cool as a cucumber during work (freaking out and screaming inside of course) but after work I'm a mess. It's not the new nurse role that is affecting me--I can interact fairly well with doctors and nurses and patients and families--I can advocate pretty well for patients and stay on top of labs and medications. I know when to admit that I don't know something and to ask for help. What I can't seem to cope with is the stressful environment of the ED; and well that's what the ED is! Knowing that I am going into work and I will be responsible to either save someones life OR have a matter of very short minutes to prevent them from crashing/coding/dying is what I cannot handle. I know that I am new and I can't know what I don't know and it will come with time; but I am not sure my nerves/health can wait for that "time" to come. I've gotten great reviews from my preceptors and fellow peers so I know in their eyes I am doing well and progressing as I should as a new grad nurse but personally I feel I am going to burn myself out if I stay in the ED. I know that any nursing job, especially as a new grad nurse, is going to be stressful but I don't want to be sick and dread going into work like I do now. I think I should speak with my director and be honest and open about my feelings and see if there is another unit I could move to; but I am afraid that he would take this as my resignation and I would be out of a job with only 6 months of RN experience under my belt.....So just wondering what some of your thoughts are? Thanks in advance!

[PacoUSA, BSN, RN]

You should stay a least a year. 6 months starts to give you the reputation of a jumper and you don't want that on your profile. 6 months hasn't begun to recoup what the department has invested in training you as a new RN and your next department will wonder if you will do that to them as well in considering whether to hire you on.

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[HelloWish, ADN, BSN]

I don't think anyone should stay in a job that is making them sick. Your idea to speak with the director about transferring departments sounds like a good idea.

[MunoRN, RN]

Unfortunately in most RN roles you aren't going to be able to avoid having patients who could be on the verge of crashing, so you should make sure you've exhausted all the resources available to help cope with how you are feeling, particularly since the feeling is pretty normal in a new grad or even with an experience nurse in a new role. I work ED, ICU and tele mostly, and between the three I actually find ED the least stressful in terms of a patient's propensity to crash. I might get a patient on the verge of coding but I'll also get a few with the sniffles, so on average I find it less nerve racking than the ICU or tele where you're going to have a load of patients who have all been deemed to be potentially unstable. So before you go leaving your ED position for something else that won't be any less stressful I'd pursue coping options which vary from facility to facility but generally they should be something that your CNS or manager could direct you to.

[thenightnurse456]

I think you should talk to your management and also some sort of counsellor to talk about how you're feeling.

Most job areas will be high stress unfortunately, it's not just ED where your preventing people from crashing.

[NurseSmallHands]

Vicarious traumatization.

It's a thing.

It comes from witnessing fresh trauma repeatedly.

could also be PTSD.

You probably need some counseling.

do you have critical incident debriefings where people can talk about their feelings after bad codes and high profile incidents?

[Oceanpacific]

Some employers have really excellent Employee Assistance Programs that provide free short-term counseling. Or, through your health insurance you could find one. I can't stress enough the value of being able to get all those anxieties out there.

I'm worried about you. Take some cam, deep breaths. Take one piece of paper and create 2 columns. One should be "Things I Like About My Job" and the other "Things I Don't Like About my Job". See if any of your dislikes can be lessened or tolerated.

Most of all, be kind to yourself. Do you still have a preceptor? Maybe he/ she could share some insights about

your performance.

Lastly, do not beat yourself up. It is a job, not a prison. What other departments in the facility do you think would be better.

I am am sorry for your suffering and I hope you find a spot in nursing that is less fraught with constant anxiety. You sound like a great person who need support and perspective on making the best decision for you.

[Weary1]

I disagree with some of the posts saying you should stay..you are fairly new as an RN but you are NOT new to nursing or healthcare. You sound mature and thoughtful..if the job doesn't fit you it doesn't fit. Sometimes the excitement/fantasy we have about a job and the reality are not even close. ANY job that you makes you physically, mentally, emotionally or Spiritually ill on a chronic basis (not just a bad day here or there) is not one to stay in when there are other options. A job you have to take medication or go to counseling for (when it's only the job creating the discord) is also one I would not stay in.

I worked in a hospital setting for years, left for about 4 years and returned earlier this year...I realized quickly, that like you, I could provide great care, deal with coworkers/physicians, etc. but feeling like you do is exactly how I felt and I realized that I, as well as the hospital setting, has changed. I shifted to PRN and will be leaving completely for another position outside the hospital setting in a few weeks. Part of me felt badly, like a failure in some way but the fact is, the failure would be staying in an environment that just doesn't work. I also realized I am the one getting up, going to this job that is not a good fit, that I really don't want to be in the hospital setting any longer and I don't have to explain it to anyone. This was a "biggie" for me.

My leaving will also open a position for some other nurse who may be feeling the same way where ever he/she is working and allow someone else to change their situation. My unsolicited advice is if you can change to another unit, do it now. Yes, there is stress is all areas of hospital nursing but there are more controlled units than the ED and yes, a patient can code anywhere, but the likelihood is less on some units.

Life/time are too short - the "golden" year rule doesn't really apply in your case since it sounds like you have to stay with the employer for a few years. Look into outpatient surgery or something similar, but whatever you do, don't keep going down an emotional and physical hole because of some invisible year mark. Take care of yourself.

[ChunkyM0nkeyz]

As a new nurse (graduated Dec 2014 as well) what I have found most helpful was stress reduction. It is easier said than done but it is a must. Leaving work at work is difficult. I am quite a believer in quite meditation before and after work to reduce anxiety. There are a lot of free apps that offer guided meditation for a time frame of your choosing. It helps keep your mind off of the high stress and anxiety of the job. Also, while overtime time and extra shifts can be tempting...just say no. Do not take on more shifts until you are able to cope and reduce stress in this line of work. I'm going to use this cliche phrase but "take care of yourself first!" You cannot take care of patients if you yourself are in bad shape. In order to do that I picked back up my old hobby: painting. Your life does not revolve around work..so why should it control you? Take care of yourself. You need a break too!