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setsuna92 setsuna92 (Member)

Thinking about returning to nursing

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I've been lurking around all nurses for a while contemplating whether or not I should give clinical nursing another try.

When I graduated in 2015, I was hired in to a pedi unit where I seemed to do well. There were a couple of hiccups here and there, but my fellow coworkers were hopeful that I would succeed. In a mixture of low self esteem and an undiagnosed mental disorder, I couldn't bare to work at the bedside for longer than 6 months. I know it sounds dramatic, but it was the truth. I contemplated suicide almost every day. I left the bed side for another position at our local mental health clinic. It was not a nursing position... it was more like a case management/education job. I remained there for a year and a half until my symptoms flared up again, which led to hospitalization. I had always considered myself to be depressed (so did my doctors), but after a comprehensive assessment with a psychiatrist, I was diagnosed with bipolar disorder II. After that, I was on FMLA on and off, trying to figure out my medications and treatment with my psychiatrist and therapist. At this point, management (at work) was very involved in my recovery. This was good, as they worked with me and got me the help I needed. It was also bad because my recovery was not progressing as quickly as they expected. They began implementing goals that I would do my best to reach monthly, but I was always short. I called all my clients every day, schedule and double book appointments, but only a hand full of clients would come in weekly. I felt personally responsible. In the end, I felt I was no longer an asset to the company and looked for other jobs. I took a part time job where I do... nothing... But it has given me the opportunity to rest.

I've realized where I went wrong in my previous jobs. From lack of disease management, to organization, I know that it was not just the illness, but also my character. I feel like I have a different outlook and I want to try nursing again. I've been looking at psychiatric hospitals because I've always wanted to work there but I never had the guts to move away from my home town to pursue it. But I'm afraid that I'll go back to that dark place. I can't afford to lose myself again, for the sake of my son and husband. I've been stable, with no symptoms, for 4 months now. I'm pretty restless in my current job, and I always find myself looking on Indeed for psych rn positions, I even day dream about it. Does anyone have input or experience they'd like to share? I hate to come across as whiny or needy, but I honestly feel pretty lost.

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You have my sympathies. I'm a "retired" nurse with bipolar I who had to leave nursing entirely because of it. With the occasional hypomanic episode, I've been stable now for a couple of years, but I'm living a comparatively stress-free life being on Social Security Disability so that helps a lot. I can't imagine a world in which I'd be able to go back to nursing though. I'm too old and used up.

That being said, I think there are plenty of opportunities for you to continue in your career, as long as you manage your illness correctly and can remain stable for long periods of time. Not all cases of bipolar are disabling. A lot depends on how well you care for yourself---sleep, medication compliance, even diet and exercise. Regular visits with your mental health care provider are also necessary.

You sound like you're pretty discontented with your current job. Be aware that this restlessness can sometimes be a subtle symptom of bipolar disorder. I used to change jobs almost every spring for years...I didn't realize I was manic, I just got this irresistable urge to shake things up. But even if you're simply ready to move on, I think psych nursing might just be the thing for you. You have lived experience with mental illness, which often makes people more compassionate. The thing you have to watch is oversharing with the patients---it doesn't benefit them, and they may use such disclosure against you. But as long as you understand that you aren't there to get your own psychological needs met, you'll probably do very well.

I wish you all the best in whatever you do.

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Thank you. I will keep in mind the thing about over sharing. And I will also be mindful of my state of mind to prevent/manage manic episodes. Your words give me hope. :)

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This is a great post and I think you might be surprised at the nurses with mental health issues that seek out jobs in psych or psych related fields ( like say, addictions ). Who best to care for these clients than a nurse who has been there and recovers. Recovery is an action, which means it never ends. It's not a goal, a destination, etc... I don't have Bipolar but I'm in active recovery from depression/addiction. The most pivotal action I take on my own behalf is having a support group and others I can talk openly with about my struggles. I'm not defective, I am unique. One of the best nurses I ever worked with was Bipolar and she would go off the deep end about once every 3-4 years. But, she was smart as a whip and honest with her employers. They loved her and they knew when she was having a lapse in recovery. Once, she got severe diarrhea, her lithium got off. Her friends recognized it and loved her enough to say, "hey, lets call the doc." She got straight back on track.

It's hard sometimes, but the worst thing we can do is hide and be ashamed of ourselves. A fungus grows in the damp, dark, moist. But a flower grows in fresh air and sunshine.

Check out the support groups in your area, there are 12 step programs for mental illness too. There are nursing support groups too. It's not necessary to be a complete disaster to seek support. If you can find somewhere where you can be yourself, you will be surprised how that one thing can make a huge difference. Best of luck to you!

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I just wanted to give a quick update: I got a job! A dream position in a dream city! I'm a little nervous about all the change, but I also welcome it. They offered me the position during the interview. I'm just waiting for the official offer from HR. I hope all goes well. Thank you for giving me the courage to put myself out there. :)

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Hello everyone,

I am regretful to say that I did not thrive in the position I was offered. Everything seemed to go well, until I started making some mistakes and I take them really hard and personal. They were not severe and no harm came to anyone from them. It threw into a depressive state. I managed to stick it out for 4 months before I decided I was too unstable to continue. The job itself was great and I think that in an alternate universe, I would've excelled in it. I've been working a low-stress (and low paying) job, but due to some general dissatisfaction and craving to help others, I've been thinking about joining the nursing workforce once again... maybe third time is the charm? I don't know... and frankly I worry. But I'm certain that I want to continue trying and finding the right setting for me. I'm not looking for sympathy, as fellow nurses, I wonder what your thoughts are? I don't have many nurse friends... so it's difficult for me to ask for advice. 

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So sorry to hear it didn't work out as you had hoped. Have you considered a position that allows 1:1 patient contact like Home Health or Private Duty nursing? I'm not familiar with that work so I can't comment on the stress level but I would think at least while you are at at work it would be a lot less hustle and bustle being able to devote your attention to one patient at a time.

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I'm so sorry things didn't work out for you in that job. It sounds like you were just in the wrong place at the wrong time, and there's nothing that could have been done about it. Thank you for letting us know what happened. I think kbrn is right, you may want to consider home health or even hospice nursing; even though you have a caseload of patients, you only deal with one patient at a time and can form good relationships over time. In the meantime, how are you managing your illness? Have you been able to remain stable throughout, or has it been flaring up due to the stress you've been under? As you know, bipolar is a very tricky disease to deal with, and if you want to continue in nursing (and enjoy life overall) you may need to have your meds adjusted. I hope you're seeing your mental health professional(s) regularly and getting enough sleep...not always easy, I know. Please keep us posted as to how you're doing. I wish you peace and wellness. Viva

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Thank you much for your supportive replies. I have also thought about home health and I'm hoping to get a job soon. I've had a couple of interviews, but it's hard to explain my short terms of employment without disclosing that I had an illness I needed to treat. I dont have much experience and that's hurting my chances of getting hired right now. I live in a big city and it's pretty competitive.  I have been stable and I'm currently participating in an intensive outpatient program to prepare me for the new role I will hopefully assume, whether it be a home health nurse or hospice nurse. But I'm still keeping my chin up. I will keep everyone updated. Again, thank you for the support.

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On 1/16/2019 at 3:51 PM, kbrn2002 said:

So sorry to hear it didn't work out as you had hoped. Have you considered a position that allows 1:1 patient contact like Home Health or Private Duty nursing? I'm not familiar with that work so I can't comment on the stress level but I would think at least while you are at at work it would be a lot less hustle and bustle being able to devote your attention to one patient at a time.

Here is my advice (as someone who struggles with severe depression/anxiety and job hopping r/t boredom tendencies) if the OP decides to go the home health/1:1 route: when it's great, it's great...when it's stressful, know how to manage yourself and your self care.

 

It's usually a welcome challenge to learn the equipment and care needs of your patient. Depending on your shift, once you're familiar with the intricacies of care and the social dynamics in the home, it can be smooth sailing and even have its dull moments (especially depending on what the family allows you to do).

 

But when the BM hits the fan, it can happen fast. My patients can go from fine to super-critical in the blink of an eye, and sometimes the family-for whatever reason-doesn't want me acting in my best nursing judgement (whether that is suctioning/another tx, following the 485 orders, calling the doctor, or calling EMS). The biggest thing that I struggle with is lack of support from the home office/case managers and family not wanting me to follow doctor's orders/let me call EMS when the patient is turning critical.  Just be aware that such moments that will test your ethics and backbone have the possibility to arise...and know to document your butt off.

 

Documentation is a big thing in home care: it determines how the State awards the number of care hours to the patient; it can protect you if the family states you did/didn't do something; and it's the only real way to communicate between all of the nurses on the patient's team (as you only see the off-going nurse you're getting report from and the oncoming nurse you're giving report to, but there might be other nurses on other days in the home).

 

If you'd like to chat more about home care, please feel free to PM me.

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