To go back to the bedside...or not

[Ejwat2021]

I got my nursing degree when I was in my late 20’s. I spent a year working med surg, 2 years in LTC managing a unit then went back to hospital nursing in a float pool for a year before accepting an assistant manager position and now the manager position of a med surg department. I’ve been in this role for two years and why I really love my employees I don’t feel satisfied with what I’m doing. I’ve contemplated returning to bedside nursing. I have to work for another 30+ years and I feel like my career is on the fast track but...do I want to be in leadership this whole time? The more I’m away from the bedside/ the more skills I’m loosing. Has anyone been in leadership and gone back to the bedside? Working 3 12’s, clocking out and being done is very tempting...

[DavidFR, BSN, MSN, RN]

Yes, been there.

In a past life in the UK I was what is known there as a Ward Manager. I hated it. I don't have a manager's head on me and I hated being this piggy in the middle (e.g. I order an agency nurse for a busy shift - the team is happy but the hierachy screams "budget" at me. I don't order the agency nurse, the hierarchy thinks I'm wonderfully efficient but the team feels unsupported).  I found I was constantly in no-win situations.

I got out of that rôle by becoming a Clinical Nurse Specialist. I did that for 5 years and it was a wonderful way being in a senior position but having direct patient contact at the same time.

On moving to a new country 20 years ago I went to back to bedside nursing. I figured new country, new system, start at the bottom  and see how the land lies. I'm still very  happily at the bedside and will stay there until I retire. I love being back in hospital based clinical nursing.     

Do what you want to do. Money and status are superficial things at the end of the day, and a career trajectory doesn't necessarily have to be onwards and upwards for ever. 

[TheMoonisMyLantern, ADN, LPN, RN]

What are your long term career goals? Do you see yourself more aligned for a clinical role or an administrative role? Depending on your goals depends on whether going to back bedside is a "downslide". As far as skills go, the skills that most nurses fear losing are technical skills, which in my experience, are the easiest skills to regain, it requires practice. Intuition, clinical judgement, assessment skills, critical thinking skills, those degrade slower in my opinion, especially if you are on top of continuing education. 

Sometimes it can be liberating going from being the "boss" to a peon, but others struggle with not being in charge anymore, that's something to consider as well. Sometimes being away from the bedside we begin looking at things through rose colored glasses, it's important to remember that bedside, while not having the stress of 24/7 accountability, means that you are in the direct line of fire when it comes to abusive patients, co-workers, families, doctors, body fluids, admissions, discharges, management, lifting, turning, no break, no bath room, no staff, patients crashing, dying, confused patients, hitting, spitting, screaming, pills, pills, pills, a million IVPB, IV pumps beeping, bed alarms beeping, telemetry beeping, phones rining, not mention running around in all the PPE sweat dripping off your face, you get the idea. Don't get me wrong, I like being a bedside nurse, and I'm not saying you don't deal with some of these issues as a manager, but typically the less power you have, the more crap you have to deal with. 

Have you considered doing house supervision? The nice thing about it is that you typically still have a clinical role depending on the hospital but you also have an administrative role as well. Most hospital supervision jobs require critical care or emergency care experience but since you're a manager maybe they would make an exception? Or maybe you could work in an ICU for a couple years before stepping into the role? 

Good luck with whatever you decide!

[Jedrnurse, BSN, RN]

Judging from a large number of posts on AN from bedside practitioners, I can't see why anyone would want to jump back into it.

Also, a "12" is never a 12, although the employer may try to only pay you for that amount of time...

[OUxPhys, BSN, RN]

From my experience everyone I know who has left bedside has said they are never going back. I think this pandemic and the way hospitals have treated their employees really shed light on the future of bedside nursing. I have been and will continue to look for a gig that is not bedside.