Traveling-sooner or later?

[Mojojojo05, BSN]

A (not so) little background: 

 

I graduated back in May 2016 and started working at a Level 1 trauma center. I spent 2 years on a Stepdown PCCU/tele unit, then proceeded to transfer to the endoscopy department where I spent another 2 years. 

Around my 4 year anniversary of being a nurse I started considering travel nursing for endoscopy, but then Covid-19 really started ramping up in my area. I found out that anyone with heart center/tele experience in our facility was eventually going to be “temporarily” reallocated to help boost the number of bedside nurses. 
 

While my endoscopy nurse manager told me they were arguing to keep me from being reallocated, elective cases had taken such a nose dive that we really didn’t have the workload compared to pre covid. It was around this time I noticed that the CVICU had an opening, and since I figured I would be pulled back to the heart center eventually anyways, I applied thinking I might as well get some critical care experience out of it.

And boy did I ever get experience. I was put on night shift where it was mostly comprised of new graduate nurses. 4 months after starting was the first time I walked in one night to find that everyone else working that night had 6 months of experience or less, an occurrence that became increasingly common as time went on. Despite the fact that I was new to critical care as well, the fact that I wasn’t a new grad meant that I was often charge and/or given harder assignments because they “didn’t feel comfortable with a new nurse” having certain patients. 

In the end, I stuck it out for a year, getting experience with fresh post op hearts, vascular surgeries, EKOS, ECMO (covid and non-covid), ext. When Covid peaked with delta and everything went to hell, we stopped being just a CV-ICU and started taking care of just about every ICU type patient, since we were over crowded and they were just putting critical care patients wherever they could find a bed.

Towards the end of August, I made the decision to move back to my hometown to help deal with some family issues that had arisen during the past year.

I left my level 1 trauma center and transferred to a much smaller level 3 facility. After spending a year on nights in the ICU with a gaggle of new grads, I’m not gonna lie, I was stressed and looking for a little bit of a break. So I turned down a bigger sign on bonus to work at the new place’s CVICU and instead accepted a position in the PACU for days.

I accepted the position as 9am-7pm four days a week, one overnight call/week and 1-2 weekend calls per 6 weeks. Almost immediately after starting, changes started being made.

It was gradual at first. It started with backing my hours up to 8a-6p. Then it was moving away from doing 4 10hr shifts and alternating weeks of doing 4 10hrs and the next doing 3 12hrs. Which wouldn’t be so bad, except the hospital, like everywhere else in the nation, is absolutely over capacity. So being on call has often turned into holding patients for hours on end or even overnight on account of there being no beds/bedside nurses to staff them. So, my 40hr/week job that I originally thought I was getting has routinely turned  50-60hrs/week.

Another issue is about a month after starting, they started making me be PACU charge. In the beginning, it was only in the afternoon after the regular charge went home at 2-4pm. The charge nurse/supervisor (the former supervisor who hired me quit a few weeks before I started) sat me down one day and asked if I was comfortable being charge more frequently. I was honest with her and told her that since I had literally just started the month prior, I wasn’t ready to be a regular charge. She told me she understood and that I would only be a backup charge when either she or two other more experienced PACU nurses weren’t working or had to leave early.

That has also not panned out. One of the other “regular” charge nurses works primarily weekends, with 1-2 weekday shifts depending on the weeks. And the other one has now decided she will be quitting to do travel nursing in the near future. So most days, it’s either me or the main charge, which means I often have to come in early at 6-7am to fill staffing needs.

The main charge nurse will be going out on maternity leave soon, and will be out for 3 months. So this past week it was announced that when she goes out, I will be the only charge nurse 4 days a week. Which means I will have to come in at 6am most days, since when the main charge and the one that wants to travel are gone we won’t have any early nurses. The problem with that is just because I come in early doesn’t mean I get to leave early, and I often wind up working 1-2 hours over due to late cases/ not enough PACU nurses. To meet staffing needs on the weekends, our department management wants us to start taking back up call on additional weekends for when the first call team calls out sick or they get overwhelmed with cases/holding patients. So that’s an additional 1-2 weekends out of every 6 weeks I would at least have to be on standby for the hospital.

I want to be very clear, I don’t necessarily blame the unit itself. I know hospitals all over the country are struggling with staffing crisis and nothing is guaranteed. I also know that no matter where I go, it’s going to be stressful and being adaptable is a must. The main charge and department supervisor have been very nice and are also available if I’m in charge and have questions or concerns.

Having said that, I took a significant pay cut to come to this hospital and their PACU, not including the lower sign on bonus I accepted because the hours and less stress were worth it to me at the time. Plus, I was originally OK working in a smaller town and hospital hoping I would have a better work life balance. Now my hours are all over the place and my stress level is often through the roof dealing with being in charge, short staffing, hospital overcrowding, ICU/floor holds, etc.  

I don’t think it will be better anywhere else in health care, but if I’m going to be stressed out, I might as well get to travel and make significantly more money and have the ability to take time off between contracts. I’m also aware that I don’t have enough experience to travel as a PACU nurse, and I’m OK with doing contracts for bedside.

My family and friends are pressuring me to go ahead and put in my notice, but I’m struggling because I know this unit has already made plans for me to be in charge when the current one goes out on maternity leave. On the other hand, I’m really not looking forward to doing another 5 months or more, especially since I never wanted to be in a supervisor roll to begin with.

How bad will it be if I put in my notice and finish out the schedule that just came out, which ends mid February? How do I explain to my higher ups in way that doesn’t completely burn bridges that I’m leaving? Is there even a way to do that?

If you’ve made it to the end of this extremely too long post/rant, thanks in advance for any advice or reality checks.

[agencynurse_rn]

Girl, just do what's best for you.  In the end hospitals don't owe you any loyalty. They are a business.  Handle your own business and go make the money in travel nursing. Like you said, if you are going to be stressed you might as well have some control over it and get paid in spades for it.  Tell your manager you need to take a LOA for mental health reasons (burn out). If they refuse, resign with enough notice and a well thought out letter.