Where Do I Go From Here?

**VivaLasViejas, ASN, RN**

What to do when you can no longer work as a nurse?

Isn't it always the way that once you've gotten one HUGE problem under a semblance of control, another rears its ugly head? My husband and I just received a new lease on life......and now I have to figure out what to do about work.

I had a very honest--and very upsetting--talk with my boss on the phone yesterday after we'd gotten the great news from the university hospital about hubby's stage IV pancreatic cancer being treatable after all. Frankly, I'm shocked that all this emotional whipsawing hasn't triggered my bipolar illness--I feel like I'm on the rollercoaster ride from Hell--but my daily gut-checks tell me that I'm only experiencing the normal ups and downs associated with major life changes. Which is a good thing, even as uncomfortable as it is.

Knowing this does not solve my dilemma, however. Yesterday I had to say No to picking up several floor shifts at the beginning of September, much to the dismay of my friend the DON at my facility.....and once again, I found myself having to explain why I couldn't do it. To say the least, I feel awful about it--as the fill-in, I feel like I've left her totally in the lurch, and from my own DON experiences, I know all too well what that's like. She's invested a lot of time (and company funds) in my orientation and training, so it's only natural that she's disappointed. She deserves better, and so do the staff and residents.

Then came the phrase that ended any hope of extricating myself from this awkward situation with a modicum of grace. She said that she'd had so many plans for me "because of how great you were".......and with her emphasis on that one tiny word, she summarized everything that's gone wrong with me in regards to my career.

Yeah, I was a great nurse. I'm not a great nurse anymore. I'm not even a good one now. In fact, I'm really not even a nurse at all anymore, even though I still possess a valid license that says I am, and I still hold a nursing job of sorts. But I know I'll never work as a floor-running, wound-bandaging, IV-starting, doctor-calling, shot-giving NURSE again.....and that absolutely INFURIATES me! I wish people could understand how hard it is for me to say "I can't do it". I wish they could understand how much it hurts to admit--even to myself--that my career is essentially over.

What I don't say, of course, is that I am sick and tired of losing parts of me to bipolar disorder. I lost the job that I'd planned to retire from someday. I've lost a good deal of my dignity and self-respect. I've lost my ability to concentrate, to get and stay organized, to cope with ever-changing priorities. I can do resident admissions and paperwork, but that's it......and a trained high-school graduate could almost do that much.

Bottom line, I'm losing a big chunk of my identity. Who am I, if not a nurse? Yes, I'm a wife, a mother, a grandmother, a sister; but so much of my substance has been inextricably linked to my work that I don't know how to untangle what I do from who I am. And where do I go from here? What do former nurses do to keep a decent roof over their heads and give themselves a sense of purpose?

I've received several excellent suggestions from friends and family that, unfortunately, are difficult to pursue in a rural area, so my options are somewhat limited. (And since relocating is not on the table, I'm going to have to get creative.) Like me, a couple of these friends had to give up active nursing because of their own mental illnesses; they did it because they knew that even with medication and therapy, they were unable to practice safely. And much to their credit, they were honest enough with themselves to admit it before they committed a serious med error or missed a critical assessment that could have resulted in harm to a patient.

I'm proud of them for having the courage to do that. Heck, I'm proud of ME for having the courage to do that.

So why do I feel so bad?

CheesePotato, BSN, RN · Aug 21, 2013

I attended a lecture a few years ago who touched on the interesting fact that when we ask people who they are, something like 98% of them will answer with their names and their occupation in the same breath.

Long and short of it: people introduce themselves based upon what they call their "active role".

So it is not unheard of or strange for your identity to be associated with your job. And as one who, due to a physical malady, has had to bow out of a role that was not only something I loved dearly, but was how I identified myself, I can appreciate where you are in your grief and anger.

Because remember, that is all part of this process of changing and assimilating identities, limitations, and goals. Before one can move on, one must first grieve. So take your moment and make your peace all in due time.

As far as fulfillment and job ideas, I know that many here have had suggestions. You could always check into doing pre-admissions screening for a hospital OR or perhaps work in a central scheduling office. As far as fulfillment goes: Volunteering works wonders on the soul for that one. There are so many places where you can go, from nursing homes to hospitals to veteran's centers, and truly make an impact.

VivaLasViejas said:
We'd gotten the great news from the university hospital about hubby's stage IV pancreatic cancer being treatable after all.

This, Marla. This.

In spite of everything that is going on, I really wish that this one little fact would eclipse all others.

Perhaps it is time to rest the mantle of asskickin' nurse and instead become immersed in the life that exists outside the doors of the hospital. It is time to rewrite your active role.

I don't have to ramble to you about the frailty of life or the downright insanely amazing news that you have been given in regards to your husband's condition. I know you know.

Rather than wondering where you go from where you are now, I think the more fitting question is the following:

You, yourself, stated that you have just been given a new lease on life (such a rare and precious opportunity)--

How do you plan to make the most of it?

With kindest regards and sincerest belief you will find your way,

~~CP~~

NurseDirtyBird · Aug 21, 2013

I'm happy to hear there are treatment options for your hubby. Hope will do your heart some good.

I do understand your identity being intertwined with nursing; it's one of those jobs where you either are or you aren't. There's no "off-duty" really. That's why retired nurses are never just "a retired person," they're "a retired nurse." An identity crisis is inevitable when you're looking the end of a significant part of you right in the face. I hope you have some support and are taking care of yourself.

I'm not a huggy person (virtual or otherwise), but I'll send some telepathic hugs your way.

starlisa14 · Aug 21, 2013

My husband is bipolar. He has pulled peanut butter sandwiches out of the air to eat, let 20+ chicks loose in my kitchen in the name of raising a chicken farm, put mine and my son's life at risk while driving...But I could have stopped that as his wife. He hauls 80k steel coils in an 18 wheeler truck today, and I nor he sweats it, because me being his wife and the closest person to him has learned to identify changes in condition/precursers/activators etc. I don't know why you would feel defeated with this illness; to live as if you can't do the things you want or are called to do because of this illness. That truely breaks my heart. You can be a nurse, you can be a positive, healthy influence in someone else's life; you just need support. I pray you get that support in whatever you do and I pray that you don't let society dictate what you can and can't do. ALWAYS

lamazeteacher · Aug 21, 2013

My heart goes out to you! Everything you know, love, and want is being challenged at this turning point!

Life can present one hurdle (when things are more stable), to one heck of a battle.

In a parents of teenage drug users' program I attended many years ago, the concept that "God never gives us more than we can handle", came up. We who had followed our children down what I referred to as the "rabbit hole" (think "Alice in Wonderland") of our children's and our own turmoil, looked at the possibility of a grand plan set by our super power for us to learn about our strengths and weaknesses. That I had been given this wonderful, beautiful inside and out daughter for adoption, was a miracle in itself.

That I am a Nurse, saved her life several times while she was an infant, due to physical challenges no one could have predicted, was one thing. Finding her in the jungle of predatory drug dealers was quite another! Time and again shen I thought that I could go no further in that quest, miracles occurred that assured me of God's support. I'm no bible "thumper", and thought such belief was only in the realm of Christian evangelism, and I'm Jewish! However since on many occasions nothing other than divine intervention could explain circumstances in which I found myself, and her, cemented that belief!

By recognizing and knowing that God was on the journey with us, I was able to persevere. Since then that wayward child has found her "natural" mother who, had adoption agencies in the '60s been honest enough to share that background information, we might have been better prepared, or possibly done things differently. But life often doesn't come with a "bill of fare", and things just happen..... We use what we can and hope for the best.

For my daughter, the "best" was finding her full sister who is one year younger than she is, and so like her, it's shocking. She lived the life my daughter could only imagine might have happened. For me, it's knowing that I did my best and more, to bring about an outcome that is far from the one that might have been..... Her "natural" mother refers to me as her "hero", and my daughter has delighted me by thanking me, over and over, for adopting her. It was a very tough fight and everyone won.

You, Marla, also need to appreciate support whenever and wherever it appears. Sometimes it's quite ethereal. Yet it's there. Perhaps not quite as you envisioned it....

txredheadnurse, BSN, RN · Aug 21, 2013

Marla first off huge cheers and cartwheels and confetti showers for the news about your DH. You ask where do you go from here? I bet there is a quiet voice deep inside that is waiting for you to listen to it. This voice will guide you on the next stage of your journey. You are still a nurse but you aren't the nurse you were a year ago or 10 years ago. That is OK; it really is OK. What you haven't fully allowed yourself to process is the grief for having to let go your internal image of your nurse self. When you finally listen to the quiet voice inside and realize that your internal image of Nurse Marla needs to change and that the change is acceptable I think you will find some peace and where to go from here.

CrunchRN, ADN, RN · Aug 21, 2013

You should not feel one bit bad. You are doing what is best for your patients, your employer, and your self and family. You need to file that guilt or whatever in the trash where it belongs.

CountyRat · Aug 21, 2013

VivaLasViejas said:
So why do I feel so bad?

You feel bad because something that you love has been taken from you, and someone that you love could be. How do you think that you are supposed to feel? Happy and care free? If you did, THAT would be abnormal. The way you are handling this very difficult time tells me that there is much more to you than your diagnosis, and I admire you for that.

Your current work is not what you want, but it is honorable work that allows you to meet the needs of your family while helping others who need your services, which gives you the right to be proud of the work you do.

And Viva, you ARE a nurse. You will always be a nurse, and I will always be proud to call you my colleague. For today you are wandering, but you are not lost.

TheLiberation, ASN, BSN, RN · Aug 21, 2013

You are a nurse. And a d@mn good one. Maybe you're not in crux of it all anymore, but you're a damn good inspiration. I look forward to reading your articles so often because you give me a hope and I don't even know you. So if you can create such intense emotion and support and hope for a stranger, I can only wonder what amazing things you can do for your patients.

Please don't let anything block the sun shining. And have a great day ?

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Aug 21, 2013

Where do you go from here??? You are already there! A strong woman who is withstanding the test of time!!! I've used being a nurse as my identity. Nursing is what I do for a living, not who I am. Unfortunately though, since I've been a nurse for most of my adult life, I have no other answer to who I am except a woman who has been forced repeatedly to stand against the odds as well. You were a young woman before you became a nurse. Where do you go from here? You go nowhere but stand your ground as firmly as you can for your husband and your family. You are loved there MORE than any job could possibly make you feel.

Nurses are ALWAYS replaced at some point in time because that's what you DO. The woman that you are will NEVER be replaced because that's who you ARE. So what if you can't hit the floor running now. How many years did nursing get its money's worth out of you? I say your career owes you and should feel bad about inflicting such physical and emotional hardships on such a dedicated professional....not the other way around. Chin up...for years of service well done! Blessings and prayers for you and your family!

TeenyTinyBabyRN, BSN, RN · Aug 22, 2013

If you have the time, I recommend reading "The Power of Now" and/or "A New Earth" by, Eckhart Tolle. He speaks of issues with identifing onself. I suffered from depression for over 10 years and I really feel like these books helped me get a new out look on life and brought some peace and comfort to some trying times I was experienceing.

I will say some prayers for you and your husband. Stay strong.

**VivaLasViejas, ASN, RN** · Aug 22, 2013

My husband is bipolar. He has pulled peanut butter sandwiches out of the air to eat, let 20+ chicks loose in my kitchen in the name of raising a chicken farm, put mine and my son's life at risk while driving...But I could have stopped that as his wife. He hauls 80k steel coils in an 18 wheeler truck today, and I nor he sweats it, because me being his wife and the closest person to him has learned to identify changes in condition/precursers/activators etc. I don't know why you would feel defeated with this illness; to live as if you can't do the things you want or are called to do because of this illness. That truely breaks my heart. You can be a nurse, you can be a positive, healthy influence in someone else's life; you just need support. I pray you get that support in whatever you do and I pray that you don't let society dictate what you can and can't do. ALWAYS

Thank you for this perspective. I can only imagine what it must be like for you to live with a spouse who is bipolar. I'm glad he's as functional as he is, for there are a good many who aren't.

I am functional too. I don't see myself as disabled, although I do have a disability. I also don't allow society to tell me what I can and cannot do; otherwise, I would never have "come out" as bipolar on here, at my job, or with my friends. But I do recognize that I have to accept some limitations, lest I harm someone in my care, and I have to work within those limitations. That is not feeling 'defeated', that is accepting my reality, and I am looking at this new normal with sadness but not guilt.

That's why I say I feel bad. I do feel bad. But "bad" means I regret that I can't do the job I signed on for. I'm sorry that I've disappointed the people who thought I was a rock star. I wish with all my heart that this was NOT my reality.

But it is.

My thanks to everyone for your support, as you have once again made me very glad that I joined Allnurses 11 years ago next month. Y'all know I'll land on my feet somehow.....I always do. :yes:

Where Do I Go From Here?

What to do when you can no longer work as a nurse?

About VivaLasViejas, ASN, RN

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