Which Nursing Jobs are the Least Stressful?

jab1432, BSN · Mar 6, 2015

I agree with your assessment neeka8. To add some detail as to why I found rehab to be a high-stress job:

In-patient rehab is nowhere near the bottom of the ladder in terms of stress. You typically have more patients and less staff than other units. The patients are supposed to be "medically cleared for rehab" but whoever is clearing these patients for rehab must be on crack. I worked in-patient rehab for a year in a hospital and hated it. 8-12 patients sounds right, tending to lean more towards 10-12 but on occasion you can have 14-16 (as in about once a month in the hospital I was at). If you are unlucky enough to be on 3rd shift (11p-7a) then you will be dealing with many sun-downer patients with considerably less staff than the other shifts... and some nights you will spend your ENTIRE night running from one bed-alarm to the next... no exaggeration. We often had to get patients in wheelchairs and sit them in the nursing station and then deal with getting scolded by the someone from the other shift (sometimes the manager, sometimes the oncoming shift, sometimes PT/OT) since the patients didn't get their rest, to which you have to rebuke this person and tell them that either the patient doesn't get sleep and may not do well today in rehab, or they fall and break their head open and the hospital gets sued... funny thing is when you do this sometimes when you come out of another patient's room you find the patient in the wheelchair butt-naked (because they are confused and removed their clothing) and then you have to throw a blanket over them, wheel them back to their room, dress them, try in vain to persuade them to go to sleep, and wheel them back into the nursing station... rinse and repeat.

I worked in the ICU before this and at least in that particular ICU I found the job to be low-stress (though it was a 36 bed ICU with residents who spent the entire night awake on the unit and a dedicated charge nurse who took no patients and just helped out and responded to codes)... and I worked cardiac-telemetry after this and found it to be equally stressful though in different ways.

Day shift rehab consisted of trying to get assessments done, round with doctors, assist with med-pass and wound-care, bath before PT, daily patient review-board meetings, admissions, and discharges all while trying to work around PT/OT's schedule because if, God forbid, the patient is on the crapper when PT comes to get them they will say "patient not ready for PT due to nursing" and if the patient isn't able to be fitted back into their schedule to fullfill their full 3 hours of PT/OT between 0830 and 1600 then the hospital may not get paid for their ENTIRE STAY and of course you'll be hearing about it from your manager.

Evening shift on rehab was about the same as day-shift minus working around PT's schedule, although now you are "cleaning up the mess" from day-shift since it is absolute chaos during the day since you pretty much are task-focused... which means calling doctors (none of which want to take accountability for the patient and you have to call 2-4 before choosing one to get snippy with and force them to give you orders), finishing discharges and admissions which are sometimes not even touched or done completely wrong... assisting with showers, getting the patients ready for bed which means you have to assist them out of the hospital gown and into normal clothes.

Night shift on rehab is different in you usually (but not always) don't have any admissions or discharges. However, you are expected to WAKE the sleeping patient, de-clothe them for your assessment, then reclothe them. This in-of-itself is highly stressful as you can imagine how happy you'd be to get awoken between 11:30pm and (however long it takes you to assess 8-16 patients)... getting lights thrown on, asked stupid questions, rolled to your side, wounds assessed, etc... after having an exhausting day of rehab and knowing you will be awoken between 5am-6am for vitals and meds... not to mention how often they get awoken by their "neighbors" jumping out of bed and setting off alarms. Night shift is the ultimate "clean-up crew" because you are expected to go through the entire day's paperwork, find missing orders that weren't completed, find out of consulted physicians ever saw the patient (and try to read their chicken-scratch if you are in a hospital that still uses paper charting)... get the charts ready for the next day, ensure all ordered meds are on the MAR, ensure all D/C'd or held meds were properly D/C'd or held, obtain samples/specimens needed for testing, ensure orders were put in the computer properly and often do it yourself because you won't have a secretary... pass pain pills constantly throughout the night to patients who are usually only awake enough to ask for them (which at first you don't do but afterawhile you stop giving a crap and give them against your better judgement because you grow tired of the patients whining/b*tching about not getting their meds and then PT/OT gripes at you for having "snowed" your patients [one time a RN on night-shift called a rapid response and gave narcan to a patient she snowed because they wouldn't wake up enough to talk.... but I had that patient before and she would wake up, scream holler b*tich cry and moan, threaten suits, etc... if she did not get her pain meds... and or course after the narcan she did all of the above), not to mention you have 30 minutes or less (depending on how long report was) to check and pass sleeping medications since most institutions don't let you do so after midnight since it will make them drowsy for PT/OT because evening shift doesn't have to deal with the consequences of not passing sleeping meds so they don't think about it and don't always do it.

Not to mention, at least on my rehab unit, you are working with a lot of burnt-out staff who have been on rehab too long and lost their normal nursing skills so when it is time to do anything even slightly invasive such as starting an IV, foley irrigation, changing a PICC dressing or pretty much anything that an experienced nurse should be able to do with their eyes closed... they are going to cry for you to help them... and if they ask you about a patient who "isn't doing too well" you had better go assess the patient yourself or you will be dealing with a code or a dead patient.

Not to mention all the rehab-specific paperwork... I know all other floors have their caveats... but rehab is a different beast entirely and, at least in my opinion, you have too many patients that you are solely responsible for than is safe.

Wishinonastar, BSN · Mar 6, 2015

I am enjoying this, but I think it is really easy to see the grass as greener in other areas. Each area of nursing has unique stresses and it depends on what you can tolerate.

I am a school nurse and am usually extremely busy, responsible for 600+ students and also staff. We have lots of emergencies and I am alone. I am isolated and have no one to talk to, not that I have much time to talk. I miss other nurses. I am not respected and am not accepted by teachers. I love the kids and the hours, no on-call. But bad things do happen and I have a lot of responsibility. My pay is lousy, but my benefits are good. I am always busy, I am always behind.

Home health and hospice were draining for me, with long hours, tons of paperwork, and never enough hours in the day. But I felt good every night and I enjoyed dealing with one patient at a time. I really could give my all to my patients and I think I excelled with that kind of stress, more so than the craziness of acute care, LTC, or school nursing.

QI was enjoyable, but the stress is in showing results and dealing with resistance to change. Staff resent any attempts to change things, even if it is to make things better.

Teaching can be enjoyable, but you feel like you are always on the stage and you have to entertain, plus you are constantly being judged by administration.

LTC spreads nurses very thin, but most days are pretty predictable. There are times when you are overwhelmed with crisis- deaths, falls, sudden worsening of status, demanding patients and families, overwhelming meds and treatments that are impossible to get done on time. And the regulations are a nightmare.

Acute care, well, as we all know a lot depends on the facility and the unit. But wherever you go it will be stressful, though the time goes fast and if you are on a good unit with a close and supportive group you may just love it.

So what kind of stress can you deal with? Fast pace? Paperwork? Being spread thin? On-call? Overtime? Tap dancing to show your abilities? Isolation? What one nurse thrives on another may hate. That is what you need to look at.