Why is it so hard to leave where you are comfortable?

[SP1CEGRL]

So I was an LPN for 5 years who became an RN two years ago. I worked as an RN at the nursing home I worked at as an LPN for several months before I got a position at a local hospital on a med-surg/respiratory floor. We also have respiratory step-down patients. I also kept the nursing home per diem and I supervise there as well. Now I want to get into my next venture - I really want to eventually become either a nurse on a cruise ship or a flight nurse. I originally wanted to go into the Air Force but I found out after a lot of stress and a lengthy application period that they would not be accepting me at this time. I was pretty upset for awhile but am trying to look at it as a positive thing that there is so much more out there for me- which is why I am really looking at cruise and flight nursing. Both jobs require at least 3 years of ER or ICU experience. I really want to go into the ER over ICU, but I am so nervous. I feel like I am not as confident in my skills as I could be - I also feel so comfortable on my floor. I absolutely love the people I work with and I could walk to my job, however the ER position I'm looking to take offers a $7500 sign on bonus and is about a 30 minute drive away. It's owned by the same company as my hospital but I believe the way it works is I go in as a brand new employee. I also may have to go from days to nights. I'm not sure how I will adjust to this, but I know it is a better opportunity because the hospital I work at has a very small ER and the one I am trying to go to is a trauma center. I would really appreciate suggestions from ER nurses out there about how to improve my skills, what to brush up on. Should I go for it? Should I wait another year? I know some people recommend having one year med-surg experience while some people say two. I do feel like there is much more to learn but I already feel bored working med-surg at times. I guess it's never easy to leave a job your comfortable in, but I really feel that I need to expand my knowledge and I feel the more comfortable I get at my job, the harder it will be to leave later on.

[DeenieRN]

I've discovered that nursing is really just a journey, and you pick which road to take, there is no right way, just the way you choose.

For your plan to get into flight nursing you will need ER and trauma experience. I thought I wanted to do flight nursing, but after doing a tour of the chopper and speaking with the staff that deliver the traumas to us, I found out that it's not for me. I love the ER and trauma, but I'll skip the flight side of things. I work with a lot of nurses that do flight nursing to the caribbean, I love their stories, it's exciting but also confirmed to me, that it isn't that path I want.

Now back to you, if you feel uncomfortable transitioning straight to a trauma facility, why don't you get into the small ER at your current place of work, and do OT on your floor. Anyone going to the ER will feel overwhelmed at first, the process is different. Get into the smaller ER, get in your groove, then make the move to the trauma facility.

Whatever you decide, there is no right or wrong answer, do what makes you happy and you'll end up where you want to be. Best of luck!

[DianaT]

I am in a very similar situation right now. I've been a RN for almost 2 years on a tele floor. The same floor I worked as a tech on through nursing school. I've always wanted to work ICU or ER. As such, I take every chance I get to float to the ICU (which is fairly frequent). I had applied for an ICU position a few months ago. I had been passed over for the day position (it was given to an external hire who has ICU experience) and I was offered nights. I work days now, so I passed knowing that it wasn't a good fit for me right now. Then 6 weeks ago I floated to the ER and it was like finding my people! I was offered a spot within a few weeks of floating and start down there Sunday. I've been picking up shifts down there to help them out and am feeling very self sufficient. But I can't help but feel a little freaked out as my last day approaches. I'm leaving the only unit I've ever known. I float to all the units regularly (I love to challenge myself by learning new things, so I will volunteer to float if someone doesn't want to), but knowing that I can come home to my tele unit is comforting. Now I have to create new work relationships with the nurses and the docs. I'm most nervous about leaving my physicians. The cardiologists and hospitalists I work with are amazing and we have developed an excellent communication system. They know me, I know them, and as such I believe my patients get better care. I can anticipate their orders before I even get them and they truly listen to me when I think there is something wrong with a patient. That's not always the case for nurses and especially one with relatively little experience. I'm hoping I get to that point in the ER as well.

Anyway, my point of that whole rant was that I totally understand where you are coming from. Nursing continually pushes us outside of our comfort zone, so I figure this is just the next step in the journey. Good luck!

[Buyer beware, BSN]

OP: Human nature is the answer. Just ask some of the old crones who have been at one job site in one specialty for a dog's age, act like they single-handedly run the place and drive off fresh talent like they own the means of production.

It all comes down to the often cited expression "the devil you know is better than the one you don't." Been this way for years. Don't expect it to change unless robots take over patient care; in which case they'll most likely program at least one with a personality described above.