I've had the last week completely off of work as I transition into a new (and exciting) job role- but first I'll start by telling you the beginning of the story….why I am transitioning to a new job after only 10 months in to my nursing career.
This February I started on a busy medical unit - not a med-surg unit - just medical (all the surgical cases were on a separate floor…) - I'm convinced that means that our floor had the heavier/more acute patients. Anyway, I knew what I was getting myself into since I had finished my practicum of 400-hours there for school the previous semester. I spent August-December of 2013 working 36 hours a week on top of attending classes an hour away at school. It was extremely stressful, plus I wasn't getting paid at all for my free-labor. I was learning a lot however, and my preceptor was great.
So I applied to that same unit, thinking that a year of acute care experience would benefit me no matter what I chose to do next. After 3 months of orientation I was on my own- and doing really well on the job. However, I was mentally, emotionally, and physically exhausted at the end of each shift. Working more than 2 12 hour shifts in a row was almost unbearable. I found myself binge eating crappy food at night in front of the TV, just trying to relax and turn my brain off so I could sleep.
Each shift I'd be faced with 5 patients, sometimes discharging my entire team and admitting 3 more patients. It was insanity! The day that sticks out to me the most is the day I discharged 3 of my 5 and admitted 3 (1 transfer from the surgical floor, 1 ER admit with respiratory distress, and 1 direct admission from a community oncologist who is notorious for delaying orders for pt's but wants them admitted ASAP). All 3 of these patients came within 30 minutes of each other! It was seriously unbelievable and extremely stressful. I complained to my director, who was mostly absent throughout my orientation and never provided any insight. She didn't do anything, only told me that I should relax and would have me sit in a chair while she "cleared my energy field" by waving her hands around my face. It was infuriating!
But I told myself I would stay for a year. I would wait until December/January to start job searching and by the time something came up I would have already completed my year off experience and could check that off of my nursing-career bucket-list.
Only fellow nurses will understand this- but there are some weeks that are great and everything flows smoothly and then there are weeks from hell where you despise your job and question your career choice every time you leave the floor (after 13 hours of hard work). I had just come back from a long vacation - taking advantage of the few perks of shift work - and was ready to get back into the swing of things on the unit. I was dreading my first day back, and actually cried the night beforehand - I was so relaxed on vacation I didn't realize how anxious and unhappy I was on a daily basis at my job. Being overworked and stressed 24/7 had given me a new baseline of constant anxiety that I didn't recognize until I was away from the job for an extended period of time.
I had that gut feeling that my first day back was going to be a nightmare. Maybe I set myself up for a negative day, maybe not- my attitude certainly didn't help things. But neither did the fact that I was given 6 patients that day - as a new grad (just 3 months off orientation) - and the only nurse with 6 patients on the floor. And these weren't patients that were there for routine CP, GI Bleed, etc. these were heavy duty acutely ill patients. Here was my list of patients:
1 total care patient with a PEG tube, tube feeds, crushed meds, oral care q2hrs, etc.
1 ETOH withdrawal and cirrhosis of the liver (who ended up vomiting a TON of blood and I had to call a code for later in the day)
1 chemo patient with q2hr pain medications at a very high risk for falls (I'm not trained to hang chemo at all….)
I don't remember the other 3 exactly- but they were all 80+ years old and very high risk for falls, incontinent patients with demanding family members.
I was so pissed. That was the day I decided I have got to get out of this place. I would literally work my ass off (walking 15,000 steps a day- taking maybe 2 bathroom breaks and one 20-minute lunch while my phone rang off the hook) and not get any recognition from anyone- not even patient's or family members. No one would say thank you. It was disgusting.
So I decided to start looking at other jobs. I would hunt on Indeed.com all the time for jobs outside of the hospital, anything I could do- I have a Bachelor's Degree and an MSN- this shouldn't be too hard I thought. So I applied and applied- and something came through! My director and fellow coworkers didn't realize that I had started this process well before I had my 'meltdown' one day.
I interviewed for an amazing position at an outpatient psych facility on a Friday - the director was great, I would be the only RN, and I would have an office (a big one with a closed door!) - and a substantial amount of respect too. Weekends, holidays off, and a generous benefits package (although the benefits at the hospital were pretty great too). At first based on the job description I didn't even know if I should go- but I'm so glad that I went. I haven't started my first day there yet but the atmosphere of the place and my new boss were amazing. I fell in love with the idea of this new job, and they wanted me for my education and my experience.
So I interviewed for that position on a Friday, and I knew that I was so over hospital nursing I could hardly stand it. I went in to work that Monday feeling confident about my job opportunity and just wishing things would move along so I could quit. I was so sick of cleaning up poop and spending 90% of my day doing CNA activities, ordering food, getting patient's straws or changing the TV channel.
That particular day I had 6 patients - again!- the only nurse on the floor with 6. But I shut my mouth and started my day. Except this time, I had a patient with a BP of 80/40 with endocarditis and a possible fever- but none of our thermometers were working. Plus, all of our CNA's had been so burn out- this particular CNA - I'll call him Frank - was complaining nonstop and wouldn't answer his phone. So while I'm in this patients room contemplating a Code since he is lethargic and non responsive -ALL 5 of my other patients call my phone to ask for various things or scream into the phone:
"I made poopy pants! Help me!" - from an oriented older gentleman, yes he said this verbatim
"I need a stool softener immediately!"
"If you don't come help me out of this bed to the chair I'm walking myself!"
"Can you help me order breakfast?"
"I need the nurse!" - "What can I help you with?" - "I Just need you!" ??? Ok then…
How can one person not mentally breakdown when all of these things are happening at once- and it's not even 8AM yet?????? I could not do it anymore.
Like I said- this place was just a nightmare. I had a freak out that day- a professional one. We need more staffing, we need more equipment, and obviously none of these patients were rounded on before night shift was done- and they are severely understaffed so I'm not pointing fingers at anyone other than the director and the folks who sit in offices and decide where the money needs to go.
Needless to say my director was around during this time, as well as an MD who respected me and appreciated my feedback. She told me not to leave - that the hospital was burning out good nurses and that I should stay - I hadn't even mentioned leaving. So you can imagine that when I turned in my notice that Friday- everyone thought I was just angry/burnt out. When I actually had an amazing job offer it was shocking! My boss started crying- it was very unprofessional.
Anyway- I've enjoyed my week off. I still have nightmares about going back to the hospital and part of me wonders if this is a good idea. I guess I'll let you know next week! :)
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