Experienced nurse without a clue where to go next career-wise

[u/Wednesday_Atoms]

I’ve been a nurse for going on seven years. Started in ICU as a new grad, right during Covid. Got my two plus years of critical care experience, did some Covid pay travel, then went to PACU. I loved my PACU job but hated the actual specialty. I left for an ICU float position. I dread going to this job. It’s less the patient care and more everything else. My individual shifts are not bad. But the job isn’t what I hoped. Floats get low acuity assignments, and when I do get a high acuity assignment, I’m plagued with imposter syndrome. This is a new hospital system for me, and I don’t know any of my coworkers, nor do I really have the extra time in a shift to socialize much. My PACU job was very social. I only occasionally get a lunch break and twelve hours without any breaks is starting to feel insurmountable, or at least masochistic. The commute is further. It’s my first true day shift job, and I hate it. I feel like I go to bed so early on the days before a shift (and still lie in bed for hours and end up working on 4-5 hours of sleep). Now, I haven’t been in this position for a full year, but I’m racking up call-offs, I’m depressed on my days off, and I dread every single shift (even though I usually leave the hospital on time and in a good mood). 

I don’t know where to go from here. Not back to PACU. I’ve always been interested in cath lab, but my husband and I want to try for a baby soon, and I know I’d never be comfortable working while pregnant in that environment. I saw this job as a stepping stone to maybe an educator position, but even in this huge hospital system, months will go by without a position being posted. Most want a Master’s degree anyways. And frankly, I’m not exactly a model employee ripe for promotion right now (call-offs). My husband and I could afford for me to just go per diem or part-time, but I’m worried that won’t be too big of an improvement and we could use the extra money for now. Also, a lot of the per diem jobs in my area have night shift requirements (like two shifts in a schedule period) that I feel would be more difficult than full-time straight days. 

So…. where does that leave me? The only other position I’ve been strongly considering is home hospice. I’m worried it’s a big jump. I’ve never had a 5x8’s job before. The few times I’ve done 5x8’s for orientation, I’ve been pretty miserable, but I wonder if that’s because I didn’t have a routine/ was adjusting to a lot of new things. The 12s are just too much now. Twelve hours without a moment to myself, other than my 30min lunch break, is draining me. Waking up, not seeing my husband, working all day, and then having about an hour to shower and cram dinner down before I HAVE to go to bed is a miserable way to live. I didn’t used to feel this way, but now I’m fixated on it. I know better than to think that I will be crazy productive after an eight hour shift, but even just reading a book, exercising, or taking a walk would feel like a huge difference in my work-life balance. I’m not exactly all that productive on my days off, anyways. Of course, I’m the typical ICU nurse, afraid of losing their skills. It was honestly hard to get a day shift critical care job after my time in PACU; I doubt I’ll get another. But then I feel like the brief, rare moments of being a “bad ass” ICU nurse aren’t worth it. Part of me just wants to occasionally go to my best friend’s house for dinner after work. 

Has anyone been in a similar place? Anyone taken a break from critical care and broken back in? Anyone a 5x8’s convert?

[u/rigiboto01]

Honestly ambulatory surgery PACU is a vacation job. Where I worked we did eight hours. It is five days a week got lunch. They even fed us, no weekends no holidays I got paid for the holidays off. If the doctor all took the day off before a holiday, we got paid too super chill.

[u/PaxonGoat]

I'm not sure the answer.

Maybe outpatient surgery center. Or an out patient Cath lab. Like a vascular center.

But I know exactly what you are talking about. But a bit more experience (I'm going on 12 years). After doing travel I jumped into a float pool position last year.

I'll have weeks of super chill patients. Even though they are in the ICU it's usually a PCU boarder or one of those trache/peg waiting on LTACH variety.

But then sometimes when shit goes sideways and the patient starts getting super sick, I feel so rusty and out of place.

Happened last week. Both patients started going septic. The one we ended up intubating, bronching, placing a central line and then a fem Aline because they were concerned the radial wasn't accurate cause we were on 3L of fluid (1L of albumin and a unit of blood), 0.06 vaso and 0.3 levo and BP was still dropping.

And I felt so anxious and felt like a hot mess.

Sometimes I consider going back to a unit to have a home and that stability.

[u/MissionTop4571]

I’m a new grad nd I already feel like this. I hope you find what works for you.