January 18, 2007, 9:23 am

If You Don’t Have the Answer, Why You Still Standin’ Here?


Oh my!

And I thought flying suppositories in via paper airplane was funny!

It’s starting to look like “tampon” week at Emergiblog…

This must have been pre-suppository times because they are referred to as “sphenoids”.

Again, for female nether regions.

I can’t say their marketing ploy of showing the sphenoid being rammed into a tree trunk is very subtle!

And that’s all I got to say ’bout that!


Do you hate nursing?

Have you ever thought about leaving it?


You’re overworked, your manager doesn’t manage, your co-workers don’t work, you hate your shift and the “Three B’s of Nursing” (Bitching, Backstabbing and Bickering) are alive and well on your unit.



No, don’t quit nursing!

Quit your job!

Nurses are in demand. Unless they are two years from retiring, there is absolutely no reason for a nurse to stay in a toxic environment.

There are better jobs out there. Hospitals with administrations that actually support nursing – yes, they exist. Units with nurses who are motivated and empowered. Smaller/larger facilities that can offer a change of pace.

Or a change of specialty.


What if you are the one who is “toxic”? Burned out. Apathy so thick you can cut it with a butter knife. Not exactly fun to be around.

It may be time to take stock of your career and change its course.

By getting a different job.


The best ER I’ve ever worked in is the one I’m working in right now.

And I have worked in some nice ERs in my time!

But…I’ve also worked in some not-so-nice departments, too.

I’ve done med/surg, CCU, ICU, telemetry, psych and pediatrics.

Which is why I can appreciate the job I have now.

I’ve made changes. Sometimes major changes.

I know what’s out there.


Why would a nurse stay in a stressful, toxic environment?

  • Seniority.
    • Switch facilities in the same network. If you work for a health care “system” like Sutter Health or Catholic Healthcare West or Kaiser Permanente, you can switch facilities and keep your seniority/benefits without a break.
    • Switch units in the same hospital. The bigger facilities often offer training programs in specialties like neonatal or intensive care. Expand your horizons.
    • Sit down and figure out just what that “senority” means to you in terms of pay or benefits. Is it worth sacrificing your mental health for the often nebulous perks of “senority”?
  • Fear
    • They’ve never worked anywhere else and change is scary.
    • They don’t know that another job/facility/unit could be totally different. They assume that what they are experiencing is “nursing” as it is everywhere. These are the nurses we lose within a few years of graduation!
  • Family responsibilities
    • There is often a waiting period between the beginning of a job and the start of the medical/dental benefits, although this seems to be decreasing. There are low-cost interim insurance policies that can be purchased to cover the family for the few weeks before the benefits kick in. Being responsible for the health benefits, I took advantage of this every time I changed facilities.
    • There may be jobs with hours that fit your family’s needs much better than your current job. I was once able to move to a facility offering four-hour shifts in the evening – with benefits! Dad was home, no childcare needed! You have to look – I found this job as a tiny ad in the San Francisco Chronicle!
    • There is sometimes a slight drop in pay if the new facility starts you out at a different “step” than your current facility is paying you. I notice that experienced nurses are being paid higher on the pay scale these days. Again, you have to ask yourself if keeping your current pay is worth your mental health! Here is where moving within a facility or within a network is advantageous.
  • Burnout
    • This one is dangerous because the hallmarks of burnout are apathy and depression. The ability to see that you need to make a change can be impaired. The will to make any change is virtually absent.
    • Usually at this point, even if you don’t want to switch jobs, you at least need a break from nursing, period. If you have vacation saved up, take it. All of it. Use it between jobs to give yourself some breathing room. Discuss it with your manager, not your co-workers.

So, how do you get out of the mire of your current position?

    • Find out what is available in your area. Check your local paper, too. Usually on a Sunday.
    • Don’t get blown away by fancy brochures and nurse recruiters. Ask to see the department in action. If it’s under a collective bargaining contract with the RNs, get a copy of the contract. Look it over.
  • The biggest names aren’t always the best places to work. I live near a World Famous Medical Center with World Famous Medical School and they have the oldest, most crowded, least staffed, most hectic, least flexible ER I’ve ever worked in. Blech. I stayed ten weeks. (In all fairness I hear they added more staff.)
  • Give smaller community hospitals a chance. In the ten weeks I stayed at the teaching facility I never saw an x-ray and could hardly get my hands on lab work because it was all geared toward the interns and residents. You will have more responsibility and actually get more experience in a smaller unit, IMHO. Unless you get off on pure adrenaline, then go for the biggest of the big!
  • Afraid to cut the ties of the old job altogether? Stay per diem at the old job until you make sure the new one works out. Sometimes you actually have to work the department to know the department.
  • Or…do the opposite. Go per diem at the facility you are trying out and make sure it’s a good fit.

Maybe it’s my personality, but I was never afraid to make a switch when I felt it was in my best interest or if I wanted to try a new department.

Look at it this way, we are nurses! Facilities are begging for our skills and talents! We don’t have to “settle” for second (or third) best. We can write our ticket to the jobs we want!

I found one of the best because I was willing to make a change.

Ask yourself:

Do you work for your job or does your job work for YOU.

If you don’t have the answer, why you still standin’ there?

Just walk away….

To the right job for you.


  • TC

    January 19, 2007 at 1:09 pm

    Once again, you are right on the money. And that’s why I became a nurse, for the flexibility. (The $$’s not bad either). I’ve worked tele, ER, OR, PICU, agency and, of course, transplant coordinator. Once you’re a brain surgeon, chances are you will only ever be a brain surgeon-so you better like it.

    And yes, I am smart enough to be a brain surgeon, thank you.

  • PixelRN

    January 19, 2007 at 1:31 pm

    I completely share your philosophy. Show me a nurse that complains bitterly about her job (and continues to stay there) and I will show you a nurse that has no idea (or chooses to ignore) that possessing nursing skills in the middle of a nursing shortage is a win/win situation.

  • Burned to a cinder

    January 19, 2007 at 3:42 pm

    I am,sad to say,at that crossroads now. I never thought I’d even think of leaving nursing but my last job situation was so incredibly stressful,draining and demeaning(by management) I am wondering what else I can do. I’ve been a nurse 26 years,have critical care,peds,trauma experience and despite the shortage,I find myself not really caring about what happens to nursing as a profession.I do hope this feeling doesn’t last and that I can insert myself somewhere where I can be utilized,a non clinical position maybe.
    Or maybe I’ll be an organic farmer,who knows?
    (sorry to be such a downer,guys)

  • Type-B Premed

    January 19, 2007 at 3:43 pm

    “Once we get the wedge in, the task is easy”

    Where do you find this stuff? I’m laughing, but I’m also keeping my legs crossed.

    I’m lucky that in the department I work in, the nurses are pretty nice. Everyone gets along pretty well.

  • ChiaLing81

    January 19, 2007 at 5:47 pm

    Love your posts – your enthusiasm jumps off the page!

    BTW – did I see you in an ADVANCE for Nurses article recently about the ED? 🙂 Very cool!

  • A Bohemian Road Nurse...

    January 19, 2007 at 9:36 pm

    Thank goodness there’s plenty of different specialties in the world of nursing. Although I loved the ER, I finally got too “burnt” and moved on to something different. But the great thing about nursing is that each and every experience is valuable in the next job…

  • Erica

    January 19, 2007 at 9:58 pm

    Well said, Kim. There are a whole buncha jobs out there – but it’s hard to be patient while the right one comes up. I’m thrilled to say my patience paid off today, a new gig in my Current Health System’s new facility that opens in April – working for a manager I dearly love and professionally respect, and whose philosophy is the oft-forgotten “take care of your people and they’ll work hard for you.” It’s sad to say that’s such a rarity these days.

  • Ursa

    January 19, 2007 at 11:45 pm

    Amen. I’m wondering why some of the bloggers i read who are in such lousy situations haven’t left, and i’m thankful that my floor and my hospital seem to be pretty cool.

  • S. R.

    January 20, 2007 at 1:41 am

    I’m a new nurse, but that’s how I think about it too. If management doesn’t like me, or I don’t like the situation, I’ll just go work somewhere else. I do the best that I can, but life is too short to hate work, espcially in this diverse field.

  • Shodan

    January 20, 2007 at 6:50 am

    From the patient’s side of the fence:

    If you’re unhappy, in a toxic job, how the heck can you be a caring, attentive caregiver? My last couple of hospital stays I realized that while I saw the doc for 5 minutes, tops and the residen for 10 minutes tops, I was with the nurses ALL day (off and on of course – a stroke doesn’t require THAT much care). The nurses were much more important to my well being than the doc or resident….

    FWIW, I have NEVER met an angry, pissed-off-about-her-job nurse at Kaiser Permanente. Every nurse or NP that has been involved in my care has been wonderful. However, angry, uncaring nurses are about all I’ve ever seen at Sutter General, where my mother has stayed….

  • Burned to a cinder

    January 21, 2007 at 3:52 pm

    Referring to myself only,of course,I would NEVER take out my frustrations on my patients. If I even thought my attitude towards my pts would suffer and there was nothing I could do about a situation,I would and have left.I’m just having a hard time finding a acute care setting where it’s not so cut-throat among the nurses here.I AM going to try a different type of job,non clinical like quality control or telephone until I decide how to proceed with my career heading.Remember…..”until you walk a mile in their shoes”.

  • apgaRN

    January 21, 2007 at 7:25 pm

    Sometimes I think you’re speaking directly to me, Kim. Crazy. I’ve been pondering for a while the idea of going per diem at a hospital closer to home and a little smaller with one of my old managers from better times. However, it’s heartbreaking when there are good things about the current job… things I don’t want to get away from, but management that is stifling and spiraling downward. Hmmm, in a perfect world…

  • NurseWilliam

    January 22, 2007 at 4:27 am

    I don’t know if I am an anachronism or not. I absolutely love being an ER nurse. I get antsy to get back to work on my last day off. I love the mundane parts, I love the challenging parts, I love the difficult and heartbreaking parts. I would not change a thing. I have been a soldier and a merchant seaman. Being an ER nurse is the wildest adventure I have ever had.

  • Candy

    January 22, 2007 at 7:34 am

    Kim, right on the money, as always…

    Cinder, there is a world of nursing out there that ISN’T on a hospital floor, so you’re heading a good direction. Telephone triage and advice nurse positions need good RNs, too — and you might consider home health or hospice. Speaking from experience, I can tell you the rewards are not all financial there…

  • Burned to a cinder

    January 22, 2007 at 11:56 am

    Thanks so much Candy & Kim. I am encouraged.

  • tammy

    January 27, 2007 at 4:18 pm

    well said Kim, the most unhappy bitter nurses are the one stay in one place for too long because of fear of change…to be a nurse is to able to flex and make changes.

  • […] Just for fun, I pulled an old post from the Emergiblog archives, specifically January of 2007. My submission this week discussess what to do when the burn out has hit and it’s time to move on in If You Don’t Have the Answer, Why You Still Standin’ Here? […]

  • Kim:

    You’ve got some great points & advice here! It takes courage and self-awareness to know WHEN you need to make a change, and follow through with it. Fear and burnout definitely cloud your judgment and stifle your courage to take action. I’ve seen a lot of this in coaching my clients.

    I can relate to what you said. I’m also one who’s not afraid of making changes and starting over. Starting out as a RN, I’ve changed my career paths many times over the years – sometimes due to family circumstances but mostly following my heart. Now I’m a Certified Empowerment Coach and Wellness Consultant, and I’ve never been happier, because it allows me to use all my gifts, talents & previous education, including nursing. This semester I’m offering continuing education courses for nurses at my local college, so I feel it’s come a full circle. I get to work with nurses & doctors again, although in a different position. There are many great careers out there – nursing and otherwise. You just have to have faith in yourself and keep looking until you find one that you truly love.


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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