I recently wrote an article about my #1 biggest nursing career fear.
It was a hard post to write. It brought up a lot of emotions for me, but also helped clarify new career goals that I needed to set for myself.
At first glance, it may seem to some that I did that to torture myself. But there was a method to my madness.
I recently began a comprehensive writing and website development course that will take me at least 12 months to complete. And one of my first assignments was to write about a significant fear that I have that pertains to my current writing niche.
As a nurse mom blogger who writes about finding ways to help nurses take better care of themselves, I put a lot of thought into this. And I have concluded that one of the ways I want to take better care of myself is to NOT work as a floor nurse for my entire career.
Unfortunately, the wear-and-tear is starting to break me down. I am afraid that what was once a cerebral challenge is beginning to turn into full-fledged irreparable nurse burnout.
Never let your fear decide your future: my 2021 nursing career fear mantra
As a nurse blogger who frequently blogs specifically about the topic of nurse burnout, I have worked very hard to find solutions for my exhaustion.
My #1 reason for starting a website was to create an outlet for my own overwhelm and fatigue as a nurse and new mom.
Over the last two years, I have spent nearly every minute of my free time researching and exploring possible solutions for these struggles. Then I write it all out clearly as I can with the hope that I can help myself and (hopefully) other nurse moms in my position.
And voila, it works! For a while, anyway.
But, sadly, I eventually find myself feeling burned out again.
So, in the spirit of continuing the blogging assignment I mentioned earlier, I am going to dive in and open up about all of my fears about my nursing career.
It saddens me to think that I may not be a direct patient care nurse for much longer. The healthcare system needs great nurses. But I will always be a nurse, and as I like to say, a nursing practice can take many forms.
My biggest fears as a bedside nurse:
#1. I fear physical injuries from years of nursing.
Nursing career fear #1: physical injuries on the job
There is alarming evidence now that even proper lifting techniques expose nurses’ spines to dangerous forces.
Also, chronic back pain in the nursing population is a common ailment. An evidenced-based review at the Texas Women’s University reported that estimates of chronic low back pain among nurses range from 50%-80%.
Many non-nursing professionals may be alarmed to hear that after only seven years as a bedside nurse, I am already feeling the wear-and-tear of being on my feet all day. I already have chronic back pain. My legs and feet ache for days after a 12-hour shift.
I do a lot of yoga as a preventative measure, and it helps tremendously. But as soon as I have another busy shift with a heavy patient load, the pain returns. Especially when I work with total-care patients.
#2. I fear a life of burnout and constant exhaustion.
Nursing career fear #2: years of chronic exhaustion
I have written many times about my fatigue as a nurse and have even come up with several solutions to beat my nurse burnout (at least temporarily). But if I’m being honest, the only way I even recover from burnout is just not to work at all. It is incredible how much better l feel after stepping away from bedside nursing for a week.
Admittedly, I have created a few of my own unhealthy habits to cope with my nursing career. This is why one of my goals this year is to start taking simple steps to help keep my stress in check so that I don’t end up becoming a patient myself.
I realize now more than ever that, to care for others, I must take care of myself first. And the only proven way I have been able to do that thus far is to step away from the bedside and practice nursing in a different realm.
#3. I fear verbal abuse and violence.
Nursing career fear #3: violence against nurses in the workplace
Abuse against nurses is prevalent. Nurses are expected to put up with levels of abuse that would NEVER be acceptable in any other professional setting. I have been cussed at more times than I can count, in just about every colorful way you could imagine, for just doing my job. And guess what? Not one single abusive patient or family member as EVER been asked to leave the hospital. Sadly, it appears that nurse abuse is acceptable and that nurses must deal with it as a part of the job.
Here is a recent example: I had a patient verbally assault me in the vilest way possible when I brought them their scheduled life-saving anti-rejection medicines. I explained that I was there to help them, and calmly asked the patient several times to stop using vulgar language at me. Finally, I told them I would find them a different nurse and left the room.
Tearfully, I told my charge nurse, who supported me and assigned the patient a different RN. I found out later that the patient was so offended that I refused to be their nurse, that they filed a complaint against me. I also found out later that there were several other nurses in the days prior who had been putting up with the same verbal abuse.
Even worse, violence against nurses is prevalent (especially emergency room nurses), and it usually isn’t even routinely tracked. I have been lucky not to find myself the victim of direct physical violence as a nurse as of yet. Many nurses have not been so not fortunate.
#4. I fear not having more earning potential.
Nursing career fear #4: not reaching a higher earning potential
Working for an hourly wage kind of sucks. I am very driven, and I have a great work ethic. But no matter how hard I work as a nurse, I’m just not going to make any higher (or lower) than my hourly wage. I could work more hours, but I am already experiencing a lot of nurse burnout, and I have a family to take care of as well.
I often think about how nice it would be to get paid more for working harder. And I want the opportunity to earn a better living. Especially because we live in one of the most expensive cities in the US, and it’s only getting more expensive.
#5. I fear to have a terminal position with no growth opportunity.
Nursing career fear #5: not growing professionally in my career
There are opportunities for nurses who want to move into administrative roles or become nurse practitioners if you are willing to go back to graduate school for a master’s degree or Ph.D. in nursing. (When you work in the UC system in California, you MUST have a Masters Degree In Nursing to move into administration. No exceptions).
However, my bachelor’s degree in nursing was already my second college degree as I am a second career nurse (I have a prior BA in journalism). Not only was going to nursing school in my early 30’s the single hardest thing I have ever done in my life, but it was also extraordinarily expensive. I know a few nurses graduating with over $100,000 in nursing school loan debt (I don’t have it in me to tell them they will likely never pay it off on a nurse’s salary- at least not in California).
In addition, I have a family now with two toddlers who need me – and I’m already a working mom. So, I could spend a ton of money going back to school, spend almost no time with my family, have a whole bunch of brand new student loan debt, and have a terrible quality of life for the next 3+ years.
And quite honestly, the idea of being a hospital administrator doesn’t even sound very appealing to me. Not to mention, many nurse practitioners are making less then bedside nurses. Thus, I have a hard time seeing the benefit in more school at the moment.
#6. I fear not putting my own needs first.
Nursing career fear #6: putting my own needs last
In my first career, I was a medical device salesperson because I wanted the opportunity to make a significant amount of money. A decade later, I became a nurse because I genuinely wanted to help people and save lives. I wanted to do something that was so much bigger than myself.
I was proud to become a nurse, and I still am. However, this profession revolves around constantly putting other peoples’ needs first. And it must, because our patients’ lives often depend on it.
But I have a family to care for too. And as a mom of young children, I often feel that I am in constant “survival mode.” This leaves very little time for self-care.
Nothing to Fear but Fear Itself
Thinking about the things I fear most is probably my least favorite thing to do. In reality, I am a non-confrontational person and it feels unnatural for me to do a deep-dive into the things I am most afraid of. Especially listing them one-by-one and publishing them on my website!
But, if I can’t be honest with myself about what I feel in my gut when it comes to my nursing career, then how am I supposed to grow and create a better future for myself and my family?
As a busy working mom, I hardly have time to think about myself as it is. It would be a lot easier to pretend my fears didn’t exist and stay super busy until my kids turn 18 and go off to college. But making big life changes is hard, even when they are the best thing for you.
Plus, I would be well into my 50’s by then!
And I don’t have time to waste on being afraid!
Do you have any fears as a bedside nurse? Please leave a comment below!
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*Updated on 4/9/20 to include pregnant nurse precautions for COVID-19. *Affiliate links.
As an ER nurse who delivered my second baby in early 2018, I have done a lot of research about pregnant nurse precautions to be aware of when you work in a hospital. My goal was to make sure that it was safe for me to continue working in such a physically demanding environment with so many potential occupational hazards.
Fortunately, I was able to work safely right up until a few weeks before giving birth. As a per diem nurse, I did not have any maternity or disability benefits, so I wanted to save up as much money as possible before I went out on leave. Thankfully, I was able to do just that. But safety was still my number one concern. I hope this information can help other nurses stay safe during their pregnancies as well.
Talk to your OBGYN
First off, you must talk to your doctor to discuss any occupational concerns you have during your pregnancy. Continue the dialog at your prenatal appointments as you move along your pregnancy. If you have questions in between your appointments, then contact your doctor.
My goal in writing this is not to make pregnant nurses afraid to work in the hospital. I am so glad that I was able to safely work as a pregnant nurse for as long as I did. Still, there is no shortage of occupational hazards for the pregnant nurse within the hospital setting. Working safely is the number one goal.
You must communicate with management and your charge nurse about your pregnancy. They cannot help you avoid potential pregnancy hazards if they don’t know that you are expecting.
Additional recommended reading: Prayers For The Sick And For Nurses During COVID-19
Pregnant nurse precautions and hazards to consider:
The novel coronavirus (COVID-19) has many pregnant healthcare providers, especially frontline nurses, uniquely concerned. Because COVID-19 is so new, there hasn’t been enough time to study its effects on breastfeeding or pregnant women. Also, many nurses who are working directly with COVID-19 patients say they don’t have enough personal protective equipment (PPE) to protect them from the virus safely. That maybe even more problematic for pregnant nurses who directly care for COVID-19 patients.
“We do not have information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19. Pregnant women also might be at risk for severe illness, morbidity, or mortality compared to the general population as observed in cases of other related coronavirus infections [including severe acute respiratory syndrome coronavirus (SARS-CoV)* and Middle East respiratory syndrome coronavirus (MERS-CoV)] and other viral respiratory infections, such as influenza, during pregnancy.”
On pregnant healthcare personal and COVID-19, the CDC stated:
“Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. Information on COVID-19 in pregnancy is very limited; facilities may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability.”
Essentially, the CDC does not know at this time if pregnant women are at a higher risk when working with COVID-19 patients because the evidence is limited. As a precaution, pregnant women may want to consider working in lower-risk areas where they have less exposure to COVID-19 patients.
The most important take away is to always take care of yourself first. You can’t care for your family and your patients if you become sick.
Radiation from diagnostic imaging
In the ER and on most floor units within the hospital, patients often receive portable X-rays at the bedside. So naturally, I was concerned about radiation exposure and how it could impact the health of my unborn child. I felt it was wise to air on the side of safety by not exposing myself to unnecessary radiation during pregnancy.
If you are in an area where x-rays are being taken, you must wear a lead radiation apron to protect yourself, especially if you are within six feet of the machine. If possible, it is also a good idea to step outside the room while the image is taken.
In my nursing experience, x-ray technicians usually notify anyone within the vicinity of where imaging is being taken. I was able to leave the area for a few minutes, whether I was wearing a lead apron or not.
- Notify management of pregnancy
- Wear lead radiation apron
- Step outside of the room when portable x-rays are taking place
Dangers from working with chemo or other teratogenic medications
There is evidence that handling some medications, such as chemotherapy drugs, can cause adverse reproductive outcomes, including fetal loss, miscarriage, infertility, and preterm births. In addition, it may cause learning disabilities in babies exposed to some drugs if nurses are exposed during pregnancy.
Wearing protective equipment, such as gowns, masks, and gloves, can minimize occupational risk to a pregnant nurse. However, it does not completely eradicate it.
Nurses working in oncology or other areas where antineoplastics are prescribed may want to speak with management about the safest way to continue working. In addition, you can insist on getting help from co-workers or management to give teratogenic medications to patients. Moving to another work area may be a consideration if safety for the fetus is still a concern.
- Wear protective equipment when giving medications
- Ask for help from co-workers when working with teratogenic medications
- Consider temporarily working in another area of the hospital during pregnancy as your management allows
Additional recommended reading: Why I love being an ER nurse
Risk for infection
As a pregnant ER nurse, I was very concerned with the risk of infection from patients such as c-diff, tuberculosis, cytomegalovirus, and influenza during my pregnancy. Since the ER is often the first stop in the hospital for sick patients, I often didn’t know that a patient had a contagious infection until after they had been admitted. By then it was too late to protect myself if I hadn’t already.
Pregnant women need to be especially proactive with protective equipment and hand hygiene. It is ideal for all hospital employees to have their measles, mumps, and varicella-zoster vaccinations before pregnancy (most facilities require these vaccinations to work anyway). Hep B and influenza vaccination can also safely be administered during pregnancy.
As an added precaution, I made sure to change my clothes and shoes before leaving the hospital to minimize the risk of work-to-home contamination. The first thing I did upon getting home was take a shower to rid myself of any other possible bugs I could have inadvertently carried home with me.
- Stay up to date in all vaccines including the yearly flu vaccine
- Adhere to strict universal precautions and hand hygiene
- Request job modification to minimize exposure to specific patient populations
- Minimize work-to-home contamination by changing work clothes and shoes before going home
- Shower as soon as you get home from work
The physicality of nursing while pregnant
Being a nurse while pregnant is exceptionally hard work. Not only are we on our feet for up to 12 hours a day, but pregnant nurses are also carrying an extra 25-plus pounds towards the latter part of pregnancy. Additionally, the extra girth makes it significantly more challenging to fit into tight spaces.
Movement becomes even more awkward for pregnant nurses due to having an altered center of gravity. Also, high serum levels of progesterone and relaxin loosen muscles, ligaments, and connective tissues. For nurses who do a lot of heavy, repetitive work requiring lifting, pulling, or pushing their risk of musculoskeletal injury is increased.
It is wise for pregnant nurses to use patient transfer equipment and to ask co-workers for help with moving patients. However, if your work situation is still too physical for you to manage safely during pregnancy, you may want to consider a modified duty in a lower risk setting with a less physical patient load.
On another note, pregnant nurses also have a higher risk of developing varicose veins due to an increase in total blood volume caused by pregnancy. The added blood volume, combined with being on one’s feet all day, leads to poor circulation, puffy legs, and swollen ankles. Compression socks or stockings can help reduce the risk of blood clots and varicose veins as well as prevent swelling.
- Pregnant nurses may want to inquire about modified duty
- Understand how the altered center of gravity and hormonal changes in pregnancy predispose a nurse to injury (despite using best lifting practices)
- Use patient transfer equipment when available
- Ask for additional staff help with transfers
- Wear compression socks or stockings
Additional recommended reading: Top 30 Ultimate List Of Nursing School Supplies And Essentials
I worked in our ER psychiatric hold area several times throughout my pregnancy. There were a few incidences where I had patients verbally threaten me or begin to escalate towards violence. I always had a security guard with me, and I stayed a reasonable distance away from patients when I felt that my safety could be at risk. I was likely overly cautious at times, but it is better to be safe than sorry.
Violence against nurses is not uncommon, especially in the ER setting. Stay vigilant and keep away from any potentially threatening situations. If a patient is escalating towards violence, then leave and call for help immediately.
Working during flu season
The CDC recommends that pregnant women get a flu shot. Not only do hormone changes during pregnancy often make pregnant women more susceptible to getting the flu, but a common flu symptom is a fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. Getting vaccinated can also help protect a baby after birth from flu through passive immunity.
My experience: The flu season in December 2017 was unusually bad. Many patients came to our ER for flu symptoms. Unfortunately, almost every nurse was infected with the flu or a cold at least once during the season. Myself, included.
At the time, I was over eight months pregnant, and I was struggling with how horrible I felt. I always get a flu shot to reduce my chances of getting sick during flu season. However, if I ever got pregnant again, I might consider starting my maternity leave towards the beginning of the flu season – especially, if I was that close to my due date.
An unexpected benefit of working as a nurse during pregnancy
One of the best gifts that pregnancy gave me was that it forced me to not be sedentary on days that I felt fatigued. (Although while you are carrying an extra 25-35 pounds of extra weight, you may not consider it a benefit).
Many studies show that not moving enough during pregnancy is bad for both mom and baby. If fact, exercise during pregnancy can boost your baby’s brain development and make them smarter. Who knew that working a 12-hour shift might promote health for both you and your unborn baby?
Good luck to you during your pregnancy and take care of yourself!
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