A Leap of Faith

Time has come for me to bid adieu to my ER family.  I've accepted a job offer back up at Hood Hospital in the PACU.  All the joys of critical care, none of the headaches of long term care.  Essentially, a short-stay ICU unit, with no weekends, no overnights, and no holidays (only on-call).  2:1 ratio, 1:1 for ICU patients until stable, wide open department with full visibility and staff jumping in to help each other, average of 30-60 minute patient stay, then it's off to an inpatient bed or back to day surgery bed for discharge, occasionally an admission hold (not nearly as often as the ER).  Limited family interactions, and even those are always pleasant and grateful that someone is taking good care of their loved one.  Patient satisfaction surveys encompass all outpatient, so, while PACU certainly plays a role, many factors are out of control of the entire department.  Metrics are fairly simple: Beta blockers, Foley, Antibiotics, and DVT.  You know it's going to be a good place to work when the manager asks how you feel about downtime and will you be bored if it's slow.  I'm hoping that the switch to days will be a blessing in disguise, but since it is a fairly behind-the-scenes kind of place, I don't expect much administration to walk around, and as long as I'm off their radar I'll be happy.  Low turnover, one employee graduated as an NP, another one switched to the late evenings position, so day shift has 2 openings.  Staggered shifts four days per week for 9 hours.  Can get crazy hectic but not nearly as draining as the ER.  I will still pick up OT in the ER, simply because it's only a ten-minute drive, so I will have to still play nice nice, but I am glad to be making a switch.  I will miss my friends in the ER but it's simply a toxic place to work full-time, the staff is burning out and leaving, both Hood Hospital and Tiny Hospital.  The new director has her head in the sand and is completely oblivious to the department's problems, no matter how many times you bring them up or throw them in her face.  The Hood Hospital manager sounds like an evil sea witch, and the Tiny Hospital manager is quick to back pedal and protect herself whenever problems are mentioned.  I'm trying not to leave unhappy or disgruntled, but it's hard to see any positives anymore.