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As a seasoned career coach working with nurses and other healthcare professionals, I often hear stories from my clients that are both heartbreaking and maddening. Nurses and nursing students go through so much in their careers, and there can be plenty of pain, struggle, blood, sweat, and tears. And when things go south, and a nurse’s career seems endangered, it can be a frightening and worrisome time.

No matter the cause of a nurse’s career cookies appearing to crumble, there’s almost always a way to get things back to how they should be. I’ve seen many varied scenarios of how a nursing career can take a bad turn, and I’ve seen many nurses turn it around and get back on top.

When the Cookie Crumbles

I’ve written before about recovering from being fired or bullied and other speed bumps that crop up on the nursing journey. It’s just not easy when the career cookie crumbles. So, what cookies can crumble? What flies might you find in the ointment of your nursing career?

Getting fired: Being fired can be demoralizing and painful. We can judge ourselves harshly, beat ourselves up, and otherwise feel miserable. Failure  or what looks like a failure – hurts, and picking ourselves up by our bootstraps after being fired is a tough task.

Not getting hired: When your job search seems fruitless, and you’re not getting called for interviews, it can be demoralizing. And when the interviews you have don’t lead to job offers, you can feel very much discouraged.

Bullying: Bullying – also known as lateral or horizontal violence – is a scourge on the nursing profession. Nurse bullies are out there, although inspired individuals like my friend and colleague Dr. Renee Thompson are fighting the good fight to eradicate it from our midst, with Dr. Thompson doing so under the auspices of The Healthy Workforce Institute. Unfortunately, some nurses quit their jobs and even leave the profession entirely because of the effects of bullying. This is unconscionable, but it happens every day.

Stress and burnout: Stress is an enormous factor for nurses. Untenable nurse-patient ratios, long hours, passive-aggressive colleagues, poor management, difficult patients, difficult doctors and colleagues, and lack of time to rest, eat, drink, or go to the bathroom all add up to an overflowing rain barrel of fatigue, worry, and stress. And when that stress barrel overflows, nothing good can come of it. Physical, psychoemotional, and spiritual symptoms arise, and the nurse may soon realize that they are burnt out, toasted, fried to a crisp, and exhausted.

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Boredom and dissatisfaction: Sometimes, nurses aren’t burnt out, bored, or otherwise under great stress. Believe it or not, sometimes we get bored. When you’ve been doing the same thing for a long time as a nurse, it can become rote and robotic. In some ways, you can relax when things are so familiar that you can do your nursing job with one hand tied behind your back. Still, this type of familiarity can breed a form of lassitude and professional laziness that doesn’t serve anyone. You can go through the motions, but what’s the point if your heart is no longer in it? Is a paycheck enough, or do you need and want more from your work and career?

ADPIE for the Crumbled

The good old nursing process can be invaluable when things go south in your career. So when a patient’s condition begins to dive, what do you do? You go back to the nursing process – ADPIE – whether you’re conscious of it or not.

When the cookie crumbles, one of the first things to do is assess the situation and see what’s happening. Whether it’s a cardiac patient with tachycardia or a nursing career turned sour after being fired, it’s the same thing – you gather data before taking action.

Next comes the diagnosis. Is it a lack of self-confidence? Was your workplace just too toxic, and getting fired was inevitable? Did your communication skills alienate you from your colleagues, leading to an irreparable rift that resulted in your being laid off? Diagnosis your situation and determine the root cause if you can.

A plan is next on the crumbled cookie to-do list. What are you going to do about it? Career coaching could help, and so could counseling or psychotherapy. If your communication skills are lacking, you may need to find out what kind of communicator you are and learn to alter your style to fit various situations.

Next, you implement the plan and see if it helps. Does career coaching move the needle? Does counseling uncover some uncomfortable stuff you need to unpack? The plan may be short- or long-term, but it needs to be geared towards getting your career and life back on track and overcoming how your cookie crumbled.

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Finally, evaluation is necessary. Did your interventions work? Have you moved the needle? Did you uncover new diagnoses that need to be addressed? Maybe parts of the crumbled cookie were reassembled, but some other areas still need work. For example, if learning about your communication style opened a can of worms about how your mother treated you when you were a child, some communication coaching or training could open the door to the need for intensive counseling or psychotherapy. It may be time to reassess.

Fortifying the Self

Crumbled career cookies are no fun, and there’s sometimes a lot of mess to clean up. You might be challenged emotionally, or the potential damage to your lifestyle could be financial. Our work is an intrinsic part of the fabric of our lives, and disruption in our careers can be challenging to process and move through.

If a negative work experience has damaged your self-esteem, it’s a good time to lean into activities and relationships that fortify your self-worth. Spend time with people who are able and willing to reflect your best characteristics to you. Connect with a career coach who can help you identify your greatest strengths. Attend a workshop that can help you pause for some self-reflection or spend time doing things that you genuinely love.

Some things make you feel good, whether camping, reading, writing, hiking, or skiing. So, when things in your career go south, lean into activities and people that can build your spirits and elevate your self-esteem.

Picking Up the Pieces

If your career cookie has crumbled, picking up the pieces is essential. As mentioned above, fortifying the self is crucial. Next, finding the missing or damaged pieces related to your career trajectory is also important.

If you were fired because your clinical skills were lacking, honestly assess what skills need to be sharpened and what you can do about it.

For various reasons, the nursing specialty you were pursuing in your particular case could be a better fit. Sometimes we nurses feel obligated to work in the clinical space, but we could do better in academia, research, or entrepreneurship. I have left clinical work behind to pursue writing, speaking, podcasting, and coaching. What would make you most happy and fulfilled regarding how you spend your time and earn your living?

When you’re in a job search process, you may be dissatisfied and frustrated with the lack of response to the applications you’re sending out. If you’re not getting any positive feedback or interview offers and feel like your strategy could be better, a new approach to the job search process is called for.

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A crumbled cookie isn’t destroyed – its shape has been changed, but it’s essential ingredients are still intact. Your nursing career is similar – nothing truly spells the end unless you’ve determined that the end has been reached. Sure, there are situations wherein circumstances may determine that nursing must be left behind as a viable career path. But this is rare – most careers can be reinvigorated and breathed back to life with some effort and sweat equity.

Has your career cookie crumbled? Do things feel like they’re falling apart? Have you lost your way? Do you feel the bottom has fallen out from under you regarding your professional life? Never fear – things can still be repaired.

Picking up the pieces may be challenging, and there may be a tough road ahead. However, with the right support, self-care, and a keen eye toward what’s most prudent to do to make things right, you can get your nursing career back on track, and your cookies reassembled. Whatever type of cookies they may be, it’s not too late to bake a new batch and turn up the heat on your nursing career again.

Daily Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.

Keith Carlson
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