Career Changes Are Challenging, but Hold On to Hope

June 04, 2021 by Rebecca Loh RN, BSN, OCN®

In nursing, we talk about progressing from novice to expert. I remember my feelings as a new nurse, of being overwhelmed by the many things that I didn’t know. Over time, I became comfortable in my growing knowledge. I developed skills, learned about diseases and treatments, and adapted to the politics of my particular unit and the people in it.

After eight years, I’m opening myself to those feelings again as I switch from inpatient oncology nursing to outpatient practice.

Reasons to Change a Career Focus

It’s hard for me to articulate why I decided to make a change, exactly. Sure, on the surface, the regularity of an outpatient nurse’s schedule is deeply appealing. No more nights! No weekends or holidays! Who wouldn’t choose that?

My new job is in a unit that specializes mostly in phase I clinical research for cancer therapies, and the work excites me. Before, I could only support my patients through the ravages of cancer; now, I am actively involved in finding new ways to fight it.

Also, my new patients have access to potentially groundbreaking therapies and come of their own volition. They walk in wearing their own clothing, and we engage in relatively normal human interaction: we talk about kids and traffic and the weather. It’s a stark contrast to the many inpatients who are too sick to be anywhere else.

And I must admit that part of me was tiring of inpatient nursing. The physical demands of shift work are grueling, such as the stresses of constantly turning and toileting patients. And while I think I have a reasonably high tolerance for rude, demanding, or contemptuous people, I have felt my patience pushed to the limit at times and worried that I didn’t have the reserves of kindness I once did as a shiny, brand-new nurse.

Let Hope Overcome Doubt

Now that I am settling into my new role as an outpatient nurse, I’ve started to wonder: have I made the right decision?

I find myself mourning my old role as an inpatient oncology nurse and the loss of that part of my identity. I miss my inpatient coworkers. I miss the intensity. I miss the way the patients needed so much and how special it felt to be in the unique position to make their time better. I also miss the feeling of knowing what I was doing.

Most nurses have a fluid transition from novice to expert; that was disrupted and I am new again in so many ways. The robust knowledge base I built during my inpatient career feels like only a starting point for a whole new world of phase I research. My new work requires tremendous attention to fine detail. And I’m in a unit full of new faces, names, and roles, whose interplay I have not fully deciphered.

Of course, doubts like mine are totally normal. And I know I must sit with those uncomfortable feelings until I find my feet in this new environment. Hope is leading me through that process.

I hope I come to love this work, as I’d loved being an inpatient nurse. I find hope in talking with my new colleagues about their patients. Their faces light up. They brag about how many years they’ve known them. They talk happily about celebrating milestones; they grieve when a treatment stops working. And I realize how special this type of relationship is, even if it lacks the acute intensity of the inpatient connection. Knowing a patient longitudinally provides a different window into the human experience, a bond that strengthens with time. What a gift it must be, to watch a patient’s life over years, share in their hopes and dreams, and ride out the ups and downs with them.

I’m going to embrace this chance to see for myself.


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