To leave what I thought was my “dream” job due to the culture?

[Hellskitchen24]

I’m a nurse. A year ago I started what I thought was going to be my dream job, what I thought I had trained for, one of the so called ‘pinnacles’ of nursing. Now, I actually like the work, but the culture sucks. Management is toxic and all about hierarchy. There is a MASSIVE blame culture. No one really bothers with each other; interactions between staff are only transactional, there’s no chit chat, it’s generally just you, your patient(s) and the brick wall. I don’t crack a smile most shifts never mind saying much more than “hello” to a colleague. One colleague actually blanks me entirely, but she’s a known bully with other staff so I just ignore her back.

I am used to working in smaller teams where we all get on so well, have a laugh, but obviously get the job done as well. I’m still good friends with colleagues I worked with 10 years ago. Where I am now is the polar opposite.

The logical answer is to leave. I’ve got a couple of opportunities lined up that would suit me. But there is still this huge element of guilt. This was supposed to be my dream job, the one I literally worked my arse off to achieve. The sad thing is like the job, I feel like I make a difference and I get to provide excellent care. But the culture is horrid, like really horrid. I don’t know why I still feel so torn. What would you do?

I’d leave.

If there's something nice to go to, I'd leave too. Life's too short.

In my head it’s sort of taking a step back in terms of the job. The things I have lined up I mean. That’s sort of why I’m so torn. But mentally I just can’t keep doing it where I am.

Is it an option to do the same job in a different setting?

I think you'll burn out if you stay there. You will get roped in and affected by the toxic management or bullying eventually.

Is it possible to do this type of work elsewhere?

Why do you feel guilty?

I'd leave.

I would need to commute into London to achieve that so no, not really unfortunately. That would be a 1.5 hour commute minimum there and back.

DD lasted six weeks in her dream job. Although she was disappointed as it was what she'd been aiming for for ten years, she said it helped her work out exactly what she did and didn't value.

Personally, I would rather take a step back than be unhappy in my job OP. However, before you give notice, or accept another position, could you speak to HR about the situation, mentioning that while you love the job, you are seriously considering leaving as there is a very uncomfortable atmosphere between the staff, which makes you in turn feel miserable.

On the other hand, would it be possible to make a joke about people who take themselves too seriously? I once worked in a place where a particular member of staff always set everyone's teeth on edge. Because I was new, I made a bit of a joke to him about how did he always manage to look so serious, and gradually, as time went on, I was able to get him to take things less seriously, while other staff members also seemed to learn the art of having a joke, and a bit of a laugh while we worked. The job always got done, but suddenly the atmosphere in the whole place changed, meaning that people looked forward to going to work rather than dreading it.

I completely understand, I secured a job in critical care in what is perceived to be "the best" hospital in my area. This was my dream job and I was so proud of myself, when I first started I had big plans to do further study and progress into a specialist role - I have no desire to progress into nursing management roles. I loved the one to one patient care, I felt like I was a actual proper nurse, delivering the type of care that I had trained & studied for.

But the culture was awful, I had been warned about the culture of this hospital before I joined (I ignored everyone). I also wasn't aware of the toxic culture in critical care. Nobody talks to each other, some nurses barely talk to their patients (if they are awake). I left because I was offered another opportunity, but I regret leaving critical care. I wish I'd stayed and moved to a different unit instead I think I would have been happier.

My advice is don't feel guilty if you decide to leave, do what makes you feel happy. And due to the nursing shortage, if you change your mind and want to return you can! Or maybe find a different hospital with a better culture.

Good luck x

Your mental health and well being should come first and be top of your priority list,

Can I PM you?

Leave leave leave and don't look back..this is not uncommon in nhs sadly... Particularly more niche areas. And I hate to say this but from what I have seen its women driving this behaviour. At least you have recognised it and aren't tempted to join in. Other opportunities will come up. Don't worry.

@NurseButtercup I l wondered whether this might be critical care (maybe with a focus like transplant/ECMO etc). I also work in critical care and the staff not talking to each other and lack of team feeling has been a big problem since the pandemic (I suspect in large part due to the massive exodus of experienced critical care staff).

I'm sorry that you and the OP have both been affected by toxic areas. It's such a shame that there seems to be so much bullying in healthcare.

I wasn’t aware this seems to be a ‘thing’ in other units. Why is it like this?! It makes me so sad, because I means I can’t even jump ship to another hospital.

Are you still there or did you move on?

I once knew a nurse who had the same issue in ICU (bullying and toxicity) and left the profession for good. She was dedicated and bloody good at the job, but just couldn't take the atmosphere anymore.

Still there- I'm in a senior role, and am trying to change things. I am lucky to work with some lovely people, both within the nursing team and wider MDT. Most of us seem to be working towards a more integrated team. This is why I stay, as I feel there is motivation and work happening to improve things. I also still love critical care nursing, and enjoy the (sadly few occasions) when I am allocated to the bedside.

The 'not talking' where I am seems to be more down to a large number of junior staff trying to balance their workload and find their feet, and the layout of our ward with small bays and side rooms, which make it difficult to leave the room sometimes. Also, it can be difficult to integrate in to a larger team, and this is a common comment from nurses who come to us from smaller teams.

The bigger knock-on effect of a more inexperienced workforce also seems to have have pushed us back towards a more hierarchical structure again. Although the senior nurses and medical team have been trying to support the bedside nurses to become more autonomous, the bedside nurses don't have that confidence yet. This is then becoming the culture, and our new starters were noted to be picking up this way mindset, hence the work to improve this.

When I'm on duty, I do my best to get round to everyone, check on the patients and offer help and advice to other staff. I am finding that I am being asked for more help, and often with more 'basic' tasks or issues, than ever before. I am of course willing to help them, I think it reflects the deeper issues withing the NHS generally at the minute.

At the same time, the workload for managers is getting larger and us more experienced critical care nurses are still somewhat beaten and bruised after 3 years of pandemic nursing. I can easily imagine that this has manifested as stress, with some managers burning out and behaving poorly towards other staff. I am not for one moment suggesting that this acceptable, nor that it was never a problem pre-covid, but I do think it explains why this is such a widespread problem at the moment.

Sorry for the ramble- my overall advice to you OP is that you do need to think of yourself and your needs first. Nursing is a very diverse field, and you may in future find a critical care area or role that fits you much better. At the moment, you sound like you need a change. I would have a look at other opportunities and see what is the best fit for you.

May I also advise speaking with a counsellor if you haven't done so- critical care nursing is already a very stressful job (lots of death, very distressed families) and you've also had to deal with a toxic workplace- you can self refer through occ health or through your union, if a member. I wish you the best of luck, whatever you decide to do next

“This was supposed to be my dream job, the one I literally worked my arse off to achieve”

You did achieve it. Congratulate yourself, then go and do something you enjoy.

Sadly that is quite common in competitive/advanced areas of nursing. Ambitiousness (and egos) don't always make the best teammates. But I find the tone is mostly set by management. If they don't care, no one else does. People just want to get the day over with.

I’m going through v similar and finding it hard to actually hand in my notice. I feel for you @Hellskitchen24 it absolutely sucks

Management is always the problem

Hi OP, I can identify with your experience. The problem is that you don't know about a toxic workplace/culture until you are in it. I had a similar experience that was adversely affecting my mental health. I sought another job.
Believe me when I say this is more common than you think.
I would say take another job opportunity despite this being your dream job.
Your health and happiness are very important. Please make sure you document the reasons why you are leaving in your exit interview

Ask yourself about the ethical base of your job. What I mean is a "what if". What if a horrid outcome to a patient occurred. One that was a one off, but no one persons fault but it became public knowledge. Would the ethical culture support the team or invoke a blame of a specific portion of the team?

I'm in exactly the same position. Love my job, the culture is toxic, complete and utter lack of clarity and a micro managing style. I've already made up my mind to go. I'll also be taking a small step down but I think it's worth it. Good luck!