As Marta* begins her commute to work, her hands become clammy, and a dull ache begins to radiate from her temples. As she draws nearer to the hospital where she works, her nausea refuses to yield to a bagel and orange juice. How she’d love to call in sick from her cell phone, but she’s done that five times this month. Instead, she’ll schlep through her day, barking at her colleagues, and being a less-than-effective caregiver. She’ll live for her next day off, then return to work to do it all over again.

Marta, like other healthcare professionals, is sick — sick of her job and in the throes of worker dissatisfaction. Despite a red-hot economy with booming job opportunities and comfortable inflation rates, some employees are feeling paralyzing despair in their positions.

Most Workers Are Unhappy

“Nearly 85% of all employees are dissatisfied with their jobs in some way,” says Tom Welch, MBA, president of Career Dimensions Institute, Stuart, FL. A well-known authority on workplace satisfaction and career strategies, Welch is also an expert in the field of healthcare dissatisfaction and is known on the speaker’s circuit as America’s “career coach.”

“There is so much turmoil in the healthcare industry, and it filters down through an organization,” says Welch. “Administrators are in turmoil because their funding is changing — it filters down to physicians who are upset with HMOs and that filters down to nurses and pharmacists who have to do more with less, and further to phlebotomists and lab personnel who are stressed and burned out.” Job dissatisfaction not only rubs off on coworkers, but affects patients, too.

“Research suggests that when nurses suffer from work-related burnout, patient satisfaction is lower,” says Eileen Lake, RN, PhD, assistant professor of nursing and assistant director, Center for Health Outcomes and Policy Research, University of Pennsylvania College of Nursing. Often nurses are quick to blame a lack of autonomy in their jobs for their dissatisfaction. “It’s important to create and maintain work environments that value professional nursing practice, support autonomy, encourage collaborative relationships, and ensure adequate staffing,” says Lake. But is there something more?

“Some of nurses’ dissatisfaction depends on how much autonomy they are given by an organization’s leadership,” says Welch. “But much of it may be old habits. Many people make a commitment to improve their work habits, but stay in the same mode or niche because they’ve done it that way for five or 10 years.”

Change of any kind can be difficult. As author F.M. Hudson writes in his book, The Adult Years: Mastering the Art of Self-Renewal, “Being stuck, being depressed in your job is awful. But it’s safe. It’s like walking around in a dark, familiar room, which may be ugly and drab, but is familiar all the same. But when you change — when you take a risk that’s out of your character — it’s different. It’s like being thrust into a dark, furnished room that is unfamiliar.... You don’t know where anything is yet, and you’re afraid. You might bump into something. You might even trip and fall.”

A Quick Quiz

Do you feel like Marta? One way to discover the true source of your dissatisfaction is to take an inventory of your career. How happy are you in your current job? According to Welch, nurses can assess their lives based on eight parameters. Think about your —

On a scale from 1 to 10, estimate how you’re meeting your goals in each area. Do you feel neglectful of your family as you pursue your education? Are you in debt? Do you make time for leisure activities? If you scored an eight or above in any category, consider yourself pretty satisfied with that part of your life. Scores of seven or less indicate areas that need attention. For most people, the source of dissatisfaction in their lives will be their jobs.

“You can look at job satisfaction as one component of your life, but there are seven other ones that can contribute to or detract from your job satisfaction,” says Welch. “If you isolate just one, you might not be getting the entire picture.”

Indeed, finances are intrinsically tied to work, and job dissatisfaction can influence how you interface with your family and interfere with leisure time. “For most people, finding satisfaction in their jobs will spill over into every other aspect of their lives,” says Welch. “We spend eight to 10 hours a day at work. If you can really enjoy what you do, you’ll see it affect everything else in your life.”

The Exercise

Understanding why you’re unhappy in your work is easier than you might think. According to Welch, there are four components that lead to happiness and fulfillment in our jobs and careers. If you’re lacking one or more of these components, you’ll feel dissatisfied.

he good news is that if all four elements are in place, you’ll absolutely love what you do.

Do you use the talents and skills that you enjoy?
By the time we reach adulthood, we’ve developed more than 700 different skills, although we only enjoy using a dozen or so on a continual basis.

“To identify your talents and skills, make two lists — one for work life accomplishments and the other for family life accomplishments,” says Welch. “For each accomplishment, figure out which talent or skill you needed to get that done. What you’ll see are five or six talents that keep popping up.” These talents or skills are most likely the ones you enjoy using and have learned to use repeatedly to gain satisfaction. And with the diversity of nursing, chances are your perfect job is somewhere out there.

“One of the best things about nursing is that there are so many ways to practice,” says Jeffrey Zurlinden, RN, MS, ACRN. As an expert in nursing career dynamics, he urges nurses to take advantage of the spectrum of opportunities the field has to offer and considers job satisfaction essential. “We all work too much to hate it. You need to find something that you really like.”

Do you use these talents and skills around people you enjoy being with?
If you’re a very motivated person, but your coworkers are unhappy and uninspired, you won’t enjoy your job even if you’re using the skills and talents you enjoy.

“You must be associated with folks of like nature and philosophy so you can find fulfillment,” says Welch. “Working with people you don’t enjoy is a definite problem.” Helping them trudge through their days may be the worst thing you can do.

“I think we try to help our unhappy coworkers too much,” says Zurlinden. Lightening a colleague’s workload day after day or bowing to chronic complaining may mean that you’re ignoring signals that show the other person just isn’t happy in his or her job. “Some people need help for the day, and that’s different. But those who chronically complain don’t benefit from others’ pretending it’s okay. It doesn’t do anyone any good.” He suggests confronting unhappy coworkers about their discontent: “Pretending the unhappiness is a part of the job perpetuates the problem.”

Are your career values met?
Ask yourself, “What is the most important thing I need in my job to be happy?” Your laundry list may have a number of things: financial expectations, a job close to home, flexible work schedule, particular hours of work, type of facility, and so on. Welch suggests making the list as long as possible, then prioritizing each entry.

Is money more important to you than location? Or do you need flexibility for your children more than the type of patients you care for? Prioritizing these puts your needs in perspective. Once your list is in order, look at your top five or six career values. “If these values aren’t being met on a continuous basis, you’ll most likely be dissatisfied with your work,” says Welch.

Do you feel you’re making a difference and a contribution to something?
What makes your world go ‘round? This is different for everyone, but if you’re feeling your work has little purpose, chances are you’ll feel little satisfaction from it.

The Evaluation

“If all four of these elements are in place, you’ll love what you do, and you’ll finally understand why,” says Welch. For those who identify the reasons they feel so dissatisfied, it can be an eye-opening experience. “You’ll understand why you’re not happy — your values are not being met, you’re not using your skills, you’re around the wrong people, or you don’t think you’re making a difference.”

Have you ever left a job for more pay, only to find out that you’re more miserable? Or moved to a different unit to be with another type of patient population, only to find out you moved for the wrong reasons? Join the club.

“Moving and changing jobs for the wrong reasons happens to a lot of people in any profession,” says Welch. “They go and get a new job because they’re dissatisfied, but as soon as the newness of the job wears off, they find they’re even more unhappy.” Most often, nurses will think the problem is their judgment rather than the misunderstanding about what brings them satisfaction and fulfillment. But for many nurses, it’s easier said than done.

“I think many nurses are afraid to take risks and so settle for very little in their careers,” says Zurlinden. He doubts unnecessary job-hopping is the answer either, but sifting through jobs is part of the process. Finding the right career is essential: “There’s no reason to settle for something that doesn’t make you happy.”

The right opportunity

Let’s take a look at some personal examples. Julie needs to work days. John would rather be somewhere more clinically diverse. And Marta, who was mentioned at the beginning of this article? She might be happier as an interior designer. “I realized that when I took stock of my job, I like my colleagues, my facility, the unit I work on, and my pediatric patients,” says Julie, RN. A nurse at a suburban community hospital, she’s been working nights for more than two years so that she and her husband don’t use outside childcare.

“I prioritized my career values and found that working more days would make me happier,” she says. “I wouldn’t be so sleep deprived, I’d be able to function more clearly, and I think I might even be a better mother.” But can it be done? “We’ll have to see if it will work realistically, but just being able to point the finger at that [night hours] is a help.”

“I strongly believe that there’s opportunity in every situation, in your personal as well as professional life,” says Zurlinden. He advocates that nurses care for themselves first. “The biggest challenge most nurses face is chronic unhappiness that may blind them to other opportunities. Find a way to make it work for you.”

Making changes in your work schedule may indeed breathe new life into your career. For nurses like Julie, just working a different shift may change their attitudes enough that they better enjoy their personal and professional lives. For other nurses, just changing from the night to day shifts won’t do.

Looking for Excitement

When John P., RN, MS,* comes to work as a staff nurse at a prestigious long-term care facility, he knows what lies ahead — mountains of paperwork, a bushel of medications to administer, and limited clinical diversity. A freshly printed degree in management hangs on his study wall, and he’d hoped it would propel him to a top-level management position at his facility’s parent corporation. Now he’s having second thoughts.

“Looking at my quiz results confirmed what I already knew — I love my patients and feel I’m making a contribution, but it doesn’t offer me the variety I need,” he says. “Even though I like management, I’d really like to do some high-tech work in an ICU. I think I’d like the faster pace and constant challenge.”

Making the transition from long-term to critical care might not be tough, but it will require effort on John’s part, according to Joan Orseck, RN, president-elect of the National Association for Health Care Recruitment.

“Ten years ago, nurse recruiters wouldn’t consider a nurse with a background like John’s for an ICU or step-down position, but today it’s a different story,” she says. “His best bet is to make sure he’s IV and dysrhythmia certified and look for a position offering him solid acute care experience, such as a staff position on a busy medical/surgical floor or telemetry unit of a community hospital.” Once he has solid experience, Oreck adds, it’ll be easy to make the transition to an ED or ICU area.

She also suggests that John look for hospitals offering critical care orientation programs to help bridge the experience gap. And taking extension courses in telemetry and advanced cardiac life support in preparation for his first interview would be a big help.

Oreck recommends that John network with the management personnel he knows through school. “I bet he has some good contacts already,” says Oreck. “Talking with them and letting them know his interests may be the most effective way to get the ball rolling once he’s prepared himself.”

Another way for John to get his feet wet is to walk in the shoes of an ICU nurse for a day. “Many hospitals offer shadowing programs for prospective employees,” says Oreck. “It might be a way for him to try out the role before he makes a time commitment.”

Looking for a Way Out

Marta has a tougher problem. Her colleagues recognized long ago that she may have chosen the wrong profession. Her hospital locker is decorated with beautiful sketches she’s rendered on her short lunch breaks, while the corners of her patients’ paperwork often are covered with doodles. But her nursing paperwork is sloppy, and her attitude is poor. More important, it rubs off on colleagues and patients. Worst of all, the daily stress of doing a job she doesn’t really enjoy is making her sick and depressed.

“I’ve known for a long time that I probably should have chosen a different profession,” says 42-year-old Marta. Nursing was her mother’s idea, a way for Marta to support herself. A nice career “for a woman,” said her mother — just not the right one for Marta.

“I love art and decorating, although I never thought seriously about pursuing them,” says Marta. “I’m just too old and too scared, I guess. I’ve been a nurse for almost 20 years. How can I do anything else?”

“Fear can paralyze you,” says Tom Welch, MBA, president of Career Dimensions in Stuart, FL. “But after really doing some soul searching about your job, you may find out you’re in the wrong career. Remember: It won’t get any better until you formulate a plan of action and stop complaining.”

Some of the most successful and best-respected people in the world made mistakes, so why shouldn’t you? Thomas Edison said he knew 1,000 ways the light bulb didn’t work, but on the 1,001st try, he figured it out. “Like Edison, you’re going to make some career mistakes — some big, some small,” says Welch. “But take words like failure and mistake out of your vocabulary and replace them with action and result.” Welch recommends that if you don’t like your results, you can tweak the action, but don’t expect anything to change if you’re repeating the same ineffective action — in other words, going down the same wrong road.

Looking for Help

Still confused? Welch recommends asking those who know you for some advice. “Ask your friends, family, or colleagues for help. Ask them, ‘This is what I do well. How can I contribute these skills and talents to the workplace?’” The answers might amaze you.

Julie’s family knew she loved her job but hated the hours. Her husband thinks she’s a great nurse, but the stress of working nights spills over into their family lives, making it hard to cope with her children at the end of the day.

John’s colleagues were generous with their advice. “I got some different perspectives from those I work with,” he says. Most said he’d be great as a clinical nurse specialist or nurse educator because of his talent for teaching. Indeed, most of his colleagues look forward to his inservices because they’re interesting — he even makes their CPR recertification a pleasure.

Marta’s coworkers relished the chance to help guide her. “Not one person I asked thought I lacked the talent or interest to succeed in an art career, especially interior design,” says Marta. “One colleague thought I should combine my skills and work to redecorate hospitals, and nursing homes, making them more comforting and appealing.” Her manager suggested that she take art courses at a community college and talk to local designers before taking the plunge into a new career.

Look to the Nursing Process

Assess. Plan. Implement. Evaluate. How many times have you used the nursing process for your patients? Now’s the time to use it on yourself — and your career.

“Most of us don’t think about relating the steps of the nursing process to our own careers,” says Zurlinden. “Figure out what’s going on, make a plan, put it into action, and then evaluate.” He encourages RNs to get proactive about their careers, reminding them that only they can put themselves on the road to job satisfaction.

“Sitting and doing nothing — and hurting because of it — isn’t good for you, your coworkers, or your patients,” Zurlinden adds. “Do something. Fix it. Life is too short to waste on a job that’s not right for you.”

*Name has been changed.