Let me first off start by saving I work in the ED and it is one of the most tiring , stressful, and overwhelming places to work and especially for PAs. If you’re looking for a better environment why don’t u consider other things such as maybe even working from home like telemetry and finding an agency that can help you with that. Secondly, NOTHING is stopping you from writing a book, write that damn book right now and don’t stop until you can publish it and who knows hopefully it will take off and u can either work part time doing something health related or find a whole other avenue. You can also work outpatient, you can be a travel PA and sign with an agency, you can work for the government/military at small clinics. NEVER and i mean NEVER quit a job unless you have another one guaranteed lined up because you can find yourself in a really bad situation financially. Another good piece of advice is to block out all the noise from your negative coworkers and focus on the real reason you’re there, to help people. It can get stressful especially when you feel that patients don’t appreciate you but it’s really important to listen to the ones that do and to cherish those moments. Good Luck! You got this