Help with career decision

[HeartNursing3]

I received a job offer to work in a family practice clinic that is associated with a hospital. The clinic is a residency training program so each year you get new residents who come through. The residents see the patients but confer with the attendings. The clinic sees a large portion of the underserved population. They see the entire lifespan and do a few procedures and see far more adults than kids. The clinic has mostly medical assistants as there is only a very tiny portion of the job that requires a RN license, but they want RNs to get PCMH certification. I worry that I'll lose my RN skills or an edge in the job market down the road by doing a job that is 98% medical assistant. We don't even do patient education because the residents need to learn, but we're supposed to help teach the residents. Any thoughts? I have 15 months med/surg telemetry experience to date. Long term goals include going back to school for FNP, but strongly prefer pediatrics to adults. The hospital is a large financially stable hospital, but not super well ranked (I only place so much emphasis on rankings though). They do still have a good reputation in the city. They have good tuition reimbursement if you attend their college of nursing, but the MSN programs are campus based, not online, and the campus is in the opposite direction of my home and the clinic. If you attend another MSN program, they give you $3,500 a year. While they do have a pension plan, they got rid of 403b matching.

I also have a job offer to work at our pediatric hospital in the endocrinology clinic as a diabetes educator. I would see patients both in clinic routinely as well as respond to any inpatient consults. There are 6 educators currently and I would make the 7th. It's a high ranked and well respected pediatric hospital. They only offer $3,500 a year in tuition reimbursement, making it likely not feasible to go back to school while working there. However, there is always the chance of making it work or transferring to another system in a few years once I have more experience. They do have both a pension plan and 403b matching.

Both jobs are daytime Monday to Friday hours. The diabetes educator position takes weekend call, but only every 7th weekend. Both jobs are about the same distance from where I live, but the family clinic job would not have to deal with rush hour traffic. Any help or insight would be greatly appreciated!

[OldDude]

I think the deciding factor hinges on whether you want to work pediatrics or adults. If you like grownups go with the family practice - if you like kids go with the endocrine clinic. If I had to work with adults everyday I'd quit nursing and try to get a job on one of those crab fishing boats like Deadliest Catch. :)

[klone, MSN, RN]

IMO, you would be more likely to keep up your nursing skills in the urgent care clinic. You will see a wide range of conditions, work with a wide range of meds, and learn a LOT.

What skills, exactly, are you worried about losing? Any time you change roles, you will have less opportunity to do certain things, but you will have an opportunity to learn new things. Tasks are easy to relearn. Growth in knowledge is more important, IMO, than tasks.

[LuckyDevil2020, BSN]

I work in a family practice clinic that has been PCMH certified (and it was the clinic that got awarded the certification, not the individual in my case). I do a lot of administrative functions, but I also do way more care than I expected. The clinic I work in is also a teaching clinic and quite large - 34,000 pts assigned to it. There is always something going on and so far my skills are still in pretty good shape! I agree with what the first poster said, but I am the opposite! I would want to pull my eyelashes out if I had to deal with kids (and their parents!) all day long! lol

As far as school, have you considered some online MSN programs or combo programs?

Another big factor for me is traffic. I grew up an hour away from everything and after leaving home and moving to places where 15 - 30 minute commutes were the norm I could never go back. I had a job once as an adult where I was 45 minutes away from my job in good traffic, but NEVER traveled in good traffic and it could easily be 2 hours each way parked on I-5. I quit after three months because I just couldn't take it anymore.

The positive news here is that you have options, and that is always a good thing!

[jae_mc]

I agree with a previous poster stating that the deciding factor would be Peds vs Adult. Also, depending on how soon you want to go back to school would also be a factor.