Help....advice Needed Stat

  1. I am graduating in May and have been out interviewing over the last few weeks....my focus has been Critical Care (i.e. ER, Tele, ICU) I have had some amazing offers....One of which is in a beautiful Level 2 ER....the orientation is a 6 month New Grad Residency Program....

    They offer flexible shifts (i.e. 7a-7p, 10a-10p, 2p-2a etc....) , self scheduling, new grad nursing orientation includes 3 day-12 hour shifts with 1 full day each week being in a classroom and not on the floor....the will send the new grad to tele for 3 weeks and to icu for 3 weeks as well as have the new grad follow the IV team for a week....

    they teach and certify you in all of your competencies and have you work with a preceptor for 9 months....on the shift of your preference....

    by the end of one year....ACLS, PALS, and Trauma Certs will be achieved...

    this hospital is 8 miles from my home....not bad

    The other offer i am seriously considering is 1/4 mile from home....in Tele.....also a nice hospital....this one is union....has a few retention/night bonuses and when all is said and done pays $13,500. more in the first year....

    They too said they would train me well (12 wk orientation/preceptor) pt/nurse ratio is 1-4 on days and 1-6 or 7 on nights....

    WHAT TO DO !!!!?????!!!!!

    Some say the ER is the opportunity of a lifetime.... esp. since just 2 years ago it was virtually unheard of for a new grad to be hired directly into the ER.


    ANY advice for a new grad in this dilemma is welcome and desperately needed.....be brutally honest....my feelings won't be hurt...
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  2. Poll: Which position should I accept?

    • ER

      88.89% 8
    • TELE

      11.11% 1
    9 Votes
  3. 6 Comments

  4. by   TazziRN
    I went straight into an ER preceptorship with similar offers in 1988 and have never regretted it. I love the ER and I doubt I will ever go to another field.
  5. by   CCL"Babe"
    I did Tele for about a year before I started in the ER. Tele gave me a good base plus I had volunteered as an EMT while going to nursing school. Going straight into ER is hard. I have precepted several new RNs. But if you have what it takes, go for it. The ER is a wonderful place. Good Luck.
  6. by   MPHkatie
    I'd say it's all about your comfort level. On tele, the patients will have a defined problem (however, of course, any patient can develop new problems at any time). And you generally will have a bit more time to think about the problems (medical ones) that your patients present with. ER is a bit different, as once the pt has a defined problem, they should be getting some sort of dispo.

    I worked ICU before I came to the ER. Now I work with and occasionally precept new grads. I think our new grads do a great job, but they lack the perspective of the RN's who have been elsewhere. Sometimes it is difficult for them to decide what level of patient they are caring for (triage system) and they tend to get more a bit unsettled by unusual patients (Those with trach's, colostomies, port-a-caths, feeding tubes) because they did not get an opportunity to work with a patient who was slightly more stable with one of the gizmos. For example, I had a new grad recently argue with the MD that her patient was an ICU patient because he had a trach and did not walk. He normally lived this way in a snf, and was going to recieve treatment for possible urosepsis. (He went to the floor) Our new grads also spend time in the ICU's and such, but 3 weeks isn't that long a time. HOWEVER, I'm not sure the lack of perspective hinders their care giving or their ability to succeed in the ER. The RN I mention is doing a great job.
    You don't state a clear preference for either type of nursing. If you are burning to do ER, I'd go for it. If you feel you would be happy on Tele, I'd recommend that first. The positions sound good, and I am sure you can not go wrong.- until they pull that 9 month orientation out at 3 months due to staffing shortages.
  7. by   ERNurse752
    I voted ER, for an obvious reason.

    The New Grad Residency program sounds absolutely wonderful.

    For tele, 1:4 ratio is OK...1:6-7 could ***really*** stink...plus, why do they have so many bonuses? Usually places that pay so much more are doing so for a reason - they can't get anyone else to work there, so they pay the big bucks.

    I do agree that it is valuable to have other experience besides ER...either as a student or a nurse. You'll have a broader perspective on what happens after pts get out of the ER, which means you can take better care of your pts while they're still there.

    But, if ER is really what you want, go for it. Especially with what sounds like such a great opportunity.

  8. by   RN2B~MAY4ME
    Thanks for all the great advice....I accepted the ER position....less money ....but I was driven by the passion thing, you know?

    :kiss :roll
  9. by   amy
    Late responder, but I, too, went to ER right out of school in 1999. I am going for an interview back to ER after doing Public Health x 8 months. GO FOR IT!!! Once it gets in your blood, you will never be the same... Most of all, GOOD LUCK!

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