benefits vs. work environment

[ThePrincessBride, MSN, RN, NP]

I know you are just about sick of me and my endless Job Search, but I need your assistance.

I have an offer contingent on passing a background check (which I am sure I will pass) on a med/surg floor. This job is affiliated with a state university and has state benefits: great medical insurance (which is big), a state pension (I have a couple years until I am full vested), more vacation and sick time, 100% paid for tuition at the university, etc. I am extremely familiar with the system, their charting and the floor. However, it is nights and the patient: nurse ratio is high (in my opinion). The nurse manager has stated that she is in the process of changing things. She did ask a few inappropriate questions (why has it taken you so long? Did you struggle on NCLEX? Are you expecting?), but other than that, no problem.

I also will be shadowing on a unit at another hospital nearby my house. It is a tele unit, day shift with about 1/2 the patient:nurse ratio as the other unit. The commute cannot be beat: 3-8 minutes. Day shift. And I haven't seen any unprofessional behavior...yet. On this unit, I will be working with a higher acuity of patients, and it seemed like a nicer work environment. However, the benefits are not as good as the other hospital (less PTO, less tuition assistance, retirement and health insurance are not as good), and I am not as familiar with the system.

With my psych problems, it is important that I have great health insurance. I also want to be able to travel, and the state university allows for more vacation accrual through comp time, and I know I want to go to grad school. I have been fortunate to graduate undergrad debt-free, by choosing the med/surg unit, I will save about 45k-50k and get a master's debt free.

So I guess I am asking: how important are benefits to you? By the way, the med/surg job isn't something I plan to do long-term, for a year or two until I can transfer into something else.

[Altra, BSN, RN]

Take the state job.

[Seaofclouds, BSN, RN]

In the past, I did not worry about the benefits because we did not need them (used my husband's benefits). Now that we are in a situation where we will need my benefits, I have made that a priority in my recent Job Search (we are moving). For each offer I received, I asked for their full benefits books (and was always given them). We then compared the cost of the coverage and what the coverage was we would be getting with each plan. When making a final decision, we looked at base pay, cost of travel, and cost of benefits each pay to determine which position was the best for our family. Luckily it worked out to be that my top choice was the best choice.

[MatrixRn]

I agree...take the state job. You have stated that the benefits - time off, insurance and ability to go back to school are you important factors. So go with it.

[icuRNmaggie, BSN, RN]

The benefits at the State University hospital are worth approximately 25-30,000 per year.

The defined benefit pension plan is huge, and could be the difference between retiring at 55 1/2 with a full pension of 2500 or so per month or working forever.

Assuming that this is a teaching hospital or tertiary care center, you will have the opportunities to transfer to a specialty area and earn a MSN. Which is worth anywhere from 30k to 100k. You will be exposed to experts who research, publish and teach EBP and that is priceless.

Definitely take the State position.

[Been there,done that, ASN, RN]

I do not know which "psych "issue you are experiencing. The stress of night shift with a high ratio could be detrimental to your mental health.Sometimes, peace of mind is the most important factor.

Discuss these options with your mental health care provider.

Good luck whatever you choose.. let us know!

[Jules A, MSN]

You have gotten excellent advice so far. I just wanted to add that with a higher acuity on the tele unit despite the better staffing might not be much of a plus.

[BrandonLPN, LPN]

I stopped reading at "state benefits". Take the state job.

[ThePrincessBride, MSN, RN, NP]

Thanks everyone for your replies!

I did not realize that it would be unanimous, and I appreciate all of your input. I was always told not to chase the money or benefits but look at work environment. The state hospital med-surg unit seems to have low morale (I've worked on the unit as a tech, and while it was chaotic, I enjoyed the teamwork), and there is a high turnover/transfer rate. The other place seemed a bit sunnier with more impressive work experience. But the non-state hospital has been known to lay off people without notice and stop matching retirement plans abruptly.

On the other hand, you guys make a great point. Those benefits are extremely difficult to ignore. 100 percent paid in-network healthcare. 100% tuition covered and opportunity to get more vacation hours and travel...plus, if I stayed within the system, I could retire with full benefits at 50, assuming that the pension still exists and that I stay until age 50. Hmm....

Thanks everyone! I will make sure to keep you all updated. :)

[Jules A, MSN]

Thanks everyone for your replies!

I did not realize that it would be unanimous, and I appreciate all of your input. I was always told not to chase the money or benefits but look at work environment. The state hospital med-surg unit seems to have low morale (I've worked on the unit as a tech, and while it was chaotic, I enjoyed the teamwork), and there is a high turnover/transfer rate. The other place seemed a bit sunnier with more impressive work experience. But the non-state hospital has been known to lay off people without notice and stop matching retirement plans abruptly.

If you have worked at the state hospital you know all the warts and trust me there are warts at the "sunnier" place also, you just don't know what they are. :) I also think your comfort level with the computer system and routine will be comforting to you as you begin this new chapter.

[Here.I.Stand, BSN, RN]

I agree: state hospital...unless the ratios are completely insane like 10:1. Early in my career, I worked on a floor--mostly neuro and ENT with all of their close monitoring, impulsiveness, GTC seizures, and lumbar drains (neuro); and fresh trachs, tubefeedings, extensive wounds and flaps for later reconstruction, alcoholic personalities, body image disturbances from losing large portions of face (ENT.)...........with a smattering of urology (CBIs), adults w/ CF (frequent abx, depression/anxiety issues, and diabetes), and ophthalmology (q 1 hour eye gtts.)

It was a very high acuity floor! On nights we'd often have 7:1, and while it could get overwhelming at times, usually it was doable.

Another plus with a teaching hospital is they generally have better orientations. And like you said, with your disorder, insurance and PTO to take care of yourself is very important.

[ThePrincessBride, MSN, RN, NP]

The nurse:patio ratio is 1:6-7 per nurse manager. Some of the patients are on tele, some need chemo, some are also on dialysis and leave the floors several hours at a time.

Maybe it is because I am a new nurse, but that sounds intimidating. I took care of four patients in my senior practicum and I thought that was a lot of work.

The orientation is about the same length as the non-state hospital. They are both teaching facilities, the state hospital moreso than the other. But I have been floated to the unit as a tech and know the people, flow of the work place. And I am sure I will be able to get days with six months, which will help.