I would be careful about labeling a job you have yet to perform for any great length of time and at place/ organization for which you have yet to work at (assuming you did no clinical there) as your "dream job." On what criteria are you basing this? I had a similar situation happen to me in another industry. I interviewed for 2 airlines 15 years ago around the same time. I really, REALLY wanted airline X. The pay was better, the routes were better, the bases were better, the uniforms were nicer, the service was better, and EVERYONE else wanted this airline, too. The other airline, also a major one, was good, but nothing great. As it turned out, the lesser of the two offered me a spot first, and I was in training there when the other airline called. I went with my gut and left training to work for the Dream Airline, but unfortunately later woke up to a nightmare instead. This dream company/ job changed so much after 9/11. Layoffs, bankruptcy, major pay cuts, work rule and working condition erosion, benefit reductions, base closures.... you name it, it happened. Employee morale dropped precipitously.
Things continued to get worse. Supervisors routinely bullied us not to call in sick. As a team player and wanting to be a good employee, I obliged, and continued on with a trip despite my ears becoming blocked in the middle of it so as not to rack up a sick call and deal with my b**** of a supervisor. This was the biggest mistake of my life, as I acquired permanent damage from that episode and have been medically grounded due to recurring ENT problems and the high risk of further injury. Meanwhile, friends from the other airline I have kept up with over the years (one of my fellow trainees is actually from my area and I even see her from time to time; small world) did not experience these things, besides taking a pay cut after 9/11 and experiencing a few work rule changes. In fact, a few years ago, their airline merged w/ another airline (big 3), and they now earn a lot more money and enjoy much better working conditions than flight attendants at my "dream" airline; the tables have totally turned. All these details are just to make my main point -- higher expectations increase one chances for disappointment -- as I have no basis to speak to the specifics of your two job offers.
In short, if you tout one of your jobs as your "dream job," you are assigning a lot of expectations to it. The health care industry is changing as rapidly as aviation, with many more changes to come. It is difficult to predict what these changes will mean to the positions and organizations for and to which you have applied. I am not suggesting that you should *not* take the other job, but keep in mind that you never know what the future holds, and it might turn out, totally by fate, that keeping your first offer would have, for any number of reasons, ended up being the better way to go. I realize this is a general rule; nothing new here. I just see much of myself in your enthusiasm for chasing that "dream job," just as I did 10 years ago when I left training to join the other, "better" airline. Now I find myself nearing middle age having to switch careers these years later, in part over my decision to chase the dream. Had I stuck with the "lesser" airline at the time, I would be able to hold great routes and schedules and I would be earning significantly more than most beginning nurses, enjoying really good benefits and those great layovers I miss so much. It is easy to get caught up in what seems like the optimal choice among two alternatives and I am not stating you shouldn't be enthusiastic or excited about the other job offer...I'm just suggesting you temper your enthusiasm a little bit and look a the other job with a more critical eye for a moment in order to make the most sober decision possible. Good luck to you!!!