[Calzonan RN]

I will be graduating in December :hatparty: and am starting to think about where I want to apply once I graduate. There are several hospitals near me, but there is also a pretty well known teaching hospital downtown. Would you guys suggest starting work in a relatively small (150-200 deliveries a month) hospital as a new grad or in a large teaching hospital. There are pro's and con's to both. The teaching hospital has residents on staff 24 hours a day, and a high risk unit. Lots of opportunity to learn, but very fast paced and most of the patients are non-english speaking. It also takes me about 45 minutes to get there, although rush hour traffic is going the other direction so I miss traffic. After a 12 hour shift though, it can be pretty tiring driving home. My other option is a hospital that's transferring to a brand new hospital, so new equipment etc, in about two months. Most of the mom's in there are well educated, know what kind of birth experience they want, just very 'normal' births. No high risk moms, usually, either. This hospital is about 10 minutes from my house.
I've been working as an extern in L&D since January, so I've had exposure to it and know that's where I want to end up after I graduate. I don't think I'd have a problem getting hired at either hospital, so that's not an issue either.
If you had to do it all over again as a new grad, would you start out at a teaching facility that's fast paced with high risk mothers, or would you start out slow, with basically traditional type births?
Thanks for any help

[mer_RN]

I am interviewing for an L&D position at a teaching hospital soon and I was wondering the same things you are. I have 4 years of experience aleady at a very large hospital, they do 12,000 births a year. After working with a lot of residents and med students i think i have come to the conclusion tha i like the idea of working in a teaching hospital especially when starting in a unit where you have no previous experience. Plus I think they would have more comprehensive orientations. I think in an area like L&D it is important for the orientation to include classes based at the hospital so you learn specifically how things are done there as well as orientation on the unit. I just don't think in a small hospital they would necessarily offer that because there would not be that many people starting orientation at once. Plus, personally I think it is good to go to a large hospital so you get the volume, doing 2 deliveries a day vs. 30, you are going to get the hang of it much quicker. And...i like that there is always an OB there whether it be a resident of attending. one of the OB's where i work told me one of their postpartum pts went by ambulance a few days after d/c to an er (where their group didn't have privileges) with PP hem. and there was not one single OB in the entire hospital to assist the er dr. who said they didn't feel totally comfortable handling the pt. anyways...good luck, you can tell i have already wayyy over analyzed this in preperation for my impending interview!!

[smirn80]

ask around from ppl u know. word of mouth is always good, especially when trying to look for ur first job. DO NOT ALWAYS go for the money, coz u may regret it

[SmilingBluEyes]

I would work in the place that offers the most comprehensive and longest orientation for new nurses, possible. If there is a new grad residency program, so much the better. Definately ask about their orientation program. Ask if one nurse will be primarily assigned to orient/precept you, or will you be with many varied nurses? It's very preferable to be orienting with one or two nurses, and orientation ideally should be no less than 6 months, if at possible. Walk away if their orientation sounds at all shaky or very short. (I have seen where some are oriented in 6 weeks or less-----ridiculous!). TO get the very best start in any new nursing career, orientation is critical to success over the long term.

That is my best advice for any new graduate. Good luck.