Choosing the right hospital

NurseWeasel · Mar 27, 2003

Well for comparisons sake, the VA gives you 5 weeks of VACATION per year, from the start. Obviously you don't start with 5 weeks on the books, you earn so much a month - but you start accruing on Day 1 and can use as you earn. Then you also get sick time on top of that. I had a local (non-VA) hospital tell me they could compete with the VA because they also give 5 weeks of PTO (25 days) per year. Well yeah, on the surface that matches... until you realize that PTO is vacation AND sick leave, while the VA gives something like 5 weeks vacation + 3 weeks sick leave. Just something to think about. Any guesses where *I* wanna work when I'm done with school?

You'll want to compare health insurance packages, like which insurance co they use, how much your monthly contribution to the insurance is, what your copays and deductibles are. Also life insurance, short term and long term disability - benefit amounts, waiting periods, and amount you're expected to contribute. RN:patient ratios, scheduling issues like flex & OT & length of shifts & what happens if they're over- or under-staffed, floating policy, general feel of the place, etc.

Maybe hang around the cafeteria at mealtimes and see if you can con some nurses into giving you their honest opinions of how they like the hospital and why they're working at Hospital A instead of Hospital B (and vice versa).

Can't speak to the orientations, still too much of a fledgling myself. Good luck to you!

susanmary · Mar 27, 2003

Find out actual staffing ratios for each shift. Then speak with human resources/unit managers to arrange to shadow a nurse on the floor/specialty you are interested in. If you are interested in more than one specialty, shadow a nurse for each specialty -- in each facility. Each floor is unique -- even if it is "med-surg" "ccu", etc.

Regarding the summer preceptorship, I never heard of having to commit to work after the preceptorship was over. We have had several nursing students who completed the preceptorship, worked as aides part-time on weekends their senior year, and were hired as nurses -- however, there was no commitment. A six-week orientation seems to be the norm. For many reasons, an OR orientation takes much longer. Remember, most nursing schools do not cover "OR" in their curriculum.

My opinion is:

1. Job Shadow

2. Find out the staffing ratios

3. Find out the benefits

4. Take the position that offers the most support and best staffing ratios -- as you become a more experienced/seasoned nurse -- you will realize that working conditions are everything.

llg, PhD, RN · Mar 27, 2003

I agree wholeheartedly with susanmary that "working conditions are everything." A lot of new nurses focus too much on superficial things that don't tide you over during the hard times. In other words, once you have spent that sign-on bonus, it's gone. It's not going to help you enjoy your career.

1. Try to find out how they treat existing staff. Will you be happy there in the long run? That's the most important question. Find out about on-going opportunities for education and career advancement. How do they handle issues such as "floating" and "short staff" situations? Do they have mandatory overtime? How (and whom) do they reward with extra bonuses, etc.

2. How do they do their scheduling? What type of schedule would you be likely to have if you worked there?

3. As you talk with nurses who work there ... and/or as you tour the unit ... is there as sense of commeraderie? Do people seem to work together as a team or do they just pay lip service to the concept of teamwork? Do you see staff smiling as you tour? Can people give you examples of positive experiences they have had as an employee?

4. As for orientation, ask at what point the orientee is given his/her own assignment and "counted in the staffing numbers." What you are looking for is a long orientation in which you are NOT counted in the numbers. You and your preceptor should share a one-person assignment for most of your orientation. As you near the end of orientation, it is OK to begin to be counted as a "partial nurse" in some situations.

5. Unless you are working on a general care floor on which the experiences will be very similar to those encountered as a student, 6 weeks sounds like a very minimal new grad orientation to me. I've coordinated orientation programs for years, and 6 weeks is at the low end of the norm. At the children's hospital where I now work, our standard orientation for general care floors is 8-12 weeks, depending on the specific unit and experience level of the new hire. The ICU orientations are usually 16 weeks.

I hope this helps,

llg

Katnip, RN · Mar 27, 2003

How much time can you accrue and how much can you carry over? Do they cash out excess PTO or do you lose it if you don't use it. And be careful. They may offer you a lot of vacation time, but will they allow you to use it when you want?

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The good part about PTO versus vacation/sick time is if you're not the type to use sick time, you can use it as personal leave, or in some places, get cash.

Some hospitas offer permanent shifts-no rotation to a shift you didn't sign up for. Try to find out the turnover rate. Turnover will tell you a lot.

Tuition reimbursement. Do they pay for CEUs? Are you considering furthering your own education?

NsgTiger · Mar 27, 2003

Thanks! You all gave me some good things to think about.

MelRN13 · Mar 27, 2003

I agree with everyone. You might also want to inquire about sign-on bonuses, overtime incentive, and union benefits.

Good luck!

sheanndie · Mar 27, 2003

To answer the question about benefits in a general employment perspective, I'd like to add that you might contact both hospitals and request for their benefits new hire booklet.

Once you've received them, take your time to review them side by side and list the pro/con's of the two hospitals.

When I worked in benefits office, I often mailed these books out when the recruiter requested.

I don't know of a 'benefits for dummies' book, but while many people are intimidated by their benefit statments it's not so bad once you get a handle on the basic terminology. If you have a general question about benefits terminology email me and I'll try to help. Keeping in mind that each employer has their philosophy and interpretation on the regulations. Meaning what one place says is 'right' may be their right.

Plus, some 'benefits' may be company wide (PTO trade in) while others may be department specific to nursing. (CEU payment).

Also, review if the pension program is a defined benefit or a defined contribution plan. It can make a BIG difference to future plans.

I hope this helps.

Disablednurse · Mar 27, 2003

When you ask your questions, be sure to ask about sick time, what happens when you have to call in, how they handle this. Most places have a grace period when you start before benefits kick in, ask about this. When you are there signing the paperwork or talking to them, keep your ears open, listen to how the staff talks to each other, are they respectful or nasty with each other. Just a few other things to pay attention to.

sjoe · Mar 27, 2003

weasel writes: "Maybe hang around the cafeteria at mealtimes and see if you can con some nurses into giving you their honest opinions of how they like the hospital and why they're working at Hospital A instead of Hospital B (and vice versa). "

That's what I was going to suggest, so obviously it is an excellent idea (and it's what I have done numerous times). Not to mention that it also gives you a good idea about the kind of food you'd be eating while working there--if you ever had time to eat, that is.

My first job out of school was med-surg at the VA, as Weasel is planning. I highly recommend it. Excellent system, most of them are teaching hospitals so they are used to teaching nurses as well, and patients' insurance coverage and money just does NOT come into the picture.