I'm torn, help!!

[Spoiled1, MSN, RN]

I am transitioning from HH to a hospital setting. Long story short I have no acute care experience. Today I interviewed for a job on a pulmonary progressive unit. It's considered med-surg but they have 6 beds for trach/vent patients and they also have tele beds.(I have trach/vent experience from my HH patient). I was told that I will be required to take a class on telemetry, etc. Anway the interview went really well. I was impressed with the unit--the variety of patients and could see myself working there. So my dilemma is: I have another interview tomorrow for a stepdown ICU position in a hospital that is about a 55 min drive one way from my house. I definitely want to work in critical care some day, but I guess I'm wondering if it's worth an hour drive to get ICU experience. At today's interview the charge nurse said that a lot of their nurses transition to the ICU after about a year on their floor so it sounded like they expect their nurses to move on at some point. Their comment was if you can handle this floor you can work anywhere in this hospital. Of course all this is hypothetical because I haven't received an offer yet, but I am almost certain Pulmonary progressive will offer me a job. So should I take med-surg pulmonary progressive and move on to ICU after a year or so, or start in a step down ICU with a 1 hour drive (one way)???

[NurseFrustrated]

If it were me, I would take the job that is closer to you (in the pulmonary unit). You said that you have come from HH with no acute experience. I think that the pulmonary unit would give you some acute experience before moving on to the ICU, which would probably be a good idea. Also, 12 hour shifts can turn into 13 and 14 hour shifts. I would avoid a long commute after an exhausting day if I could. Of course the choice is yours, but this is just my two cents.

[bill4745, RN]

I agree. The pulmonary unit would be a good intro to critical care. The shorter commute is a plus, coming from someone with a 50 mile one-way drive.

[mentalhealthRN]

Yeah I agree with the other folks here.......I worked on a medical/respiratory unit and liked it a lot--even better they had no tele--I left to pursue psych but I liked it. And that drive is brutal after a long shift--I know first hand. I got pulled over driving after a long shift (a 16 hour--that turned into an 18 hour shift) half asleep behind the wheel. I ended up having to give a urine sample and unfortunately the 0.25 mg dose of xanax I was on at the time showed in my urine as did the cold meds I had taken--sick with a cold--and landed myself a DWAI-Prescription drugs........ And I am not a person who uses or abuses drugs or alcohol--just a nurse driving home after a really long shift with a 45 minute drive! I feel like it is good for me to share what happened to me so that it won't happen to others....be wary of long shifts and don't try to be a hero.

Good luck to you and I gotta say--I give you huge KUDOS for going into the hospital after the HH work.......you are brave! I left for psych and am not sure I could feel competent going back.....

[NurseHotFlash]

I agree with everyone else. Sometimes I work three 12s in a row, and I thank God on that third day that I live 15 minutes from the hospital!

[Spoiled1, MSN, RN]

Thank you all. I am still waiting to hear back from that particular hospital to see if I'm even offered a job. I will still go forward with my interviews today, but the commute is what I was worried about. The comments were confirmation for me.