Local (rural) vs. Metro For A New Grad

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  1. New Grad Nurse: Local/Rural or a Far/Metro hospital for their first job?

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      Local, but Rural. Limited exposure, but more money.
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      Far from home, but Metro. Lots of experience.

I am looking for some advice on new grad positions. I live about 45 minutes west of Atlanta, but I suppose my scenario can be used for anyone outside of a major metro area.

I graduated with a BSN last week. I have received 4 job offers; two I declined because they were Med Surg and Tele, but they were 1st shift positions at medium sized hospitals. The other two are in L&D, which is my heart's desire! The first is from a very small hospital 15 minutes from my home at Tanner Health Systems. The other is from Grady. Currently, I work as an extern at Grady on their Tele floor. I like that I see people from all walks of life and I have the opportunity to touch people who have lead very rough lives (that's if I have the time).

Now, I'm torn between a night shift at a local hospital that pays better than Grady, but isn't certified baby-friendly yet, will not do VBAC's if the client is not actively in labor and progressing (because they are somewhat rural), 600 births per year, but all of the nurses seem to love their jobs there.

On the other hand I have Grady. Grady is the place where you get to see everything. They have performed two EXIT procedures in the last 2-3 years (roughly), Lots of high-risk mamas, unique family dynamics, many women without prenatal care, etc. However, it's an hour from driveway to clock-in if there isn't an accident on 20, their differentials are $1.50-2.00 less than Tanner and they require a 2 year commitment that does include a lot of prep for a new nurse. About 3,000 births per year.

I guess my issue is being afraid of not becoming the best nurse possible by not exposing myself to the crazy stuff and suffering through 2 years of driving downtown. Or starting off slowly with limited exposure, but making and keeping more money to pay off those loans.

My fiancé and his family want me to stay local. I think mainly for fear of the dangers that surround Grady with the large amount of homeless and drug addicts.

Plus, I'm a Libra and I cannot make a decision. Although nursing school has helped me with that quite a bit!

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Specializes in Critical Care, Education.

What a wonderful dilemma to have. You must be a stellar grad!

I would also say 'stay local'. The reason for their limitation on VBACs is due to physician resources, not nursing staff. From the information you've provided, the facility is a great and very supportive working environment. You will be making a difference & positive impact on your own community. What's not to like?

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Thanks so much for the advice! That's where I am leaning. You make a great point in serving my own community. That's really what it's all about, right?! It being rural, I'm sure I'll still have plenty of unique situations to experience.

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Specializes in NICU.

I'm a new grad and have just started (2 weeks in!) labor and delivery at a rural hospital in Georgia as well. I LOVE it. There's no nicu team to save me, we do all of our own labs, resus, ivs (even neonatals), everything. There isn't a dr/cnm in the facility at all times. There aren't any med students taking over your births. It's the best thing ever, and the best experience, because you will be able to do it all. And you will see all walks of life as well, though not the intensity and frequency of Grady. Stay rural! :)

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