Need advice on which job to choose as a new grad..........

  1. Situation:
    I am a new grad with a BSN (2nd degree) that has been interviewing and have multiple job offers. I am looking for a position that allows me to grow and eventually work in an ICU. I am looking to be in this position for about years before I become a traveling nurse/move to a better city/CRNA option.

    Job offer 1:
    ICU nurse: Community ICU in a 200 bed hospital. State of the art equipment. 10 bed ICU. The unit averages 3-5 patients in it at any time. This is a non trauma level hospital and any patients needing more care are flown in the helicopter. This is a night position. 2 patients under my care when I'm in the ICU. Hospital is 2 hours away from a large city. When there is not enough patients the nurse takes patients on the PCU.

    Job offer 2:
    Solid Organ Transplant Nurse: Trauma 1 level hospital with 700 beds in a large city. Transplant unit is 48 beds. High acuity patients like ICU, however no ventilators. Nurse takes care of 2 patients at a time. Average length of stay of patient is 5-7 days. This is a day position Hospital has huge growing opportunity as it is the largest hospital in the city.

    Job Offer 3:
    Neuro Nurse: Same trauma 1 level hospital on a 48 bed unit. Nurse cares 3-4 patients at a time. Average length of stay of patient is 3-4 days. Same high opportunity for growth within this hospital. This is a day position Manager stressed how difficult and challenging this position was during the neuro interview. I am looking forward to a high level of challenge.

    Questions - I want to end up in an ICU. I'm not sure the community ICU position (even though I will have ICU patients and my title will be ICU) will get me to where I'm going rather than the other options.

    ANY advice would be great. Which job would you choose and why? Just give your background when you give it. Thanks a ton!
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    About Sherbi5

    Joined: Nov '11; Posts: 3; Likes: 1


  3. by   MomRN0913
    all I have to say is congrats.

    You must have impressed a lot of people to get those job offers as a new grad.

    If your eventual goal is ICU, then I would go to the ICU. COmmunity or not, it's ICU where you are getting experience with ventilators, pressors, codes....

    You don't need to have a trauma level ICU to have challenging cases.

    Actually, if it is a community hospital, with no residents, and just a house dr, you will find you are VERY autonomous in your care.

    Personally that job on the transplant floor sounds pretty neat.
  4. by   Flare
    well, only you can decide what's right for you. You said you aspire to work in ICU and you have an ICU job in front of you. Sure, it's not at a level 1 trauma center, but even small community hospitals can have exciting and challenging moments. Is this your first job as a nurse? It may be a good way to get into the profession without going from the frying pan into the fire.

    The organ transplant job sounds pretty exctiting though as well as the neuro job, though both sound pretty stressful. If you are planning on leaving for a better city/ better job in a few years anyhom, and it were me, i'd go for the ICU job, but if you think you just may stick around if you get a good enough job, then consider one of the other two.
  5. by   RNewbie
    Wow, congrats. All are great opportunities. If your goal is to work in ICU I would go for the community ICU job. You will definitely need critical care exp for CRNA school. I think that the transplant job sounds very interesting. A job at the larger hosp will give you opportunity for advancement IMO. Good luck on your decision.
  6. by   Tutz926
    Congrats on all of these offers. If you dont mind me asking what school did you complete your BSN from? I'm looking into applying to a great BSN school.

    Good to hear that new grads are being given amazing opportunities to learn and grow in the nursing field.
  7. by   maelstrom143
    Congratulations on such lovely job offers!
    I think the Trauma I level hospital would offer you better opportunities for growth, esp since the ICU you are looking at will not have vent patients anyway, so the organ transplant placement would offer you the higher acuity and chance to see/do more than the smaller hospital.
    One of our PCU/Stepdowns actually has to have ICU experience, as they do take vented patients, so not having experience w/vents would actually be a detriment, as the longer you are a nurse, the less likely you will be to be offered learning opportunities. I have noticed a lot of facilities are requesting prior experience w/vents, etc from the more experienced nurses (2+ years).
    Last edit by maelstrom143 on Nov 17, '11
  8. by   SAHMnurse
    Interestingly enough, I totally disagree with the other posters. I took an ICU job at a community hospital right out of my BSN program. It was a larger ICU (20 beds) and we did have drips, post heart surgeries, gi bleeds, balloon pumps,AAA repairs...but the majority of our patients were elderly respiratory failure vented patients. The "easy" ICU patients. Sure, I got ICU experience, but not at all the ICU experience my friends were getting at the large teaching trauma 1 level hospital.

    With only 3-5 patients on the unit at a time, will you have the experienced staff to help you out? Sounds like you will be at PCU will be like a second home. I like the sound of the organ transplant unit; WAY more opportunity for growth. I don't think working in that small unit will be what you are looking for. Get your foot in the door at the trauma center. Grow there. Plus, A DAY SHIFT? Yay!! No, serioulsly regardless of the shift. Trauma center, then transfer to an ICU at that facility. You will learn vents eventually; and quickly.

    If I had to do over again, I would have started at the trauma 1 center.

    Keep us posted.
  9. by   Sherbi5
    This is really great advice guys, although it seems like the forum is split down the middle. I wish it was a clearer choice.

    Maelstrom - Are you sure a non trauma level ICU does not have ventilators. I thought the basic definition of ICU no matter the trauma level always included ventilator.

    SAHMnurse - Great Advice. Seems like you were in this exact same situation. Your post really helped me out. With the high acuity of the Transplant Floor and huge opportunity for growth it may be the better fit.

    Tutz - I went to Creighton's 12 month accelerated nursing program. I moved to NE for the program and it has quite a reputation in the Midwest. Overall, I thought it was a great and quick (although expensive) program and would do it over in a heartbeat.
  10. by   heathert_kc
    As a soon to be new grad myself (dec. 2011) I would be concerned about working in a rural community hospital just from what I have seen in my clinicals (which were mostly at the local rural hospitals) & as stated above: sometimes there is only one staff member in the unit especially if census is low. This is a double edged sword for you: you have the least experience and seniority therefore you will be the first pulled to another unit or sent home and you may have to work on your own before you are ready. Even working as an LPN with a couple years of experience in a much lower acuity setting, in which I am very comfy, I do not like working alone on a unit and prefer to have another nurse there for back up. Also consider pay/cost of living, benefits, and which town best suits you & your family.

    If you don't mind me asking what 'major' city did you get these ICU offers? My husband is thinking of going the CRNA route but is afraid he won't be able to get into acute care fresh out of school where we live.
  11. by   ty03us
    I went the non-hospital route for my first nursing job. I have been in LTC for almost 2 years now. I am happy I did it. I gained a lot of confidence. I don't regret it one bit. Just remember, whatever you do doesn't have to be permanent. Its the joy of nursing, we can always do something new!!!!
  12. by   ty03us
    sorry wrong post
  13. by   SAHMnurse
    Hi again! I have been thinking about your situation since I posted yesterday. I also wanted to add that I think I would take the neuro opportunity before I would take the ICU position. Getting your foot in the door at the trauma center would be ideal. Your critical care opportunities there will be fantastic!
  14. by   Sherbi5
    I have called all my mentors, instructors, and fellow nurses as well as posted on this forum for advice.

    Given that I have to make a decision by Monday I am heavily leaning towards the solid organ transplant nursing position. While an ICU position would be great, there is simply to much risk going into an all night, community, non-trauma hospital with an average census of 3-4 ICU patients on the floor at any given time. I may be stuck in the PCU for a while. The Transplant position affords me a larger network of friends in a bigger city, a day time position, and more opportunity to grow and learn.

    I am favoring the transplant nursing position over the neuro because the nurse oversees 2 acute patients rather than 3-4 (acuity is higher). The neuro floor is also a young floor and I would feel my growth on the Transplant floor where the nurses have a greater age range would be beneficial.

    The overarching theme to get to an ICU in the future by the ICU managers I talked to was not about which position I picked, but continuing my education and gaining ICU certifications (with the help of the hospital or without the help of the hospital) to show I have a passion for entering the critical care world.
    Last edit by Sherbi5 on Nov 18, '11