Please Help me decide

Nurses Career Support

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Specializes in ED, Cardiac-step down, tele, med surg.

I am torn between two opportunities and need to make a choice by Monday. I have offerred a job in another state in a small town rural hospital in there ER. I think it's a level V ER. There's a lot of sub acute patients there, all other acute patients are transferred out to a larger hospital. I'd get lots of experience there, however. Plus they are nice and invested in my learning. Where I currently live I just started an on call position in a SNF locally and work another on call job locally doing flu shots and health screenings. I'm a "new grad" with some recent acute care experience in a residency program, it wasn't paid. My family and friends are here. The out of state position is full time, I would have to stay there most of the time, and not commute back, because the sallary is low. My goal is to work in acute care, probably in CA, no particular specilty in mind yet. What experience do you think would get me to my goal, the experience in the rural hospital or the SNF? The SNF could lead to more full time SNF work and I know some nurse have gotten into hospitals after SNF. Any advice is greatly appreciated.

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Specializes in LTC and School Health.

I would move and do the ER. More experience, more opportunities. Just get up and go! Sounds exciting.

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Specializes in MDS/ UR.

How small a community is it? If is real rural- you may come in as an outsider unless you fit their mold. Did this once, it was tough. Of course, time are different now.

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Specializes in PICU, Sedation/Radiology, PACU.

The rural ER would be considered "acute-care" or "inpatient" experience, which is what almost all hospitals will want from an applicant. SNF- full time or not- is not considered acute-care or inpatient, so it will not be as beneficial.

Take the ER job. Short term sacrifice for long term gain.

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Specializes in Emergent pre-hospital care as a medic.

The ER position without a doubt. Acute care settings will enhance and improve your assessment skills with a wide variety of patients: infants, peds, adults, geriatrics as well as a variety of illnesses and traumas.

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Specializes in Geriatrics.

I agree, ER position without a doubt!

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Specializes in Trauma Surgery, Nursing Management.

Take the ER job! You will be introduced to so many new experiences, and you will undoubtedly grow and blossom in a rural ER setting.

You will learn a completely new skill set and will be exposed to a plethora of illnesses and injuries. You will also learn how to quickly triage patients and how "disaster teams" are set up.

You just had a goldmine of learning/experience dropped on your lap, Amy! Go for it, and let us know how you are doing.

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Specializes in FNP, ONP.

ED, without reservation.

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Specializes in ED, Cardiac-step down, tele, med surg.

The town is very small, I think only 1200 people. I think the hospital is like a 25 bed unit. Being this small, do you still think I will learn enough to transfer to a larger hospital at a later time?

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Specializes in General Internal Medicine, ICU.

Yes you will. I am working in a rural hospital as my first job after grad and I am learning and seeing so much. Definitely go for it! The city will always be there for you but a job opportunity won't.

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Specializes in Emergency, Haematology/Oncology.
ED, without reservation.

Definately Emergency, you will be amazed how much there is to learn. Rural positions offer the opportunity to practise without the backup of monstrous tertiary technology, the art of assessment and stabilisation with limited resources, and the gift of seeing EVERYTHING. I would take it without hesitation, have done it myself and was the greatest experience of my nursing career, and my town was even smaller. Good luck.

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Specializes in Emergency.

Do not do the SNF. You will gain great experience in a small rural ER because all sorts of crud will come in there before it is transferred out. You will learn HUGE amounts. Plus you can use the time to simply get all those pesky certifications out of the way, ACLS, PALS, CEN, TNCC, possibly even CCRN. I worked as a traveler in 2 hospitals with 6 inpatient beds (Critical access hospitals) I got experience there with: toxic ingestions (children eating mushrooms in the yard), a day when 3 anaphylactic reactions all came in within 30 mins of each other (2 nurses on only, ED packed...in a large ED you would have so many people you might not even know there were 3), major trauma, lots of cardiac and stroke...as well as the usual kidney stones, kids with fevers etc...

really this is a no brainer given your goal to work in acute care. Going to a SNF does not forward that goal in any way, shape or form.

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