new grad rpn job choice

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Hi All,

I would appreciate some career advice. Im a new grad RPN, older in my forties with a husband and two kids. All throughout nursing school it has been my goal to work in the community setting. I am very very lucky to have two job offers on the table.

One is in a HFO position in the Nursing Resource Team in the big hospital that I trained at. I did two med/surg rotations here and also my pre-grad here. I can't say I loved the hospital environment; I had a difficult relationship with my preceptor and I found the particular unit had a lot of management issues and horizontal violence going on. The hospital is a 45 min commute. BUT I know this would be a great entry-level experience for a new grad because I need the experience.

The other is a part-time offer from Saint Elizabeth in the town where I live. Of course the hourly wage is lower, but that isn't a big issue for me. The hours would be better (no nights) and it would be local. I have always been very interested in working for St E as I hear they are a good employer. I also feel that this job really fits my long term career goal of working in community and possibly being an independent foot care nurse.

I feel in my heart that I want to take the community job, but I am afraid I lack experience. I also feel I would be a fool to turn down the HFO opportunity simply because of the exposure and experience it offers.

Can anyone offer any advice?

Hospital experience will prepare you to be a better community nurse than if you go straight from school to community nursing. If your longterm goal is to be a community nurse, be the best community nurse you can be.

Enthusiasm is so important, I'd take the community position that appeals more. It's okay to specialise directly at your age, I think. Best of luck!

Specializes in Acute Care, Rehab, Palliative.

Community quite often involves making decisions and judgement calls. Hard to do with no experience under your belt. You are out there on your own and with no coworkers to go to for support.

Specializes in geriatrics.

Agreed. Community nursing is not ideal for new grads. Without experience, you don't know what you don't know. Community nursing also requires strong assessment skills which you will develop in a hospital setting, not on your own.

@marie, have you read the book Novice to Expert by Patricia Benner? It is about the stages of clinical competence and shows how nurses' clinical judgement depends on experience.

Specializes in geriatrics.

I'll give you an example, OP. I had a resident who was deteriorating over two days. She wasn't in pain and vital signs were within normal limits for her. Nothing really unusual, yet she didn't look right. The resident was more lethargic than usual, and then we noticed she was more confused.

Nothing changed with her vitals but I decided to send her to hospital anyway. I figured she probably had a UTI or some infection brewing. Well she had both a UTI and a cellulitis. She was in hospital for over a week.

As a new grad, those are the types of subtleties often missed. An experienced nurse will detect something is off and act on their intuition.

Specializes in Public Health.
Hi All,

I would appreciate some career advice. Im a new grad RPN, older in my forties with a husband and two kids. All throughout nursing school it has been my goal to work in the community setting. I am very very lucky to have two job offers on the table.

One is in a HFO position in the Nursing Resource Team in the big hospital that I trained at. I did two med/surg rotations here and also my pre-grad here. I can't say I loved the hospital environment; I had a difficult relationship with my preceptor and I found the particular unit had a lot of management issues and horizontal violence going on. The hospital is a 45 min commute. BUT I know this would be a great entry-level experience for a new grad because I need the experience.

The other is a part-time offer from Saint Elizabeth in the town where I live. Of course the hourly wage is lower, but that isn't a big issue for me. The hours would be better (no nights) and it would be local. I have always been very interested in working for St E as I hear they are a good employer. I also feel that this job really fits my long term career goal of working in community and possibly being an independent foot care nurse.

I feel in my heart that I want to take the community job, but I am afraid I lack experience. I also feel I would be a fool to turn down the HFO opportunity simply because of the exposure and experience it offers.

Can anyone offer any advice?

I have worked in community since I was a new graduate, and I have to say that I wholeheartedly disagree with the opinion that you can't or shouldn't work in community as a new graduate. That is a popular way of thinking and an especially common belief of those who do not work in community, we were even told that by our professors in school. Once I graduated I quickly learned that it is not true at all. My company (and others that I know of) actually prefer to higher new/newer graduates as opposed to seasoned nurses with hospital/facility experience. The reason? The experienced nurses often have a harder time grasping/transitioning to community compared to those without a ton of experience else where. Nothing at all related to competency, but everything to do with the fact that community nursing is just so very different in every way. I see this constantly, and have for over two years.

I say go for it. If you believe you are meant for a certain area, go for it. If it works out, it works out. If not, it will still provide you with great learning experience and opportunities.

For me it is not a matter of popular belief, it is a matter of experience with correcting a problem and/or re-education of patients who were improperly assessed and/or misinformed by community nurses. In the majority of these cases, the nurses were novices or advanced beginners with only community nursing experience under their belt.

Specializes in Public Health.
For me it is not a matter of popular belief, it is a matter of experience with correcting a problem and/or re-education of patients who were improperly assessed and/or misinformed by community nurses. In the majority of these cases, the nurses were novices or advanced beginners with only community nursing experience under their belt.

I think nurses in every area experience this, actually. I spend a seriously great deal of my time at work doing the same with patients who have just left the hospital, and I have no idea if it is the result novice nurses with little experience as I have no access to that information. We all deal with it regardless of area.

Thank you everyone for your input. It has been helpful. I'm pretty sure community is where I want to end up, but as I am very lucky to be offered the HFO job, I will take it and just enjoy the learning experiences I'm going to encounter. I'm going to keep all options open at this point. Thanks!!

Specializes in Medical and general practice now LTC.

Wise decision. Good luck

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