CNS in May, should I be looking for jobs now?

Editorial Team / Admin · Jan 9, 2006

okay guys, gotta questions here. i will be graduating in may with an adult med-surg cns. i plan to take the ancc exam as soon as possible (probably mid-june). now, comes my questions?
i have been offerred a position in a private large (17 mds) general and thoracic surgery office where i did much of my clinical time. i loved the atmosphere, the docs (most of whom i know via my experience in the er) and the general job. however, i'm getting cold feet about leaving the hospital...advice? (pay - much more than the hospital could offer). they offer health/dental/retirement similiar to the hospital.
another md (stroke fellow) asked me to consider a position too. this would be a new position and i would have lots of flexibility and would be able to stay employed at the hospital too. (pay - not much more than what i make now as a case manager).
however, (and this is the biggie), i love the er and want to stay there and develop an apn role. the med director however, is unsure where that role would be and if it could exist. so...might just be banging my head against a wall here. am trying to do some clinical time in the er this semester.
so...what would you guys do? take one of the sure-fire jobs? or, decline them in favor of hoping you can make your own job?
thanks for any comments.

congratulations on your achievement, traumarus

you have valid questions. i know your first love is the er. i understand completely. makes sense for you to desire a position where you could pave the way for a new apn role in that hospital.

since you ask, i probably would lean to the first offer. the fact you would be associated with a rather large group of well respected physicians would be a plus for you. you would be able to use your newly achieved cns status to get the valuable experience needed to excel in what you do. i for one would jump at that chance. just think, you would be working with physicians who already know you and know of your abilities. this speaks volumes for not only your professional character, but, your personal character as well. you would gain valuable experience in that role and you will carry that experience throughout your career. also, the anxiety you are experiencing is normal. leaving your comfort zone to go "out into the world" and actually practice (medicine). again, you need that worldly experience now. imho. believe me, they will not expect you to know everything about everything and "throw you to the wolves". they will allow you the room necessary to get your feet wet and develop your own style.

now, the er possibility is just that, a possibility. you might work in that position and never be able to get the powers that be to allow you to expand the role. and, then again, you might get all the support you need in order to develop a new program/role. it is a chance you will have to take. also, will this position allow you to work as a cns without restriction?

it is a choice that only you will be able to make.

make a list of all the pros and cons. be very critical of each.

again, congratulations and good luck in whatever you choose.:)

Trauma Columnist · Jan 9, 2006

Thanks Siri for the input. I really value your opinion and will take it to heart. judi

llg, PhD, RN · Jan 9, 2006

That's a tough choice and I can understand your indecision. I think you have to have a heart-to-heart with the ER person and ask for an honest appraisal of your chances of getting a role there created for you. I suspect the chances for that are slim -- but you probably won't believe that in your heart until you hear it from the ER.

Assuming that your ER chances are slim, say "good-bye" to the ER for a while and move on. Take the existing position that seems to be the best fit for you.

If they ER gives you reason to hope, then ask for a concrete timetable for creating the new role. If it doesn't satisfy you ... or if they don't stick to it ... then say "good-bye" and move on. It's very possible for people in your position to get strung along in bad jobs while people make promises they don't keep about jobs that might be created in the future. After a couple of years, they realize that people were just giving them hope in order to keep them from resigning. If they don't come up with something very soon, move on.

Good luck,

llg

Trauma Columnist · Jan 10, 2006

Linda - thanks so much. I should add that we have another nurse who just completed an ACNP as well as a PNP and she hasn't been offered a job either. We both have several years experience (her - 4) and me (almost 10) and are both well thought of in the ER. It does concern me though that they don't seem in a rush to hire her either. I think I know what I'm going to do, even if I'm a little anxious. Thanks very much for being my sounding board.

llg, PhD, RN · Jan 10, 2006

Whatever you decide ... Good luck! ...and ...Congratulations on that MSN!

llg

Trauma Columnist · Jan 10, 2006

Thanks.