Advice needed

[Kristy02_RN]

I am currently working as a case manager. I was offered a position as an ADON at a nursing home. I interviewed for a nurse manager position in the hospital I currently work at and was told to go back to the bedside and sharpen those skills before I could be considered for a hospital nurse manager. I feel like I'm at a crossroads. My husband says the ADON role would be beneficial to getting into hospital leadership. I say it's career suicide and I'll be stuck in nursing home leadership for the rest of my career. What should I do...should I go back to the bedside or should I go to the ADON job? At this point the job offers are comparable financially I'm strictly looking at experience that leads me to my goal of utilizing my MSN in nursing leadership!

[SummerGarden, BSN, MSN, RN]

Career suicide? Well, it will depends on your perception of "career suicide".

At this point there is a guarantee to work as a ADON without having to start back as a bedside RN again. There is a guarantee that you will be able to immediately use your MSN in Leadership. Also, I know of a few nurse leaders in the hospital setting who got their start in leadership in a SNF 10 years ago. They were able to move into the hospital setting leadership because they knew the right people and now are high up the food chain.

On the other hand, there is no guarantee if you go back to bedside nursing, you will be considered for a promotion sooner or later. Plus, if you are able to sooner or later land a middle management leadership position after working as a bedside nurse again, there is no guarantee that you will not remain in middle management working at the bedside for many years to come.

By the way, I worked in the hospital setting my entire nursing career to include in case management. I can safely state that nursing in the hospital setting is not heavenly! Nursing in any capacity in any setting within the hospital is not easy or lacks stress. Plus, management in the hospital setting is very challenging and not always in a good way.... Thus, although I have never worked in a SNF, I do not know if the acute care setting gets a free pass when making comparisons to the challenges of other healthcare settings....

Good luck with your decision....