Am I being too desperate to accept this offer..?

[EwokRN]

Hi. I asked in a previous post about this job that I was told would be an ideal fit for me. You see, I'm an older 2nd Degree BSN graduate who just received her RN license late Jan '09. I was accepted in an RN position 2 days after I passed my NCLEX, and started mid Feb '09 and unfortunately was told that I couldn't cut it mid April '09, and to transfer to another unit, because my critical thinking skills were not developed, and my clinical skills were not that good. This was after one month of floor orientation. Well, they only suggested one other unit and that was rehab. Unfortunately, the head nurse of that unit told me that that type of unit could be just as fast as the Medicine unit, and that it wouldn't be a good fit..plus, it looked like no other unit would give me an exteded orientation. Well, it turns out that I couldn't find another unit to transfer on a month later, and hence, I started a volunteer position at my doctor's clinic early May '09 giving IM shots, taking vitals, assisting with medical procedures like pap smears, doing assessments, etc.

I remember when I interviewed for this position back then I found out that I passed NCLEX at that moment, and I was literally jumping for joy (manager was shocked that I didn't find out that I passed NCELX and she offered to look it up for me). Before that I was given a prioritization problem and almost immediately after find out I passed NCLEX from the manager I wasn't really concentrating. Heck, I was even calling my dad telling I passed (manager offered to let me do this). I thought it *could* have been the greatest unit to work on; however, something was telling me otherwise, because they accepted me on the spot. Well, I come to find out that it was a bad unit to work on according to my friend who worked there as a Care Partner; however, my other friend said that it was a good unit to work on, and then as time went on, I come to find out that it was a bad unit to work on from the different preceptors, and the different people who said that it was a bad unit.

Well, fast forward to now. Last week, I was asking this rehab center's HR manager about positions that were available for new grads. She said most RNs at these rehab centers are charge nurses, and that it wouldn't be feasible to be an RN and to work as an LPN to get experience. Well, she said they didn't have a position. I asked her if there was any possibility that there would be a position available for someone with little experience like me, she said she'll find out. Turns out there was. One of it's sister centers had the option of putting a new grad on the med cart giving out medications. This orientation would be a week or so, and then from there I would transition to charge nurse supervising LPN's. According to that HR person transitioning to supervising LPN's would take about 6 months.

Well, I thought the manager was practically offering the position after she asked me how much experience I had over the phone, which I thought was weird, because the only outside experience out of school was that volunteer position for a month at my doctor's office assisting MED Assistants with procedures. I asked to shadow a nurse giving out meds. She agreed, and I saw an LPN pass meds on the med cart. After I finished that, I came down to the manger, and she told me when orientation started, and immediately handed me new employee paperwork. I was leery, but went ahead an accepted the positon immediately, because the manager told me that I would be trained on the cart first before really transitioning to charge nurse and supervising LPN's, because according to her, you have to start on the med cart before knowing what to do as charge nurse. She said the only people I would be supervising would be the CNA's which makes sense, because I did do that a little bit at the last position. Don't really know if I'll be cut out for it, but maybe it wouldn't be that bad? I would assume with my RN license I would be cut out for it? Then again, it didn't really seem to hard passing out the meds. Most of the meds were well organized in a sheet of meds, and I was dispensing these in cups and giving it to fairly well patients. The more challenging patients were the stroke and the dementia patients though some who couldn't really speak and had uncontrollable movements, etc.

Of course, I know that anyone who offers you the job on the spot probably shows desperation, because maybe they can't keep an employee, because they're a crappy organization themselves. I kind of don't want to make that same mistake again, accepting a job, because I need money. I am paying the bills, because I have a good savings cushion and my parents are helping. Plus, my husband's pay (though little) is helping, but recently he got his hours cut, because yes, the economy, again!

The good news though is that Sunday, I got a call for an interview at a long term pediatric care facility only 10-15 minutes away. Now, my mom has a friend who retired from there late last year to take care of her husband. From what I understand, there would be more support, and I would be interviewed. I would be a primary care nurse, and the care would be more consistent than the 6 patient load that I endeavoured to take on at the first unit I was on. I was told by HR that the primary and charge nurse positions were opened, because one was called to active duty and other was relocating. What luck!

Of course, I don't know if I'll get the position, but according to HR they start orientation in 2 weeks, so I guess they're rushed! I have to admit though, I do like pediatrics, but this unit is a little more severe, but I was reassured by my mom, the retired RN, that this would be good experience, because unlike Med Surg, the care would be more consistent. Anyways, I actually have my interview with the peds facility today at noon, so I guess they'll make a decision fairly quickly if they're rushed.

I figured that if I do get the peds long term care position, I would just quit the other job, and go to that. My orientation with the rehab facility starts next Monday while the peds position orientation starts the Monday after that. I know w/the peds position I would definitely deal with trachs and more hands on stuff.

Am I making the right decision? Am I setting myself up for failure? Sorry this is so long, but I needed a sounding board.

[Lunah, MSN, RN]

Only you can decide what's best for you ... as far as I can see, there is a fine line between a) getting stuck in a "bad" job, and b) moving around to too many jobs in a short period of time. Either way, it's great that you're finding some stuff out there -- seems like so many new grads just get stonewalled. Good luck, whatever you decide to do.

[NotReady4PrimeTime, RN]

Personally, if I were in your shoes I would take the peds job. And not because peds is my passion but because with your lack of experience, being in charge, even of CNAs, is something you're not ready for. I'd be afraid you'd be setting yourself up for a similar sort of let-down in that job. In LTC/rehab the RN has a HUGE amount of responsibility, including the ultimate responsibility for all the residents/patients/clients on the floor or in the facility, supervising others and providing a resource to them... and for that you need to know the job well and be very comfortable with all it entails. With the peds job, you'll get an orientation. You'll be primary nurse for a small cohort of patients whose care will become so familiar to you that you'll be doing it without having to think about it within a couple of months. You'll have the opportunity to establish some relationships and learn an awful lot. Just my ...

[EwokRN]

Actually, I just found out today that I'm not qualified for the peds position. It turns out that the primary nurse position at the long term peds facility would be in charge of staff nurses, and therefore, I would have to have more experience.

I was to tell you the truth a little annoyed that the head nurse didn't really seem aware that there weren't any internships for new grad nurses here, but she said that she'd keep me in mind.

The good thing though is that it turns out that the rehab position really would probably be the best, because I would primarily be on the cart for some time. I think 6 months, and then I could eventually move to charge nurse if I'm ready.

The other dilemma though is that the area according to my husband is dangerous. He grew up close to the area where I would be working. I talked with one of the workers in that facility, and she told me that there weren't any incidents in that facility and she's been there for 3 years, and she said it may not be that bad. Plus, she told me that there wasn't any security, and that if I wanted to ask the maintenance guy to walk w/me then I would be welcome.

I don't know what to do. I can't relocate, and this thing with the security is getting to me. I might just give up this position all together, and try to look for another. Sorry, just have to vent!

[SummerGarden, BSN, MSN, RN]

i don't know what to do. i can't relocate, and this thing with the security is getting to me. i might just give up this position all together, and try to look for another. sorry, just have to vent!

go with your instincts. do not play with your license or your life.

[MB37]

So: you've heard that the rehab center is "bad" from a few people but "good" from another, and your husband says that it's in a dangerous area, but a future coworker says she's never had a problem. Maybe doing a little research on your own is the way to go. If I understand correctly, this is the only job offer you have on the table at this time. If would probably behoove you to accept it and start training on Monday. If the training serves to be inadequate, or they ask you to take on a supervisory role before you're ready, then you will need to speak up and ask for additional time. If they refuse, then it probably wasn't the right job for you. Word of mouth can be a helpful tool, but remember that everyone is different, and that you may love a job that your best friend hates.

Does your local paper have a section in which they report all crimes committed in each zip code? They have everywhere I've ever lived. You can look up exactly what's happened near the hospital and see if it's something you can deal with. How are the shifts structured? Is the staff large enough that several people will get off at the same time so you can all walk to your cars together? You can also ask HR about security - unless it's a very small facility I would be surprised if they have no one on staff. Do they provide parking? Is it well lit? Do they have emergency phones? Drive over there a few times and look at the neighborhood - are you comfortable there, or are there blatant drug deals going on in broad daylight across the street? Again, people feel safe in different types of communities. Some areas are incredibly dangerous, and if you feel unsafe you may not want to work there. If you'll have to walk to your car alone in a dark parking garage, it might be worth looking elsewhere. I'm just thinking you should really get a feel for what it will be like before you turn down the only job offer you have right now...

Good luck to you, and hopefully this job or the next one you find will be a perfect fit!

[flightnurse2b, LPN]

what about working at the doctor's office you were working @ as a volunteer? or trying your hand at an urgent care clinic/medi center? it may not be what you want, but it's patient care, and it's income. some outpatient surgery centers are great places to start too, the pace is steady but less hectic than a hospital or rehab, i worked in an endoscopy unit when i was in nursing school and i really enjoyed it.

you don't want to take a job you aren't ready for and risk your license, and you don't want to work in a place where you are scared for your personal safety. it's not worth it.

whatever you decide, i wish you the best of luck. :)

[EwokRN]

Thanks for all the replies. Actually, I've decided to go ahead and give it a go. I've been there at least twice now, and no there are no drive by shootings or drug deals or blatant crime things happening in broad daylight. I've actually done a community health project near there, and I never really had any problems. I actually saw a lot of the residents out in front of the facility today staring straight into broad daylight taking in the hot sun. Apparently, they don't really fear for their life.

That future co-worker did give me some good advice though, which was try to see if you like it after the first day, and see whether you like it or not. My friend, who was a supervisor at the sister rehab facility, said they should give me extended orientation. I hope she's right.

In the meantime though, I'm still applying for other positions in "safer" areas.

Anyway, wish me luck!

[NC Girl BSN]

I think you should give the LTC position a chance instead of job hopping all over town. You said that you old job said you lacked critical thinking and I think LTC will give you good practice on establishing a routine. The set up is pretty routine and the patients take the same meds everyday. You will develop your critical thing skills when you start to become charge nurse and make decisions based on things you assess. Good Luck to you!

Oh I also worked at a LTC facility in a not so great neighborhood. The facility had been their since the 70's and there was never any violence in the place. The owners care was stolen out the parking lot one time but that was about it.

[EwokRN]

Yeah, I actually started classroom orientation yesterday at that rehab facility. Thanks for the advice. I'm actually supposed to start days next Monday, and then do the 3-11 pm shift. Now that I've read a lot of Cardillo I expected this. Oh well, it will give me a good flow about what to do.

Thanks again!