Better Hospital or Better Specialty

[momof4crazies, ADN, BSN, RN]

I am a student who is graduating in May. I have already received a job offer at the better hospital in my area. Unfortunately, it's not in an area I want to work in (the offer is for an Ortho Unit). My other option is to work at a hospital that isn't as good, but has openings in specialties I am more interested in (ER, ICU, Step Down, etc.) So I'm really conflicted - do I work at the hospital that has a better reputation, employees (in general) that seem more satisfied, and for what it's worth is a lot closer to home? Or do I work at the hospital with a less than stellar reputation, in a specialty I enjoy, but who's employees do not seem happy? From what I have heard from friends who work at the "better" hospital, the Ortho Unit is severely short staffed, has patient ratios of 1:8, and has a very high staff turnover and therefore is almost completely comprised of new grads.

[beekee]

So, if the Ortho unit is severely short staffed, has high turnover and ratios, and comprised mostly of new grads, what is “better” about it? Generalizations about a hospital don’t really matter. What is the unit like? Is the environment supportive of new grads? What’s the ratio, turnover, skills mix like? Is the manager good?

Personally, I’d go to the better unit, not the better hospital.

[momof4crazies, ADN, BSN, RN]

The general "culture" of the hospital is one that supports their nurses. There are lots of staff appreciation things that go on, they have much better benefits, and the hospital is much better off financially - which shows in a lot of ways. They have more up to date technology, better doctors, etc. Honestly, I think the Ortho Unit is the only one I have heard bad things about. I have had clinicals at both hospitals, and you can tell the difference right away with how the nurses feel about their jobs. If my job offer was almost anywhere else in the better hospital, it would be a no brainer for me. But, it's not - so I'm leaning towards the better unit.