California Consideration - Need Help

suzanne4, RN · Jan 4, 2006

Bargaining or negotiating usually only works when you have quite a bit of experience to offer them, something that they want and are willing to pay for. But something else to consider, many of the hospitals are unioninzed here so there are specifics as to the salary that can be offered as well as perks, etc.

If you are going for the LA area, you should be able to get about $28 to $30 as a fairly new grad, and most will have time and one-half for the last four hours, but not all.

Camelhappy1 · Jan 4, 2006

Training, training and more training.... If you are moving to the USA to specialise than MAKE SURE you get what you deserve (Sorry, I don't know if you are a newer nurse or not). I unfortunately learned the hard way. I moved to the US for the training (I was not a completely fresh grad), but ended up with NO real orientation into a specialty area. Scary when you don't have a clue.

My best advice to you - ask HR if you can speak with a newly recruited/ fairly new nurse at the facility. They should have no problems doing this. I have made some decsions based on what these nurses tell me.

In terms of orientation you want something structured if you are new to a certain area of nursing. Not just shoved with a preceptor for a few weeks (and it is usually whoever can take you that day - typically unwillingly). Do they do critical care courses? ACLS paid for?

Good Luck!

joey1967 · Jan 4, 2006

Thanks :). I am fairly new to the profession, I'll have one year under my belt by the time I relocate. I do want to change specialities and am looking at a specific area. One hospital indicated that they had great training programs, but I started to push to get this in writing and they backed off. So I am a little leary. There is no point in me leaving here, if I don't get the training and advancement that I want. A full time job is great, but the training is just as important. The cost of the wage for some hospitals seems low in comparison with the cost of living, but the income is lower than Canada, by far (this is if I am understanding the IRS website correctly). My plan would be to go down for 3-5 years and get more training then come back. I am curious, I read posts of Canadians on here who are now making 100,000+ a year in their speciality and am wondering if this is inflated, or if it is really possible to make this???? This seems incredible considering the top of the pay here is about 68,000 or so a year.

fergus51 · Jan 4, 2006

I made about 100K this year, but I also worked a fair bit of OT. My regular wage would be less. I also payed over 30K in taxes and could not afford to buy a home or anything. I don't think you'd make that with only one year of experience, unless you take a non-benefitted position or something.

Daytonite, BSN, RN · Jan 4, 2006

There are tons of hospitals across the Los Angeles and Orange country area of Los Angeles. You should be able to find one where you will get a good orientation in an area of nursing you want. Almost all hospitals should be offering health insurance coverage. The differences will be in what your part of paying for it is going to be. HMOs are very big out here, so if you are young and in relatively good health, an HMO is a good way to go. The cost of the HMO insurance benefit is a lot lower than a tradition PPO insurance coverage. Many hospitals offer tuition reimbursement or reimbursement and time off to attend continuing education programs. A larger hospital or one that is making a real good profit is more likely to offer a better benefit in this area. Of course, if you already have a BSN and don't intend on going any further in school, a tuition reimbursement may not be of any interest to you anyway. However, California has a 30-hour CEU requirement to renew our nursing licenses every two years, so a lot of facilites will give some kind of benefit to help out with the expense of that. With regard to pay scale, bonuses and relocation allowances you are probably going to find they seem to be the same across the board. Many hospitals participate in salary surveys in order to be able to attract new RNs. Are you aware that there are a number of large corporations who own a lot of hospitals around the L.A. area? Are you sure that you are having conversations with hospitals that are not all owned by the same corporation? These corporations are likely going to keep salaries and benefits equal among their various facilities.

The biggest living expenses here are housing and transportation. If you find yourself having to do a lot of commuting, then driving and gas may also be an expense to deal with. You must have car insurance by law and I can tell you that it is also a high cost item here. Outside of that, food, clothing and other essentials are pretty much the same as throughout the rest of the country. Young people save on rent by rooming together and splitting the rent or renting a room in a house. When you rent a room in a house, the room is just like any apartment you would rent. It has a lock and only you are the one who has the legal right to use the key to enter it.

I think one of the things you might want to introduce into your negotiations is help finding reasonable housing. I think this is one of the biggest reasons people don't want to move to California. And, I'm sure that the healthcare industry is aware of this. Some of the very larger teaching hospitals do not make a point of advertising that they have some nursing dormitories. You have to ask. Some of these hospitals know where to get lower cost apartments for their residents, interns and nurses. Again, you have to ask. You might be surprised what you find out. I know for a fact, that one of the hospitals in my area has a nurses dormitory. Also, if you are affiliated with any church, you will want to get in contact with the church leadership in the area where you want to move. Many times clergy can help you find nice afordable housing provided by members of their congregation. Something else you can do is get in contact with real estate managers who act as rental agents. Tell them your financial situation and see if they can come up with something for you. Low cost housing is not commonly advertised because it would be grabbed up immediately. There are still some very ethical people in the world who want to offer people a break, but need to be careful they provide those breaks to people who will be respectful of their property and not celebrate their good fortune by partying and being noisy and irritating. You have to employ other unorthodox ways to find these deals. There was a student in my nursing class years ago that lived in a vacation home of some rich dude as a house sitter. His only job was to make the house look like someone was living there! Crazy Californians!

joey1967 · Jan 4, 2006

Wow -Thanks for this great info. I am actually pushing 40 (nursing is a second career for me) so I won't be rooming or living in a dorm, hence the concern for affordable housing. I am also looking at working in Northern California or half way between somewhere (i.e. San Fran and LA) as opposed to Central (I think LA is central?). So this may limit my options. I see that some Canadian Hospitals are offering great training but unfoturnately they will not pay for relocation costs, nor the cost of interviews (to fly out to a city) which is unfortuante because I've had alot of interest from places I would consider moving to, but will not do so out of pocket. I could consider other States that have great incentives like SC or NC, I haven't ruled anything out but CA seems to have the best offers overall. Thanks again.

fergus51 · Jan 4, 2006

I have to say, I would advise against an HMO even if you're healthy. IMO they are the worst creation in healthcare. You can only see doctors on their list, only go to hospitals on their list, only get tests they approve of, etc. With a PPO you can choose which doctor or hospital to go to and that makes a big difference IMO (says the girl who was just diagnosed with an ulcer in her mid 20s!). PPOs are more like having a provincial health card because they're accepted pretty much everywhere.

joey1967 · Jan 5, 2006

Thanks Fergus - This is the kind of stuff I need to get educated about - I would have had NO idea...considering my age I don't think an HMO would be the best bet, I mean I am very healthy but I see women on my unit all time, in the same physical condition and same age, who have unexpected health issues, like cancer, etc., I would not want to be in this position without proper health care coverage. While I'm thinking of it, would you be able to tell me how insurance works to protect one's nursing license while working in the USA. I am thinking I would like to move into L & D or post maternal care but understand that this is an area that is heavily sued in the States. Any advice or information on Liability Insurance???

Daytonite, BSN, RN · Jan 5, 2006

Both Nursing 2005 and RN magazine (probably AJN as well, but I stopped my subscription for it years ago) publish a special yearly job opportunities issue. If you can get your hands of a copy of the U.S. versions you will be able to track down hospitals in the area of California that you are going to be moving to. Perhaps someone on the forum who has a copy of this can look the information up for you. Anyway, the hospitals who advertise in these journals, and particularly in this yearly publication, are usually hurting for nurses for some reason or another. You should approach these hospitals and see if they willing to pay relocation costs. Chances are it is going to take a committment to promise to work for them for a certain length of time, but if fulfilled, moving expenses will get paid.

Let me give you a heads up on sign on bonuses since I lost one. I was hired on at a hospital that advertises frequently in the journals and was to get a $5,000 sign on bonus. The way it worked was that that paid it in three parts. The first after 3 months of employment, then after 6 months and then the final payment when there for 12 months. The biggest hit of cash was at 12 months. Just after 3 months I was offered a management position. I was terribly flattered, but failed to discuss anything about the bonus since I assumed (shame on me) that a change in my employment status wouldn't affect it. After all, the bonus supposedly was for being employed there. Wrong. The hospital, as well, failed to notify me that if I took the management position I was automatically forfeiting the remainder of the bonus money. I was mad. The management position turned out to be terrible. It wasn't hard to go job hunting shortly after that. So, make sure you know the boundaries of any benefits you are being offered.

After my last post I got to thinking that one of the things you could try to negotiate for was a housing benefit, such as a couple of hundred dollars once a month tacked onto a paycheck as a housing benefit to help you out with rent/mortgage/whatever. One of my friends got a sign-on bonus at one hospital out in the boondocks of California that was a brand new car. It was actually a leased car that the hospital paid the monthly lease on as long as she was employed. If she left employment she had the choice of turning the car back over to the hospital or paying off the remainder of the lease and keeping it. She drove the wheels off that car until the lease was up on it, she worked there that long. Not a bad benefit.

fergus51 · Jan 5, 2006

Thanks Fergus - This is the kind of stuff I need to get educated about - I would have had NO idea...considering my age I don't think an HMO would be the best bet, I mean I am very healthy but I see women on my unit all time, in the same physical condition and same age, who have unexpected health issues, like cancer, etc., I would not want to be in this position without proper health care coverage. While I'm thinking of it, would you be able to tell me how insurance works to protect one's nursing license while working in the USA. I am thinking I would like to move into L & D or post maternal care but understand that this is an area that is heavily sued in the States. Any advice or information on liability insurance???

I actually know few nurses who have private Liability Insurance. You are generally covered under your workplace. I went to a legal nurse consulting speech and she basically said that carrying your own liability insurance can actually make you a target for lawsuits (because you have deeper pockets than most nurses would have). She also pointed out that for people like me, it would be silly because I hardly own anything. I don't own my home, I don't even own my car completely. What could they sue me for? My bills? She said she would only advise it for people who own nice homes that they are really worried about, but it isn't something she routinely recommends for most nurses.