Cardiac Rehab vs IR vs PCU (experienced)

[Nurse SMS, MSN, RN]

I am ready to get away from the bedside and have been applying and interviewing for positions on different types of departments. The two most interesting to me have been IR and a cardiac rehab position.

IR is pretty amazing stuff and obviously uses a lot of the nursing skills I have so carefully honed. The idea of call has me pretty intimidated, but the team is very tight knit and it seems like it would be an awesome place to work. It makes my heart race and feels like I would grow a lot in the position.

The cardiac rehab position is a completely different ball game. Mostly it would be doing assessments on people before and during their rehab, keeping an eye on tele and doing some ambulation/assessment of fresh cardiac patients in the CVICU as well as some pulmonary, teaching classes about medications, addressing caregiver role strain in classes for them, classes on resuming intimacy (apparently this one is popular), going to a few health fairs a year and visiting some corporate clients. The hours are pretty sweet, the call schedule is minimal. Not much use of nursing skills though. It is also a very tight knit team, but the other team members would be exercise physiologists and one other nurse. It feels like a very low stress, happy kind of job. I do wonder if I would be bored, or if this would just make room for other things and if it would not make keeping a healthier lifestyle for myself easier.

My spouse is concerned this position will make me less marketable and hold less "prestige" for me. He is also concerned about losing my tuition reimbursement, due from my current facility. However, taking that reimbursement locks me in for another two years...the idea of which makes me want to cry. I am in my 40s and as long as I am paid fairly and have a good balance in my life I am pretty happy. Floor nursing is hard on my body and honestly on my stress level to an extreme. Ratios just keep getting worse, patients heavier and sicker, good PCTs/CNAs harder to come by and their numbers being slashed by the hospital. I'm tired. Burned out.

I have no desire to go into management. Not sure right now if becoming an NP is on my radar. I am pretty tired of being in school. Not sure if I DID decide to pursue NP if this position would be a negative on my application. Not sure if I am looney to factor in potential education/job decisions in taking a job when I am not even sure I will ever pursue that education. Not sure whether or not I care about "prestige" as much as about being happy and making decent money. Not sure whether I should be concerned about being able to get another floor job if I wanted to. Right now it is hard to imagine wanting to but realize that is fatigue and emotion without a lot of reason. Thus my asking you guys.

I am interested in thoughts or opinions on the above two positions. I don't want to take something that would be a death warrant to my career. I do want a lower stress level. I have not been offered either position at this time, but just conjecturing the what-ifs. Any input would be appreciated. I am a good floor nurse and do really well with patient interaction but am so tired right now. I believe I have a reasonable chance of being offered one or both of the above positions. Help me figure out the implications. I feel a bit lost.

[OCNRN63, RN]

You're probably going to just get penal opinions on this question, but I'll bite.

I would take the position in IR--in a New York minute. Cool cases, cutting edge medicine, hours pretty good. Don't let on-call scare you off. I had some job with on-call (mostly hospice positions). They're not going to put you on call right away, and it sounds like the team would help you out until you have your bearings. You'd be doing everything from trauma, oncology, cardiology.

That's just my opinion, FWIW.

[Caffeine_IV]

Everyone I know that does IR loves it! Actually the same for cardiac rehab. I would do the one that had the most ideal hours for me. I don't think you could go wrong with either.

[Nurse SMS, MSN, RN]

Those little bursts of positivity were awesome. Thanks so much :) :)

[Lev, MSN, RN, NP]

I think even if you did take the cardiac rehab job, you can always keep your foot in the door of acute care by going PRN or per diem to keep your skills up, especially if you ever do decide to go to NP school.

On the other hand, IR sounds awesome.

[Been there,done that, ASN, RN]

Cardiac rehab has sounded like a dream job to me for many years. Far from making you LESS marketable, teaching and community reach out would open many new doors for you.

Good luck whatever you decide, keep us posted.

[nurseprnRN, BSN, RN]

Back when Florence and I were supervisors in the Crimea, I had cardiac rehab in my area and shared an office with the cardiac rehab nurses. They loved loved loved it. They used nursing skills all the time-- in-depth cardiac assessment, individualized care planning, teaching, and collegiality with the cardiac surgeons, cardiologists, CV nurse practitioners, PCPs, GPs, pulmonologists (they did pulmonary rehab too), pharmacists, nutritionists ... They attended conferences and networked. They did classes for the community and their booth was always mobbed at community health fairs. They developed long-term relationships with their patients, too. No call, no holidays or weekends, and they got to wear comfortable clothes. Their job required a BSN; one was thinking about pursuing MN.

I have a friend in interventional radiology who loves that, too, but she says it can be very, very stressful for the obvious reasons, and the call and being on her feet for hours at a time wearing a heavy lead apron and sweating in full scrub gear got old in a hurry (she is also in her 40s). She had less autonomy than she expected. On the other hand, when they all left at the end of their shifts, they were done. She is starting to think seriously of becoming an expert witness for nursing practice in IR, because there are a lot of opportunities there (especially cardiac cath), going part time to keep her hand in and using the extra money to fund NP school so she can be a nurse midwife. :)

I guess it's all about what you want to feel about work, how much you want work to control your time, whether you want to learn something new, where you see yourself in your personal life in another decade (which, as you know, will fly by a lot faster than the last one).

[Deepinthegame]

Never take a job with "Call "