Career help!

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Hi everyone, I am really struggling here with what to do and could use some insight. I graduated with my ADN in Dec. 2013. I got hired as a graduate nurse (and then as an RN) during my last 2 weeks of school on a Medicare rehab unit at a SNF. It was a nice place but I just wasn't handling the 8 hr night shifts very well plus the pay was not that great ($21/days, $23/nights). I took a job working with DDs 3 weeks ago. It is not a bad place and it is less than 5 minutes from my house HOWEVER about 90% of the job is computer work/paper work. The DDs all live in homes through out the community, not in the facility any more. So there is very little hands on care, critical thinking or skills used.

It is mainly doing three drop-in inspections of the home per week and detailed reports, processing new orders, scheduling dental/Dr/eye exams for these patients, etc. Really no med passing or treatments (rarely). Again, these tasks aren't horrible, but I feel very weird being so fresh out of school and not using or learning any skills. I feel like there is so much I don't know yet and need to learn.

The pluses are the pay ($25/hr for a fairly easy job) plus amazing, cheap benefits. The main facility is close to my home but there is driving between their sites during the day. Everyone has been pretty nice. However I just don't feel like a nurse, I wear street clothes. This would not be a bad job for someone later on in their career.

Last week I got a call from a smaller hospital about 45 min from my house. They have an opening on nights (FT, 12s) on their med-surg unit. Benefits are comparable but not quite as cheap. It's $26.50/hr to start on nights but at 36 hours (I'm at 40 hrs now) and slightly more expensive insurance, I'd bring in about $45/week less. Plus there would be more gas expense.

Part of me would like to just stay where I'm at for a year or so, because it's easy and a nice, flexible, day shift schedule. But am I ruining my career if I stay? This is the only hospital offer I have ever received. I have applied for tons of other positions. I know it is so hard for a new grad with just an ADN to get into a hospital. If I pass this up will I regret it forever? I am so torn and feel sick over this. I feel so bad leaving another job already.

Long term, I see myself as an L&D/ER/maybe ICU nurse, and maybe NP down the road. I would like to get my BSN and this would be much easier for me to do on 12s. Do I suck it up and do a year or so of nights on med-surg to get those skills? I've read so many horror stories of med-surg, it's quite a drive, and I really hate nights. Please help. I need to make a decision NOW. :(

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1) The drive and the hate nights? Those are soul-killing deal-breakers. You are new, but just about anyone will tell you that there are some things more important than money, and your mental health is one of them.

2) Everybody and her sister wants to do L&D/ER/ICU (and I'll toss in "CRNA school" too, just because I can) but this is not going to happen for the majority of new grads. A comparatively small percentage of us are doing what we thought we would when we were new grads :) and we turned out all right because one thing led to another.

You might very well find that your present job is teaching you more than you thought (keep your eyes and ears open--peripheral vision is a good thing), could lead you to an entirely novel career path and fame and fortune, and you will thank your lucky stars you didn't follow the herd mentality that takes as an article of faith that hospital nursing is the only way to have a career and "skills" in nursing.

You've only been there three weeks and you don't know a particle of what you will know in a year, plus you have the benefit of no long drives, no increased gas costs, and a good night's sleep every night. Stay there and learn some more about what it might mean for you before you even think about jumping to something you already know you'll hate.

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Specializes in Telemetry, CCU.

Man, everything GrnTea said was spot on. First, you've only been at this new job for a few weeks. I don't think it looks very good on a resume to have a lot of jobs in so little time so I think you should stick it out. Plus, a 45 min drive one way? I work 12 hour shifts with a 20 min drive and all I have time to do is eat, shower and sleep on those days and I never feel rested. I would kill to have your current job! You know what they say? If the grass is greener on the other side you should water your own grass! Good luck :)

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I understand what you both are saying. I just feel like I am so new out of school and really don't know a lot. There are so many skills I still need to learn/perfect. This just isn't where I saw myself working. It's just very boring and I can't see myself staying forever. I obviously wouldn't put this job on my resume if I left. My thinking was that I would just deal with the nights and drive for a year and that many more doors would be opened for me, with a year on med-surg. There is literally no critical thinking and it is 95% paperwork/reports/calls.

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That seems like a tough position to be in but if I were you I'd take the hospital one since you said you eventually want to work in ICU or l/d. When you apply for positions in those areas, they are probably going to want nurses with med/surg experience. Med/surg is not fun in my opinion, but the experience you gain is valuable no matter what area of nursing you want to end up in.

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Specializes in Critical Care, Education.

If you have hung out here on AN for a while, you know there untold numbers of nurses who would trade places with you in a heartbeat... M-F office job with low stress. But I understand your fear of losing touch with clinical practice. I would just hate for you to fall victim to the "grass is greener" syndrome and suffer bitter regret in a few months.

Acute care jobs are shrinking as hospital admissions decrease. Experts are saying that this is the first wave of a natural evolution toward a 'real' health care system. It makes sense - Better access to preventative health care will result in less need for acute care services. This is the crux of ACA (Obamacare). But change is hard. Our nursing programs continue to be hospital focused, and this perpetuates the idea that the only 'real' nursing care is in hospitals; everything else is second-best. Your current role .. ensuring that the health/wellness needs of a very vulnerable population are met... is no less important or less 'nursey' than the role of an acute care nurse.

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I understand what you are saying. It's not a terrible job, just not where I saw myself right out of school. I am sure I would love it when I'm older and more experienced. I just feel like I have so much to learn still and I don't want to lose my knowledge. I do want to get my BSN and keep learning. I feel like that will be more difficult for me to do while working 5 days a week. It's a really hard decision. My thinking was that even if I didn't want to stay in a hospital environment, that year of experience would help me grow and help me get jobs in other environments such as a clinic, etc with a bit more hands-on care.

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Specializes in Telemetry, CCU.

Honestly, only you can make the decision. I get what you're saying about wanting to develop your skills and think that's commendable. If you decide to go with the new job just remember that it will be a tough year for you and commit to staying for a year. Good luck!

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Specializes in Critical Care, Postpartum.

Reading your long term goals, I would chose the hospital because once your in the system you can easily transfer to those units. I transferred to OB after year on a critical care floor. Many of the nurses I've met were transfers from Med/Surg or other Critical Care units and former nursing students who precepted on the unit and made a good impression. I have yet to meet a nurse who came from LTC/Rehab/SNF.

On the other hand, when I worked on the critical care floor my nurse manager gladly hired LTC/Rehab/SNF nurses. However, these nurses had a minimum of 2 years experience.

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I am a newer ADN grad (Dec. 2013) who has ended up in an interesting RN position for a new grad. Had I realized exactly what the job entailed I probably wouldn't have taken it. I am working for a center that has homes in the community for kids/adults with developmental disabilities. The job is mostly paperwork. I do things like driving around and doing drop-in inspections on the homes and their check meds/charts, scheduling appts, labs, entering Dr. orders, q6mo meetings with other staff on the clients progress/health. I do very minor hands on things like staff/client TB tests, vaccines, quarterly client assessments, etc. I don't wear scrubs and am having a hard time feeling like a "real nurse". The schedule is very flexible, pay is decent, great benefits and its day hours. It's fairly low-stress, easy, but boring.

I was offered a job at a smaller hospital 45 min from my home, FT nights, med-surg. Now I feel like I so badly need to do a year of med-surg and get this basic experience. There is so much I don't know and skills I've never done. I know it's SO hard to get into a hospital as a new grad with an ADN and I feel like if I can just put up with it for year that it would be better for my career.

I had a hard time with nights before and that terrifies me. The drive also worries me. But it's the only hospital that has given me an offer. I told my current job and they understand and said they would be happy to have me stay if I changed my mind.

Why do I not feel relief? I am so worried that med-surg is going to be hell and I'll hate it. I don't even know where I want to end up in my career at this point. It was originally L&D. But am I stupid for giving up this position? I could try it for a year, but I am worried no hospital or anywhere else will consider me. Having to make this choice is killing me!

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It's tough to know what the future holds. If you are wanting to be in acute care then the year of med surg is prob. a good idea. Howevere if acute care isn't your focus I would stay where you are. Good luck. Choices like this are never easy. Talk with your SO and/or family.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

Would that employer consider a per diem position for you?

Your employment flexibility would make it possible for you to provide coverage on weekends and holidays while gaining that clinical experience that you are missing.

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