I may have a career choice coming in my near future, and I am really struggling on which to choose.

I have my current job; telephonic case management, working from home. I got this job after leaving a job I had as a program manager for a Medicare Advantage Health Plan. The management position turned into a nightmare because I was good, and they kept pilling on work and responsibility, but did not hire more help. I don't mind having work, but I am a realist, and it wasn't realistic how much they expected me to do. This job I have now is very low stress. I work from home, in my sweats, no makeup, no commute. I feel healthier because I can wake up and exercise, since I have no commute, and never eat out. I can be late, take breaks whenever, and work is very independent, no one standing over me watching me work. Plus, I get to help people, which is rewarding. But this job has no opportunity for advancement and can be a bit boring sometimes (but sometimes boring is good!). And it is also on contract, which could expire in 3 months (we will know by next month), in a year, in five years, we really don't know.

The job opportunity that may be coming my way is Manager of ICU in a small hospital. This ICU ships out the most complicated people, and sometimes shuts down because there are no patients. 5 or 7 beds, I don't remember. Note; I have not done bedside nursing in 4+ years, and I would have to cover the floor as needed. The appealing aspect of this job is it's an opportunity to get back into Quality Improvement type stuff (I think, you can tell me if you know more), and share my 10+ years of knowledge and experience, plus make a bunch more money, eventually 6 figures, and have all my financial dreams come true. Build my dream home, for example. All our debt is paid except student loans, and so we would be swimming in money, for the first time in my adult life. I mean, we want to live debt free forever, and we could definitely do this comfortably with this job, buy new cars, take vacations, etc. Cons of this job are, I have to be at work at a specific time, get dressed, drive to work(altho it is a short drive), work under fluorescents, and deal with possible hospital politics, difficult people and patients, and everything else that goes with working in a hospital. Those may sound minor, but there is also the stress that goes along with the responsibilities of being a manager. And I wouldn't get to pet my dog during my breaks :(

What would you do? Take the financially secure job with potential of a very stressful life, or keep the lower paying job, that you make enough to live very comfortable still, where you work at home and have very little stress?

Specializes in Critical Care, Education. Has 35 years experience.

Have you had experience as a hospital nursing manager? If not, you may be seriously underestimating the amount of work involved, especially in a small facility. Based on my own experience (managed an 8 bed ICU while I was in grad school) you will end up covering for staff vacancies much more often than you anticipate. You will be called in to provide coverage when patients have to be transported -- frequently serving as the transport nurse. Your staff will probably be the RRT for the facility - and may also be responsible for monitoring telemetry for non-ICU patients as well.

Your job will be at risk if you do not meet productivity targets, please each and every physician, maintain all regulatory requirements, keep patients, families & staff happy. Oh - and you probably won't have anyone to assist you in any administrative tasks because the unit is way too small for a unit secretary or even monitor tech. If you don't have current ICU qualifications (CCRN preferred), you need to get up to speed fast in order to garner staff respect and meet regulatory requirements.

IMHO, despite the grim picture I have presented, it would be beneficial from a career standpoint to accept the ICU manager job. This kind of experience will open the door to a much wider variety of opportunities in the future.


3 Posts

Thanks, that is what I needed to hear....More about what the job will be like. I have experience in Project Management and Quality Improvement, and I managed people without having authority over them, which was very stressful. But this type of position I have little knowledge about what it will encompass. I am good at the administrative, productivity, and relational part, but not so confident about my skills at the bedside at this point because I have been out of bedside for so long. But I can relearn that. It's a matter of what do I want to give up in order to have that type of career and is it worth it? I wonder if it's a lot of overtime. How many hours a week do you think it is?