Debating between two jobs

In my experience, the new grad residency programs are hands down better than just an orientation to a new job. Starting with a cohort of new grads gives you an instant peer group that is going through exactly what you are going through, and the support that brings can be vital for new grads. Residency programs generally show that the hospital is committed to helping new grads transition. You usually have scheduled education days with specific seminars and skills training that you will not get in a traditional orientation to a unit. I understand you're probably looking for feedback that says #2 is your better bet, but almost everyone I know that went through a new grad program is very happy that they had that experience. Good luck.

I vote for Job #1. As a new grad you will want something that actually helps new grads adjust to their first year out of nursing school. Especially with a cohort of 8 other new grads, it sounds like a great job. Although Job 2 is close to home, I would be skeptical of their ability to appropriately precept a new graduate nurse. Although it would require you to move, I highly recommend Job 1

#1 hands down.

#1! I can’t imagine starting out in tele with six patients!

Another vote for #1. It does sound like an absolute headache to move again so soon, but ultimately worth it to get a job that offers support and a residency program. A job that would regularly stick you with six tele patients as a new grad (or as anyone!) is not a great bet; that will be extremely stressful. Plus, if I'm reading your post correctly, you've accepted an offer from #1, but is there an actual offer from #2? Or they have called to express interest? I would recommend sticking with the offer you've accepted, as you do have a plan to make it work for the next year and you've already started the onboarding process.

You said #1 is within 60 miles, right? I know it's not ideal by any means, but if you work three twelves, any chance of making the awful commute a few times a week until your lease is up? I know a few people who did that and were able to either move closer the next year or get a job closer to home after getting their year of experience. Something to consider.

This isn't as clear-cut as people are making it out to be.

Yes, 1:6 tele ratio is the deal-breaker--although you haven't noted what types of ratios you will be exposed to at the #1 place. I will assume they are smart enough not to provide such information quite so freely.

A residency is only as good as its (true/actual) driving philosophy and the amount of genuine support it receives. It can be a tool for giving people an excellent foundation or a tool for churning workers. Similarly, an orientation can absolutely suck and leave a new person hanging out there alone to be chewed up and spit out....or it can be an experience where, since newcomers aren't a dime a dozen, people are dedicated to supporting and incorporating the new person and are motivated to provide an excellent foundation.

It's not ideal by any means, but I've known quite a few people who make more than a 60 mile commute every day they work and have for years. Maybe you should just do it until the lease is up.

The 1:6 tele ratio would be a deal breaker for me. That is too many patients. I worked tele with a 1:5 ratio and many days with admissions and discharges (plus frequently sending patients to the step-down or icu unit) it would bump my total number way up for the day. The acuity of the patients on my tele unit should have had us at least at a 1:4 ratio to be manageable.

I am assuming that pay and benefits are equal?? And the hospitals are comparable (or is one a big teaching hospital and the other a smaller community hospital)? Is tele what you want to do?

Given the info you shared, I would say #1 sounds better. Yes the commute is long, but I used to do it (I had young kids at the time too!) and its totally manageable!

Thanks for your inputs. Actually, the pay from hospital 2 is couple dollars/hr more than the first one and the #1 is a community hospital and #2 is a trauma center. I came from CA where tele patients is 1:4 during my preceptorship, but 1:6 is something I am not used to and afraid that I would not make it on top of being a new grad.

8 hours ago, NightNerd said:

Another vote for #1. It does sound like an absolute headache to move again so soon, but ultimately worth it to get a job that offers support and a residency program. A job that would regularly stick you with six tele patients as a new grad (or as anyone!) is not a great bet; that will be extremely stressful. Plus, if I'm reading your post correctly, you've accepted an offer from #1, but is there an actual offer from #2? Or they have called to express interest? I would recommend sticking with the offer you've accepted, as you do have a plan to make it work for the next year and you've already started the onboarding process.

You said #1 is within 60 miles, right? I know it's not ideal by any means, but if you work three twelves, any chance of making the awful commute a few times a week until your lease is up? I know a few people who did that and were able to either move closer the next year or get a job closer to home after getting their year of experience. Something to consider.

Thank you for your time. #1 is 61 miles one way so about 122 miles round trip from my place to the hospital. The work schedule is like two 12 hours shifts (Mon-Tuesday) and 2 eight hours (Thursday-friday), no weekends and holidays. Since we just move to a state it snows, not sure about driving on snowy days.

20 hours ago, JBMmom said:

In my experience, the new grad residency programs are hands down better than just an orientation to a new job. Starting with a cohort of new grads gives you an instant peer group that is going through exactly what you are going through, and the support that brings can be vital for new grads. Residency programs generally show that the hospital is committed to helping new grads transition. You usually have scheduled education days with specific seminars and skills training that you will not get in a traditional orientation to a unit. I understand you're probably looking for feedback that says #2 is your better bet, but almost everyone I know that went through a new grad program is very happy that they had that experience. Good luck.

Thank you for the detailed input. I am looking for suggestions from everyone especially those who are nurses. Maybe they have insights that I have never thought of. Everything about #2 is good but just the thing I have 6 patients and they are high acuity and very busy floor. I dont mind to be tired but as a new grad, I just not sure about if I can handle such high acuity patients.