Duke vs UNC vs UNC Rex

U.S.A. North Carolina


Specializes in Neurosurgical ICU, Emergency, Psych, Art Therapy.

I want to start off by saying sorry for yet another post about the Triangle area. I'm moving from out of state and due to COVID the hiring process has been remote/interviews via zoom which has made things pretty stressful. I've never even been to the triangle area before, so I don't know what I'm getting myself into, but from what I've read it should be a really great experience.

That being said, I have been a nurse for about 4 1/2 years. 2 1/2 years ER experience + 2 years geri inpatient psych. I'm moving away from psych, as I want to grow in my medical/clinical skills and the unit I work on focuses a lot on dementia, TBI's, movement disorders so I've developed a growing interest in neuro as well.

I was offered a position at Duke in Durham on a Neuro stepdown unit. The interview went really well, everyone seemed super nice. The unit will be in a completely new tower, so everything is nice and new and up to date. I'm currently working at Johns Hopkins so the whole teaching hospital/big name features are familiar to me, and I don't necessarily assume a "big name" is best.


- They offered me 27/hr base pay despite over 4 years experience. The differentials are great, but I would only be rotating so I don't know if that pay rate will cover my bills (I have *a lot* of student loans) It's hard to estimate how much I'll actually make a month when I don't know my schedule or frequency differential shifts.

- The recruiter mentioned their loan repayment incentive, which sounds great, but when I received my hiring packet it did not mention the loan repayment incentive, and when I reached out to my recruiter to make sure the incentive is still active, he never responded, which makes me anxious. They did offer a 3K relocation bonus and that was included in my hiring paperwork

- Parking is expensive, which I currently deal with now at Hopkins, but I'm also taking a big pay cut and the decreased cost of living doesn't take away the fact that I have a lot of student loans to manage monthly...

* Any Duke insight would be great. Do you think I could request a higher pay rate, or would that be futile? I see posts of new grads being offered 27/hr base back in 2017... so why am I being offered 27/hr with 4+ years experience? Do you think the differentials make up for the low base rate? Do you find you have opportunities to pick up overtime shifts? Do you get annual raises and is it worth starting out low with the hopes of getting more adequate pay over time? Is there room for growth/leadership opportunities? I don't want to sell myself short and be underpaid when I feel I have worked very hard to develop the experience and skills I currently have, however I am also willing to enter into a lower paying base rate if there is potential for growth. I was expecting a lower rate of pay, just want to be sure it's a fair offer.

Since being offered a position at Duke, I was also offered a position at UNC Rex yesterday for an ortho position. Still waiting for paperwork about specifics, but I've read UNC Rex typically pays more. They also have a loan repayment incentive and their relocation bonus is 5K (as opposed to Duke's 3K) UNC Rex has free parking. The manager was also very nice, and even mentioned possibilities of being qualified for leadership positions (which they do have open) based on my experience alone, which seemed promising. They seem like a fast paced unit, handling up to 17 post surgical patients a day, with a faster turnover rate.


- I'm not that familiar with ortho. I remember enjoying my ortho rotation in school and I'm pretty familiar with pain management and various levels of immobility, but not necessarily from a post-op standpoint. I'm not 100% set on neuro, but I do feel more intrigued by neuro based on my recent experiences, however I also don't want to rule out a particular area of nursing as I feel very open to enjoying many aspects of learning.

- I was hoping to live in either Durham or Chapel Hill, so driving to Raleigh would be a commute, but the parking is free and it doesn't seem to be too far from Durham.

- Still waiting to hear more about pay rate/differentials/incentives but I've read a lot about UNC Rex paying better. Is that the case? I don't want to pick a position solely based on pay rate, but I also want to be able to manage my bills without losing my mind (completely)

- There are multiple leadership positions open on this unit... is that a bad sign that it's an unstable unit? I don't want to work in a floaty/unsafe area and would feel more confident working in an environment with a very solid team. I know nursing can be transient, but it just threw me off a little...

- Does UNC Rex have the same benefits as UNC Chapel Hill?

I also had a really great interview with UNC Chapel Hill Neuro ICU, but that was a while ago and I was told there is a hold up from HR on hiring. Last I checked they said I'm still being "strongly considered" but still have the HR issue which is vague and has no known time frame, so I can't afford to decline offers in the meantime.

OK, whew, sorry that was so long. I really didn't expect back to back offers so I'm trying to decide which one is right for me.

Specializes in orthopedic/trauma, Informatics, diabetes.

I've spoken to you before.

1-Duke Neuro. We are so short now hospital-wide, you can get all the overtime you want. I am pretty sure they don't negotiate salary. I am also pretty sure you might, however, be able to negotiate a shift preference.

Rex. Nice hospital. Not a teaching hospital. I am an ortho nurse at Duke, so ortho is my thing. High turnover of patients and time-management is a must. It is kind of difficult to get a job at Rex so that is great for you! They have expanded their square footage over the last 5 years by 3 times (I did my clinical for nursing school there).

All the level 1 traumas go to UNC, they don't stay at Rex.

I am not sure about Rex and UNC-CH having same benefits. CH is a state facility attached to the university so the benefits might be difficult. I had a friend who was going to work there and Duke PRN, but after a month, she hated it.

Hey I have a question. Im trying to move down to NC from DC and I was wondering if you have your NC nursing license yet? I am applying to UNC rex and its asking if I have an NC license. I have DC one but not NC yet!


Rex like all other "UNC" community hospitals is managed by UNC, but employees are not considered state employees (apart from Hillsborough hospital which is). UNC-CH does have much better nursing culture than Duke. This is nearly universally recognized in the area. I've worked with tons of former Duke nurses everywhere I've worked at UNC.....they all like being at UNC much better. Never worked with any RN at UNC that left to go to Duke. UNC education benefit is one of the best as they will reimburse up to 20 credit hours per year at the UNC rates. Meaning for your graduate program they will pay up to $600 per credit hour up to 20 per year. They will also waive 3 courses per year at any of the north carolina state schools which includes all fees for that semester as well. So if you went to graduate school at UNC, UNCC, East Carolina, UNCW, etc you could waive one class each semester (fall Spring Summer) and have all the fees for that semester waive as well and then get an additional 20 credit hours reimbursed. Which means you could go to school full time basically and it all be covered, unless you went to school at Duke in which they would not waive any courses but would reimburse $600 per credit hour(which is not much as Duke costs 3x that). Duke will pay 90% of your tuition at Duke SON if you go there (so you'd still have to pay almost $200 per credit hour out of pocket) after one year of employment with a 3 year work commitment afterwards. So if you definitely knew you wanted to go to school at Duke specifically, working there may be beneficial although you'd still pay some and have to work for them for an additional 3 years (and be miserable LOL). 

Specializes in orthopedic/trauma, Informatics, diabetes.

Why the hate for Duke????? You seem to be spreading it on any post that talks about Duke. 

I got my MSN at Duke and I am NOT miserable. Know plenty of nurses that left UNC to come to Duke. 

Most nurses I know in this area have a preference, but nursing is a very small world and I would not be so nasty about Rex or UNC or WakeMed. 

Not sure I understand the hate for Duke...

You don't seem to have posted much except to bash Duke. hmm. 

I also worked at both Duke and UNC-CH.

UNC is a much better culture, and the pay I was offered was substantially more than what I made at Duke!

When you work for Duke you have special right to say that you was working for Duke, so you pay is 15%-20% lower compare to UNC and REX hospital. Cheapest parking 7 minutes away on the bus from unit is $50, you would have to pay $120 for parking in 20 minute walking distance . Insurance benefits is not very good but affordable if you are single person. It is teaching hospital but we are short staffed, so there is no time to learn much.


Specializes in Nursing.

Hi! I'm super late to this thread, but I'm actually doing the reverse of your move and potentially looking at working at Hopkins or Medstar Washington after I graduate in May. Do you have any advice about either of these hospitals that could be helpful? I'm concerned about parking (cost and convenience) and safety at Hopkins. And if you have any opinions as far as comparison between the two hospitals. Or UMMC as well!

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