2 ED job offers - which one?

BethulieRN · Jun 26, 2008

Facility#2:up: sounds good to me. I would pick that one. But the choice is yours to make.

loricatus · Jun 26, 2008

Which of the 2 do you think will give you "you did a good job" & give you your breaks? Since those, along with the staffing ratios, were reasons why you left, I would say to take the job which will give you the important (to you) things that were lacking in the job you left. To me, based upon the information you provided, that would be #2-teamwork is so very important and found so infrequently. This says something good about the managment of that place. And, good managment is a rarity also. You could always apply for per diem at the second place to satisfy the adrenaline rush craving; but, with #2, it sounds like you might find a home.

So very glad for you. I just left another toxic ER, ratios were as you described and even got to 1:12 at times. Am giving up on finding the good ER and probably going to another specialty for a while. Your post, however, gives me a little hope that a good ER may just be possible in the future. Good Luck

patrice meursault · Jun 27, 2008

job 1...free food . I'll work anywhere for that!!!!!

MassED, BSN, RN · Jun 28, 2008

any opinions on which ed job should i consider taking? i am totally torn! i left my old ed job due to unsafe staffing (see my previous posts). both places want an answer tomorrow! the hourly pay rate is same. and i am happy with a part-time position (we all know how there's always holes to fill in the schedule, and i don't want to commit 40hrs/week to a facility). i don't need benefits. i'm coming from trauma level 3 facility that is a certified chest pain center, which saw 80,000 patients last year.
facility #1:
-pool position, 20hrs/month minimum, 1 weekend shift/month, 2 holidays/yr
-no on-call requirements
-35 minute drive from my house
-trauma level 3 facility
-cath lab on site (cardiologists are called in when an mi comes through the ed)
-free soda, cookies, popcorn, milk, juice...
-less than 3% nursing turnover
-34-bed facility
-chest pain center
-stroke center
-private rooms, all with a private bathroom
-state-of-the-art equipment
-no bonus or overtime paid for working more than the required minimum (20hrs/month)
-~48,000 patients/year
-3 nice trauma/code rooms that are super big and have equipment to die for!
-primary nursing model, nice teamwork
-4-5 patients/nurse (but you were given only what you could handle; the plan is to lower ratio once staffing is increased, which was just approved for the budget by upper management last week)
-experienced nurses (all of them seemed to be 30 yrs old and up)
facility #2:
-part-time position, 20hrs/week, 1 weekend/month, 2 holidays/yr
-must sign up for four 4-hr on-call hours/month; $40.00 bonus if called in, plus time-and-a-half
-25 minute drive from my house
-trauma level 3 facility
- 24/7 cath lab on site (cardiologists are staffed in house)
-38-bed facility
-chest pain center
-stroke center
-curtained rooms, none with private bathroom
-old equipment
-team nursing: 3 nurses and 1 tech for 8 rooms, with awesome teamwork (i did a job shadow and was amazed at the teamwork)
-$20.00 bonus for picking up an extra shift, along with time-and-a-half if you're over your fte (which would put me near $50.00/hr)
-mix of experienced and newer nurses (i'd say most are in their 20's, early 30's)
-nurses and docs seem more relaxed and laid back
-65,000 patients per year
i did a job shadow at both facilities; before the job shadow, i was leaning towards facility #1. however, i was so impressed with the teamwork at facility #2 that i am unsure which job i should accept. all the nurses from facility #2 were saying "we're so busy!"; i wanted to laugh, because their "busy" day was an easy day for me, compared to what i'm used to. i was actually somewhat bored! guess that's one good thing that came from running my butt off 12+ hours/shift, no break, and no end in sight...

facility #2, hands down. here's why: curtains mean you can jump from room to room in an emergency (br are over rated anyway, if it's that urgent, there's always a foley). bonuses and time and a half where facility #1 had no monetary incentives, now that's the kicker. closer by 10 minutes to home, that's an extra 20 minutes per day. 4 hours on call per month is so easy and again, money bonus to come in. and honestly, do you need free soda at facility #1, which just packs on pounds anyway, or maybe they want their nurses as patients one day. you mentioned with facility #1 that the nurses are experienced by being over age 30.. i graduated nursing school when i was 29, so you never know.

loricatus · Jun 28, 2008

Just curious, have you made a decision yet? Would love to hear which one you decided and why? We can all learn something from how you made your decision.

kmoonshine, RN · Jun 28, 2008

So, I decided to choose job #1, and here's why:

less patient volume
smaller hospital "system", as opposed to a large corporation
excellent equipment
good teamwork (the charge nurse was going around and discharing people when I was observing one day, and staff was availible to help)
docs that are aggressive on treating pain
quiet environment (I think the ambulance radio rang 3 times in a 4-hour period...seriously)
supportive staff (everyone that introduced themselves to me had raved about how much they loved working there)
staff were smiling and seemed happy with their job
they have a pharmacist in the department on 1st and 2nd shift; they get meds, order meds for you, and verify med recs
if I was a patient, I would like the environment and want to go there
the hospital has the resources to make patients happy (rather than having to run around myself making patients happy)
the management values hard work and appreciates staff; during my interview I stressed that I wanted to work in a place where my work was recognized and appreciated; they emphasized that they value their staff and go out of their way to show appreciation, and I really felt like they were telling the truth
before I quit my other job, my coworkers raved about the hospital; I mentioned that I put in my notice, and one of the PA's said "you should go work at XYZ hospital, it's wonderful there"
some of my previous coworkers work there, and were well prepared for the environment because they were able to anticipate what would need to be done (at my old job, we were always so busy that you would have to be efficient; if you weren't you would sink)

Even though I could make more money at job #2, they could get rid of bonuses at any time; and just because the teamwork was great with the 3 nurses that I shadowing, it doesn't necessarily mean that it will be like that all the time. I don't think that either choice would have been wrong, and it was a difficult decision. I just thought that the department setup of hospital #1 was more efficient, and if I were a patient, I would want to go there. The patients also seemed happy (and the call light rang once in 4 hours, from what I remember). It just seemed like such a stable environment.

Job #2 is a huge corporation and made the most profit of any hosptal in all of the state where I live. My friend works in the CV-ICU there (open hearts, transplants, ECMO, artificial hearts...), and I was surprised to learn that their equipment was way out of date (as my friend put it, "we use the same ventillators as third world countries do"). It just made me think "where is all that profit going...". And the ED equipment was way outdated too; I guess if it gets the job done, thats all that matters. But it sure is nice to have the latest technology available, isn't it?

Lastly, my husband and I have been talking about starting a family...and the flexibility of a pool position would be best for us and our lifestyle.

Thanks for all the replies and well wishes! At least I have a backup job should this one not pan out, right?

loricatus · Jun 28, 2008

Does sound like you made a good choice. Best wishes for your happiness at the new job.

I did learn from the way you analyzed the choices, very impressed and very grateful that you shared your decision making process. Also, seems like you followed your gut instinct. As an ER nurse, you already know how valuable doing that is.

Didn't mean to pry too much. It is just that I made a decision to leave ER (at least for a while) and try out PACU after an attempt to get a nursing informatics position didn't work out. I used a similiar method to come to my decision. Although it will be less money, I have to get away from the toxic environments I seem to fall into. Put that together with doing it as a travel nurse for the past 7 months (started traveling to get away from the politics), where I was being treated like a subhuman who is expected to take on loads double that of staff, if I didn't get away from it I would probably burn out from nursing altogether. So, I thank you for your help in putting my mind at ease for the decision I just made.