First Job - Not A Great Facility, Take It Or No?

[BrooklynRN11201]

Hello - well I passed nursing school and I'm almost done with a 9 week graduate nurse externship I've been doing in the Emergency Department of a hospital here in New York and I love it! I'm also studying for the NCLEX-RN which I have scheduled for 9/4. The hospital I'm externing at is actually looking for 4 new ED nurses so I think I have a chance contingent upon me getting my license in September. So what's my problem?

Thing is, this hospital is in a really rough neighborhood - very much inner city public city funded type of place. A lot of what we see is drug overdoses, alcohol withdrawals, domestic violence, babies having babies, gunshot wounds, stabbings, prisoners, homeless people, well you get the idea. Now it doesn't bother me at all working there personally since I believe these "forgotten" areas are the most in need of quality nursing care (okay, that's the new nurse talking), but I guess my hesitancy is that it's got a reputation for not being a very good hospital. Would a future employer NOT hire me after seeing I worked there?

In other words, do I just take the first job for a year or so and hope to move on to greener pastures? Or do I hold out for a job at a facility where I'm not ashamed to say I work? (that's a bit of an exaggeration but you get the idea).

Many thanks!!

[MassED, BSN, RN]

It is interesting to read so many other posters say to take the job. If you are in a position to have other offers, I'd think carefully. I would never base working on a place on hearsay of their reputation. Most ER's have a bad wrap, which most of the time is unfounded. Every ER has their bad population and rough nurses that make a bad name for the rest of us.

From my outside glance at your situation, I think that would be a trial by fire ER to start for a new grad. As a new nurse, you don't know what you don't know.

That is interesting if they are willing to hire that many new nurses, are they all new grads? That kind of rough neck ER is great for someone who has had years of experience to draw on with those scenarios where you have to move/think fast. Knowing what I know, I would be hesitant to START your nursing career there. I would learn some basic stuff in a smaller (less busy) ER or work on a floor before you are thrown into the fire. Remember, your license is on the line. Never forget you are responsible for you.

[BrooklynRN11201]

thank you all for your helpful advice and comments, particularly the last one by MassED!

I have an interview with this facility tomorrow morning, and I think they're considering me for a day shift position since the day shift ADN will also be interviewing me.

On one hand, I'm ecstatic that I might be offered a day shift job in the ED as a new grad since I know how rare that is. On the other hand, have I had experiences there that have scared me a bit in terms of my safety? yes.

I've had a confused and violent patient spit on me, another kept touching my face as I was trying to get a saline lock in him, a family member of a patient verbally attacked me to the point of needing to call security to have him removed, etc. My love for the ED is very strong regardless of these experiences, and I would still love to work there.

I figure, at the very least, it's best to take the job and continue my search elsewhere assuming once I start it turns out to not be my dream job. But I think some points made in this thread are extremely valid - what if it turns out to be amazing? what if it's better to be a big fish in a small pond?

Hopefully I'll have the opportunity to find out! Thanks again!

[turnforthenurse, MSN, NP]

Take the job.

[Sassy5d]

That's pretty much my typical day. I'm just outside of a major city. We're not a trauma hosp but traumas still walk in, along with girls in labor and we have no ob dept.

Sounds like a great experience. I say jump in

[zmansc, ASN, RN]

K, so just so you know, I work at a small rural hospital, and this hospital doesn't sound any "rougher" than what I deal with on a normal shift at our facility. I think all ERs have their share of mis-behaving patients. Part of working in an ER is learning how to deal with these kind of patients and knowing how to stay safe while providing these patients treatment. Believe me, and I'm sure I'm not the only one, I've had to put restraints on someone at the beginning of the shift, and after they came around they were very appreciative and complimentary to me and the rest of our team for our care. Many times, the patient can't help themselves (I'm not saying they aren't this way because of bad choices earlier, but at that point, they can't help themselves) and need your compassion and care.... And sometime your compassion and care includes restraints or other measures that they will fight you over. That's just life in the ER.

Now, if the staff at this particular ER is not supported by management, and people aren't there to back you up when situations get nasty, well that is a different issue all together. I have to admit, I have a great team at my work, we are all in it together and I know that every person working in the ER from the docs on down will be there to help me out if I need it.

[BrooklynRN11201]

very very helpful, thank you!! nice to know all EDs have their fair share of unruly patients :)

I got the job, now I just need to pass the boards, whoopie!

only downer is it's for the night shift, but apparently that's how all the nurses are hired in the ED - night shift for a year or so first... and besides, orientation is during the day and that will be the first 4 months.

[harrird]

Congrats on the job offer. Sounds like good experience. And 4 months orientation is nothing to sneeze at. I had 8 shifts. All ED's have their share of difficult patients. Best of luck with boards.

[OlivetheRN, ADN, BSN, RN]

Congrats on the job offer. Sounds like good experience. And 4 months orientation is nothing to sneeze at. I had 8 shifts. All ED's have their share of difficult patients. Best of luck with boards.

8 shifts?! Holy moly! I'm a new grad in the ED and we get anywhere from 3-6 months depending on our specific needs.

[Sony1214]

Take the job, it will make u a stronger nurse, they will know you hve thick skin for being able to handle a place like that!!

[itsnowornever, BSN, RN]

I'm a relative new grad---and I got a month and a hog orientation. :/ take it and be happy!

Posting from my phone, ease forgive my fat thumbs! :)

[Sassy5d]

My year in ED comes next month. Although it feels like orientation was forever ago.. The veteran docs n nurses will still be there to help you, not leave you hang.. And they'll take into account you're newer.

There's never a reason to NOT ask a few people's opinions when you're doing something you've never done.

Orientation ending should not make you feel like you're cut off and left to fend for yourself. ER is team nursing.

[RNFiona]

Just because a hospital is pretty doesn't mean the patients are necessarily getting the best care....take the job