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Float Pool or Telemetry?? First nursing job offer..

Hello:) I am a new grad and just recently passed the RN boards. I have applied for an RN position in 2 hospitals in my town. Both hospitals offered me a position...one is a FT nights in Telemtry and the other FT days as a float nurse ( Acute Rehab/Tele/Med-Surg floatation). I am more leaning towards accepting the FT days (3 12 hours shifts) Float pool position because I have 2 little kids at home and I'd like to be able to be home at night with them. I am asking for your opinion especially for those who are maybe in float position at their current job. How does (float RN) it work and what are the advantages and disadvantages of doing this type of nursing job? I have heard from a friend of mine who was once worked as a Float CNA that doing float is not a good idea because most of the time they will assign you the most unstable patients ( nurses on the floor you are floated to pick their patients and then give you the ones they don't want to care for)...Is this right? I have to make a decision by the end of next week whether to accept the FT night in Telemetry or the Ft days Float Pool because both hospitals are starting their new grad program on Jan. 9th. I would like my first nursing job a positive start for me and will not scare me off....What do you guys think? Telemetry or Float Pool? Thank you very much...:uhoh21:

Indy, LPN, LVN

Specializes in ICU, telemetry, LTAC. Has 5 years experience.

I love telemetry, although my child at home is 13, my husband and I work different nights so someone is always home. I wouldn't choose float for a first job. Is there anything else on days that this facility is prepared to offer you?

Sanuk

Specializes in ER. Has 8 years experience.

I would not have chosen to do float pool directly out of school. The main reason is that I don't think it will give you the stability you need as a new grad who is learning how to juggle all the responsibilities of bedside nursing. But, it would also depend on what type of orientation they would be giving you. Floating can, depending on the nurses you work with, have less support - after all, you belong to no unit. IMO, you don't have the relationships with other nurses if you need help or have a question. Good luck in whatever you choose to do, and congratulations on graduating!

HappyNurse2005, RN

Specializes in LDRP.

First of all, we never give float nurses the most unstable patients. The patients ar assigned based on acuity, so that no one person gets all the heavy patients, float nurse or not

I wouldn't do float right out of school. first of all, acute rehab, tele, and medsurg are all quite different. How can you be expected to absorb the needed knowledge when you are on different units all the time? No one resource person to go to. No camaraderie with other nurses (because you are not with the same ones all the time). As a new nurse myself (graduated in May) having a camaraderie with hte other nurses is important, you know who you can go to for help.

Really, i'd go w/ the tele, just for the stability.

AngelsRN

Specializes in PACU. Has 8 years experience.

I am not sure floating is the best for a new grad - I just graduated as well and I chose a unit where I had been working as a unit secretary just for some stability as I learn how to be a nurse. I figured I have enough to learn - let me do it in an environment I am comfortable in. If you float, it will be harder to develop relationships in the beginning that I think us new grads need. However, one thing to consider . . . do you prefer one of the hospitals over the other. If that was the case, you may want to just get your foot in the door and then put in for a transfer when something else comes up. Some people choose a position in that way as well.

pricklypear

Specializes in Telemetry, ICU, Resource Pool, Dialysis. Has 11 years experience.

I totally agree with all the above posters. Personally, I needed the stability of ONE unit to get used to right out of school. There is so much to learn about yourself, about nursing and time mangagement right now. I think that's made somewhat more difficult when you may be placed on a different unit everyday. Each unit has its own work pace, flow and way of doing things. It's too much to deal with when you're a new nurse.

It does make it harder when you have to choose between nights and days. Especially if you have little kids who need to be cared for during the day. But most of the nurses I work with utilize child care less when they work nights. Usually, they keep the kids on the first day before a shift, maybe nap with them in the afternoon. Then have a babysitter on the days between shifts only. Then only a couple hours, or not at all on their first day off. That's two days of daycare as opposed to 3 if you work days.

I worked tele as my first job out of school. I think it gave me a great start. Most traditional tele floors get a pretty good mix of patients, and learning cardiac rhythms is going to be a very usefull skill for you in the future.

Good luck with your decision!

UM Review RN, ASN, RN

Specializes in Utilization Management.

I agree. You might want to try for a different shift, but you definitely want to get with a "home" unit where you will be adequately oriented, preceptored, and have resource nurses available.

I believe all new grads should have that kind of skills training and experiential backup for a successful transition to bedside nursing.

Best wishes, whatever you choose. And remember, you can always vent/ask questions/share here.

You need a solid orientation first as a new grad but you should even consider floating. I know that it sounds good to you right now, but when you get home stressed at night, you will not be any good to your family.

Something else to consider.

No new grad should consider a float pool without a regular home for at least six months. As we keep saying here, your real training is going to begin when you start your first job, not when you were in school. Once you start working, I am sure that you will agree with us.

Good luck with your new job.:specs:

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

No--to either position. Anyone at any hospital that offers a new graduate RN a job as a float nurse should have their head examined. A new grad does not have the experience to handle that. Run from that hospital. There is something wrong there that they would even offer you, a new grad, a position like that. They are thinking only of fullfilling their need to keep the hospital staffed and not thinking about your needs as a new grad, or even those of the patients you'll be having to take care of. Not only that, but you do not have the proper training coming out of nursing school to work any day shifts unless you are being given an orientation in one stable unit for a number of months.

I don't think much of the hospital offering you a position on telemetry either. This is a semi-critical care area and unless you can be assured that they are going to provide you with a very exceptional orientation you, again, are primarily being used to boost their staffing needs. Telemetry is often a very fast paced medical unit with patients having a wide range of medical problems either coming or going to ICU.

You must understand that your training is not yet completed. Your first year of nursing out of nursing school is a very stressful one. You have much more to learn, but most of it is going to be on your own--no instructors to poke and prod at you to keep up with things. This is where you are going to be on your own armed with the bag of tricks nursing school gave you.

Let me explain, since you don't know me. I have been an RN for 30 years, been a hospital supervisor and head nurse. While a staff nurse I worked for 5 years on a stepdown (telemetry) unit among other and various medical/surgical units. As a supervisor we floated our float nurses all over the hospital--a different unit every day. Float nurses don't have much choice as to where they are going to work. They may tell you Acute Rehab/Tele/Med-Surg to entice you, but it's not unlikely that it will turn into floating into the ICU, CCU, ER and even OB. And, if you get testy with them and stand up to this, you may find yourself terminated. The telemetry unit I worked occassionally took on new grads, but they often never made it through several months of working there without burning out or becoming so frustrated that they quit. I've only seen a handful of exceptionally intelligent and thickly skinned new grads able to handle a job on telemetry. This particular forum (First Year in Nursing) has posts filled with the vents and woes of nurses who have come before you that started out in telemetry units.

Understand that if you are thinking of joining a float pool with the idea of checking out all the units to see which one you might like to work on permanently, most places won't let you transfer to another position until you have worked at least 6 months in your current position, 12 months in some places. Then, if you don't like the situation you are in, your choices are to stick it out, or quit.

It's too bad you waited so long to apply for your first job. All the other positions got taken. You see, these are the last two left--that alone should be a red flag to you that no one else was taking these positions. Hospitals have positions opening up all the time. They run orientation for new employees once a month (most places). I know you would like to get into a new grad orientation, but if you go to work at a later date, you will get much closer precepting. The hospitals are going to be stressed to the limits to find preceptors for all these new grads. It will be sink or swim time for many new grads. Those who sink will need to be replaced. Then, you will be able to find a job. I strongly recommend that you hold out for a surgical nursing unit (not the OR surgery) or some specialty medical unit like a GI or neuro unit, or even orthopedics. You will be on one unit, learning their special little quirks of nursing patients and boning up on those specific types of patients.

I'm sorry if I'm sounding so negative, but I had a very bad start to my career years ago and I've seen so much go wrong for new grads. I'm really angry that a hospital would offer you a float position.

I thank you all for the kind and honest replies you've given me. I'm so scared about starting my career. I don't know how and where to start. I haven't even started and yet I feel like I'm a failure already. What unit would you recommend for a new grad with no previous experience except nursing school? I just got a call today from one of the 2 hospitals and seems like they have an opening in the med-surg unit. Should I go that route?

Please help!

As we keep saying, it is going to depend on the type of orientation that they are offering you, and if they do not have a full program in place, do not accept it. Consider school as only a stepping stone, your foundation that you will get over the next few months will set the tone for you for the rest of your nursing career. You want a facility that will nurture you to become the best nurse that you possibly can, not just to mass produce someone to count as a number.

I understand that you got a call from HR, but have you spoken to the Nurse Manager or even taken a tour of the unit and talked to some of the staff there?

Do yourself a favor, do not be in a rush to find something, take your time. If you are already nervous, this will only make things worse for you. You will find that perfect fit for you.

As we keep saying, it is going to depend on the type of orientation that they are offering you, and if they do not have a full program in place, do not accept it. Consider school as only a stepping stone, your foundation that you will get over the next few months will set the tone for you for the rest of your nursing career. You want a facility that will nurture you to become the best nurse that you possibly can, not just to mass produce someone to count as a number.

I understand that you got a call from HR, but have you spoken to the Nurse Manager or even taken a tour of the unit and talked to some of the staff there?

Do yourself a favor, do not be in a rush to find something, take your time. If you are already nervous, this will only make things worse for you. You will find that perfect fit for you.

Hi, Suzanne

What is the acceptable lenght of orientation? Let's say I accept the Telemetry night position, what would be the fair amount of orientation I should be looking for? The hospital that's offering me the tele position (nights) does team nursing which consists of 1RN, 1LPN, and 1CNA (patient load is 8-9 patients at night). Then the Med-Surg position ratio is 5:1 ( total care; no LPN or CNA ). Actually it was the nurse manager who called me about the position in the med-surg unit, we have yet to meet in person and take a tour of the unit. When you said, talk to the staff....do I talk to them while I'm touring the unit or should I call and talk to one of the staff? I'm sorry I have so many questions...I'm just really nervous about this. Please pardon me. Thank you!

AngelsRN

Specializes in PACU. Has 8 years experience.

if you go to work at a later date, you will get much closer precepting. The hospitals are going to be stressed to the limits to find preceptors for all these new grads. It will be sink or swim time for many new grads. Those who sink will need to be replaced.

Often hospitals limit the number of new grads they will take -- where I am going, they are only taking 4 or 5 --- they do this so they can have good precepting and orientation for them. Well, a good hospital does that. Like she said, if they are more concerned with their staffing, you will get a terrible orientation.

Sanuk

Specializes in ER. Has 8 years experience.

The appropriate length of orientation depends on the type of unit you are working on. In a critical care area (ER, ICU) it should be AT LEAST 3 months, and some are 6 months. On the floor, I would say three would be sufficient. I don't think I would have felt comfortable coming out of school and being the only RN - I think I understood from your post that's how the tele job would be. But ultimately, it's going to depend on you and what you feel are your strengths. Are you interested in tele, med-surg? What type of nursing did you envision when you started school?

Indy, LPN, LVN

Specializes in ICU, telemetry, LTAC. Has 5 years experience.

Daytonite is right, you will need at least 12 weeks on telemetry orientation if you take it, and in my opinion, it needs to be a unit that is well staffed enough so that you'll be starting off orientation with a max of 4 patients.

The unit described in the "tele nightmare" post sounds like a combo of telemetry and stepdown, a full moon and yep, it's scary. You need to ask to have a day- or a night if it's a night shift position- to shadow a nurse and observe in order to make up your mind.

And keep in mind, sometimes they're gonna fool you. You can go through a couple of really good weeks and begin to think about how nice it all is, and then have a week where you wonder what truck ran over you. I'm currently in a paranoid mode where I keep thinking they are all likely to crash on me, because I had a night where they all either did crash, or tried to crash, with a very light load numbers-wise.

So tele can be the devil, and Daytonite knows what she's talking about. I saw this particular unit in school, and did practicum there, and then accepted a job offer, so I didn't entirely have my head in the sand. However, school and job are two different beasts. It's important on any unit to actually LIKE and get along with, your preceptor; so shadowing at the very least is a good start.

Med surg is well rounded and recommended as a base for everyone; patient loads on almost all units get larger at night and for the life of me I can not figure out what nuthead thought that one up. Seriously. If they are gonna puke feces, dissect their aortas, have a heart attack, go into respiratory failure, pull their foley out or just plain yell all night long, it'll probably be at night.

I gotta think, did you do any clinicals at any of the hospitals you're considering? Think back to which ones were pleasant and did any of these pleasant experiences have to do with nurses who were a team, and helped each other out? Consider applying to those units. Maybe, just maybe, if you know someone who works there you could have them introduce you to the unit director or nurse manager; they might be interested even if the HR department says they aren't.

What ever unit you decide on, make sure an orientation period is fairly long, none of this four-weeks-have-fun stuff, and that you have the option of switching preceptors if need be, and if you think your heart might not be in that unit, ask up front how long you need to work before you can do a transfer in the facility. I hope you find something good!

-Indy

AngelsRN

Specializes in PACU. Has 8 years experience.

My orientation will be 10-12 weeks depending on how I am doing - minimum of 10 weeks, could be longer than 12 if I feel i need more support. I will be on a med-surg unit essentially with areas focusing on ortho, neuro and trauma.

RainDreamer, BSN, RN

Specializes in NICU. Has 13 years experience.

I agree with what everyone else has said here.

The hospital that I work at won't let new grads work float until they've had some experience (at least a year). As a new nurse (I've been working since Sept.), I can't even imagine working on other units because I'm just NOW starting to get comfortable with my own unit. As a new nurse, you already have so much to learn on a unit, adding more units and more chaos would just make things so much more stressful, in an already overly stressful time.

It's really an exciting time, but it's stressful, no doubt about that. I agree with what someone else said about the importance of camaraderie on a unit. I work with some great people ..... when I get stressed out and feeling overwhelmed, I know there are people that I can go to for help. I never feel alone. As a new nurse there will be times in which you feel like you're drowning and you just want to cry ..... you don't want to feel alone during those times, you want to make sure you've got good back up. You can't get that kind of camaraderie if you work float pool, you just can't. Find a nice home unit and it'll make this stressful time more smooth.

I wish you all the best of luck. Congrats to you!!

I work Tele-nights as a CNA and I like it. I would suggest that position b/c having a stable floor to work is better that floating all over the hospita. Besided the float CNA-RN get the crappiest assignment. And you always feel like and outsider on their floor.

If you have a stable home so to speak you begin to build a bond and relationships with the people you work with.

Once I graduate I have a position on my floor. They prefer to hire RN that were once NA--we have had several people to convert and they really like. They said it is nice to know how the system works.

Good luck with your decision.

twinmomoftwins

Specializes in ortho, pedi. Has 11 years experience.

yes,yes, YES!!:wink2:

Go for the Med-Surg position. You'll be on a stable unit, reinforcing everything you've learned in school. You can always transfer to a Tele-unit when you're comfortable with the routine. Nix the float pool - that is for seasoned nurses who have seen and done just about everything.

Good Luck in your New Job!!

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