Help me decide which job to choose

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Hi Nurse Beth,

Seeking your advice before I move forward with a change in the field of nursing. I am currently returning to work 2 months postpartum. Before pregnancy I did skilled nursing home health. While pursing my RN Home-care was a great fit.

I unfortunately am still working on my RN and am still currently a LPN. As much as I'd love to stay home with my new 2 month old bundle of joy, I need to get back to helping my husband with the weight and help save for our first home purchase in the nearest future. *** I've been presented with two opportunities at two different hospitals.

Position 1 is inside the hospital on the Med Surg floor. Position 2 is next to a hospital in an Acute Rehab Hospital setting with two specialty units; those recovering from stroke, brain injury, neurological conditions, trauma, spinal cord injury, amputation, and orthopedic injury. Both positions are full-time 3-12s (nightshift 7p-7a) with rotating weekends, and similar pay rates.

One is 15min from home while the other is 30mins. The 30-minute position pays about $5 more an hour and offers $1.25 might shift differential, along with a paid IV certification course. The 15min position pays $5LESS but has 10% and 25% shift differential along with a $7500 sign on bonus.

The $5 less an hour will most like equate to what I'd spend on gas money driving to the 30-minute position so I'm not too concerned with the pay difference. I'm working on a pros and cons list to better visualize however, I'd like your experienced advice in which direction would be best for my current situation.

Newborn at home, help and support from my husband to be with baby during the nights I work. I do miss the go go go from when I was in a more clinical setting before home care, yet I don't want to be completely drained when returning home at 7am to get the kids on the bus and take care of my baby who may or may not want to nap with me during the day. Everything I can find to read about Med Surg is negative and appears it's the zoo of the hospital?

However, I do enjoy a hectic and busy environment and I'm fearful I may get bored in a rehab setting that may possibly be mainly geriatric care. I did geriatrics for 6 years so I know it well and love my older folks but I'm craving something new and fresh. What are some questions you advise I ask during the interviews? PTO, sick time, vacation etc? Help me decide which way to go during this chapter of my life! Thanks so much for your time reviewing my mini dilemma novel ? Have a great day! 

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Specializes in Tele, ICU, Staff Development.

Dear Craving,

Congratulations on your new bundle of joy!  

Choosing between two nursing positions is an important decision for you as a mother and a nurse, and for your family. It's great that you're doing your research.

Here are some considerations and questions to ask during the interviews to help you decide.

MedSurg

MedSurg nurses often do not receive the recognition they deserve. MedSurg is a speciality. An experienced MedSurg nurse is a highly skilled practitioner capable of anticipating and identifying post-operative complications such as sepsis and pulmonary embolism. They can also intervene in respiratory distress, gastrointestinal bleeding, diabetic ketoacidosis, and other medical emergencies.

As far as MedSurg being the zoo of the hospital- acute care in general is demanding and stressful, however, you are not someone who is OK with being bored. It takes a certain temperament to thrive in acute care.

Pros

  • Closer to home. The shorter commute can save you time and potentially reduce stress.
  • Shift differentials. The 10% and 25% shift differentials can significantly boost your income, potentially making up for the lower base pay.
  • Sign-on bonus. The $7,500 sign-on bonus can provide immediate financial relief.

Cons

  • Med Surg environment. While it can be fast-paced and dynamic, it can also be demanding and stressful.
  • Rotating weekends. Ensure you understand the weekend rotation schedule and how it might impact your family life.
  • Sign-on bonus. A sign-on bonus  can indicate a shortage of nurses due to high turnover and poor working conditions.

Acute Rehab

 Pros

  • Specialized care. This position offers an opportunity to work with patients recovering from various conditions, which can be professionally rewarding.
  • Higher base pay. The $5 higher hourly rate can be advantageous.
  • IV certification. The paid IV certification course is a valuable skill enhancement.

Cons

  • Geriatric care. If you're looking for something new and fresh, working primarily with geriatric patients might not provide the variety you desire. But just because it's rehab doesn't necessarily mean it's geriatric.
  • Longer commute. The longer commute could be a factor, considering you have a newborn and want to minimize commuting time.

Questions to Ask During Interviews (for both positions)

  • Patient population. Inquire about the patient demographics to better understand the case mix.
  • Length of stay. The length of stay can be an important indicator for someone like you who thrives on a fast-paced and challenging environment. The length of stay in an acute rehabilitation facility can vary widely depending on several factors, including the patient's condition, the goals of rehabilitation, insurance coverage, and the facility's policies. However, on average, the length of stay in acute rehabilitation typically ranges from 1 to 2 weeks but can extend to several months in more complex cases.
  • Orientation and training. Ask about the orientation and training process for new nurses.
  • Turnover. Ask about staff and management turnover. High turnover can be an indicator of staff dissatisfaction.
  • Scheduling. Clarify the scheduling details, including the shift rotation, weekends, and any flexibility in scheduling. Is self-scheduling available?
  • Nurse to patient ratio. Understand the nurse to patient ratio to gauge workload and patient safety.
  • Professional development: Inquire about opportunities for professional growth, continuing education, and career advancement. Is tuition reimbursement provided?
  • Support for working parents. Check if the hospital offers any support or resources, such as childcare assistance or flexible scheduling options.
  • Benefits. Ask about the complete benefits package, including PTO, sick time, vacation, and healthcare coverage.
  • Team culture. Gain insight into the team culture, including collaboration, support, and mentorship.

Consider your personal and professional priorities, including the desire for variety, income, and work-life balance. Reflect on which setting aligns best with your long-term career goals and family needs.

Discuss your options with your husband to make a decision that works for your family.

Very best wishes,

Nurse Beth

 

 

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