Help me decide between two job offers

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

Published  

Please help me to decide between two job offers: one in an acute care rehab unit (patient-to-nurse ratio 6:1) and another in an intermediate care unit (IMC) (ratio 3–4:1).

I have six months of acute care experience handling post-op knee/hip surgery, DKA, alcohol withdrawal, and general patients. I took a two-year break for personal responsibilities and am now returning to work.

The rehab unit is slower-paced, easier, and similar to my previous job, but it won't help me develop new skills. The IMC unit will be more challenging, but a great foundation for future growth, even if I don't stay there long-term. I eventually want a less stressful outpatient job, but I also feel I need stronger nursing skills.

I worry that working in IMC will feel like going back to school because I'll have to learn so much. On the other hand, staying in rehab might limit my growth. Should I take the harder path now to build confidence for the future, or choose the easier, stable option? Any advice would be greatly appreciated.

Share this post

+ Add A Comment
Specializes in Tele, ICU, Staff Development.

Congrats on having two great job offers!

You've done a great job analyzing both options! You've clearly weighed the pros and cons of each, considering skill growth, future goals, and potential stress.

One thing to consider, however, is how much mental energy you're prepared to commit right now. Given that you've had a two-year break after six months of experience, the IMC might feel overwhelming. It's important to know yourself and if you typically go for a challenge. It's also important to know what type of orientation they will provide. It should essentially resemble a new grad orientation in terms of duration and support.

If you're confident you can handle the learning curve and want the experience to push your career forward, the IMC unit is a solid choice for growth. However, if you need more time to adjust and want to ease back in without high stress, the rehab unit may be a better option for now.

Rehab Unit (6:1 ratio)

Pros

  • Familiarity. Minimal learning curve, as you've done this before.
  • Slower pace. More time to focus on patient care and ease back into nursing.
  • Stability. Predictable, low-stress environment while you re-adjust.

Cons

  • Limited skill growth. Doesn't offer as much opportunity to expand your clinical skills.
  • Long-term potential. Might not push you toward your ultimate goal of an outpatient role.

IMC Unit (3–4:1 ratio)

Pros

  • Skill development. Exposes you to a variety of patients and conditions, building a strong clinical foundation.
  • Growth. Helps you become a more well-rounded nurse, improving your future job prospects.
  • Future opportunities. Opens doors for critical care or advanced practice roles.

Cons

  • Learning curve. It may feel overwhelming initially, especially after your break.
  • Higher stress. While the patient ratio is lower, the intensity of care may increase stress.

Final Thoughts

If you aim to build confidence and strengthen your clinical skills for future roles, the IMC could be a great choice and an amazing opportunity. However, if you prefer a gentler re-entry, the rehab unit offers a less stressful, more gradual transition. Ultimately, the decision comes down to how much stress you're willing to take on to achieve your long-term goals.

Also, remember that they are both good options, and neither are permanent! You are just starting back, and after a year or so, your options will be plentiful. 

Best wishes on your decision,

Nurse Beth

 

+ Add a Comment