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foxhoundma foxhoundma (New Member)

Help! Not sure which unit to choose.

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Hi everyone!

I'll be graduating nursing school tomorrow morning (yay!) and currently have two job offers that I'm torn between. One is a busy 36-bed neuro unit at a level 2 trauma center, 6:1 ratio that is promised to go down after the new unit is staffed. They basically had to open a whole new wing of the hospital and double their patient load before actually having the staff. The other is a med-surg position at a smaller hospital that is considered a community hospital, 4-5:1 ratio, generally 28 patients on the floor, very low acuity. However, during the interview I was told they "have a hard time retaining nurses", which was a little scary. I was hoping to get some input or words of wisdom from some experienced nurses! I'm the only one in my family in the medical field so it's hard to get their advice on these things. Thank you in advance!

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Hi everyone!

I'll be graduating nursing school tomorrow morning (yay!) and currently have two job offers that I'm torn between. One is a busy 36-bed neuro unit at a level 2 trauma center, 6:1 ratio that is promised to go down after the new unit is staffed. They basically had to open a whole new wing of the hospital and double their patient load before actually having the staff. The other is a med-surg position at a smaller hospital that is considered a community hospital, 4-5:1 ratio, generally 28 patients on the floor, very low acuity. However, during the interview I was told they "have a hard time retaining nurses", which was a little scary. I was hoping to get some input or words of wisdom from some experienced nurses! I'm the only one in my family in the medical field so it's hard to get their advice on these things. Thank you in advance!

Neither one sounds great and that's not enough information to decide between the two. Commute, pay, benefits, schedule, etc. would factor in heavily.

I think you're going to end up over the pretend ratio at both places. Can you shadow for a day at either unit?

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The pay and commute is the same for both, so unfortunately that's not a deciding factor. The schedule is also the same, three 12's with every other weekend, rotating weekends. I've done clinicals on the neuro unit and enjoyed them overall, my interview was the first time I had ever been to the smaller hospital. I guess my question is which would be a better first learning environment for a new grad.

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The pay and commute is the same for both, so unfortunately that's not a deciding factor. The schedule is also the same, three 12's with every other weekend, rotating weekends. I've done clinicals on the neuro unit and enjoyed them overall, my interview was the first time I had ever been to the smaller hospital. I guess my question is which would be a better first learning environment for a new grad.

I spent most of my early years in a community hospital and I am glad I did. The environment was much more "friendly". I found it easier to learn .. with a little more relaxed atmosphere.

I moved on to huge Magnet hospitals .. it was brutal.

Best wishes, whatever you decide.

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Opening a new floor before having the staff doesn't scream leadership that cares about ratios. I would bet they're staffed 6:1 more often than not.

The other is more of a mystery. I would also ask to shadow if possible. Otherwise, I would pick the best pay/benefits or commute.

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6:1 ratio that is promised to go down after the new unit is staffed.

*eyeroll*

For the med-surg, the way you've described it is probably exactly why they have trouble retaining nurses. It's not very glamorous. I'd choose it over the neuro unit, get my year or two and go too.

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Could you ask to shadow for part of a shift on both floors? Watch interactions among the staff. Are people kind to each other? Are there any nursing assistants? On a med-surgery floor they are essential. How accessible are the doctors? Do the nurses get lunch breaks?

Look for the floor with high standards and kindness.

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Personally I would go with the neuro unit. You've done a placement there and know you enjoy it. You know what your getting yourself into.

That is if your more into acute care and want to get into this area. If stable pt sound more like you then obviously med surg.

Also there isn't a big difference In ratio numbers. I'm sure the med surg will often be more than 4-5 if they can't retain staff. Screams short staffed to me. Which is something I wouldn't want to deal with.

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Thanks everyone for your input! I've decided to go with the neuro unit because I know the unit and some of the staff there!

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"We promise the staffing will get better".

I wouldn't believe that until it actually starts happening.

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One is a busy 36-bed neuro unit at a level 2 trauma center, 6:1 ratio that is promised to go down after the new unit is staffed. They basically had to open a whole new wing of the hospital and double their patient load before actually having the staff.

They chose to do that. They were not forced to open a unit without the staff to care for patients.

A community hospital that admits difficulty retaining nurses on med-surg could be scary or could just be honest. I mean, it's more honest and less scary than what place #1 has told you. Who is going to orient you (and for how long) at this place that makes bald-faced excuses for not staffing to enable safe care of patients?

I would get a few more details...

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"We promise the staffing will get better".

I wouldn't believe that until it actually starts happening.

Yeah, that's right up there with "I'll get Mexico to pay for the wall."

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