Help! Not sure which unit to choose.

Caprica6 · Dec 14, 2018

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.

I agree...I had a similar experience as a new grad. Started at a Magnet hospital, hated the culture and went to a smaller community hospital that was much more welcoming to new grads.

anewsns · Dec 14, 2018

Congrats on your choice! I just hope they keep their word on the staffing ratio changes. Did they give you a timeline? If the neuro unit is not a "good fit " I'm sure the small community hospital will still take you with open arms.

foxhoundma · Dec 14, 2018

Congrats on your choice! I just hope they keep their word on the staffing ratio changes. Did they give you a timeline? If the neuro unit is not a "good fit " I'm sure the small community hospital will still take you with open arms.

During my interview the manager said she's actually hiring an assistant manager to help her get through interviews and the hiring process quicker. She said she has quite a few positions open. So they're trying, just have to have the applicants.

llg, PhD, RN · Dec 14, 2018

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!

I think those are good reasons to make that choice. You know what you are getting into and have some friends there for support as you get settled in. Also, the higher acuity will get your career off on "the fast track" -- which is sometimes stressful, but the more intensive experience is often worth it in the long run (assuming you can be successful there -- and it sounds like you have some resources to help you succeed there.)

Good luck!

angel337, MSN, RN · Dec 15, 2018

You need to get experience. I honestly don't think either unit is necessarily better than the next. Narrow it down to schedule. I had a similar opportunity as a new grad and chose emergency room because of the various shifts. Was the best decision ever for my nursing career.

Ruby Vee, BSN · Dec 15, 2018

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!

There's a lot to consider besides ratios, which probably won't be what they project anyway. Pay, benefits, commute, and hours are all considerations. Length of orientation is another, and even more important, how organized is the orientation? You want an orientation with objective skills lists, a dedicated preceptor or preceptors, and objective evaluation criteria plus planned meetings with preceptor, educator and manager to make sure you're meeting their goals. Central orientation classes on hospital policies and protocols, equipment, charting and such are also a plus.

You'll also want a supportive environment with a supportive manager and encouraging, supportive staff. That's difficult to assess ahead of time, but that is the most important criterion for a first nursing job -- right up there with a planned and organized orientation.

foxhoundma · Dec 15, 2018

There's a lot to consider besides ratios, which probably won't be what they project anyway. Pay, benefits, commute, and hours are all considerations. Length of orientation is another, and even more important, how organized is the orientation? You want an orientation with objective skills lists, a dedicated preceptor or preceptors, and objective evaluation criteria plus planned meetings with preceptor, educator and manager to make sure you're meeting their goals. Central orientation classes on hospital policies and protocols, equipment, charting and such are also a plus.
You'll also want a supportive environment with a supportive manager and encouraging, supportive staff. That's difficult to assess ahead of time, but that is the most important criterion for a first nursing job -- right up there with a planned and organized orientation.

Orientation and a residency program is on of the main reasons I ended up going with Neuro. They had 8-weeks of unit orientation as well as a residency program vs. 6-weeks and no residency at the smaller hospital.

hawrsh20 · Dec 22, 2018

I had clinicals on a neuro floor and from the experiences I had honestly I say it takes a special type of nurse to work on a neuro floor. 95% of these patients are unable to do anything for them selves and seeing them unable to communicate really hurt. If youre the type of nurse that doesnt like to communicate with patients and likes a challenge then Id say go for it.

With medsurg you get a wide variety of patients. Not all of them will be total care and a lot of them are still able to communicate fine. I liked my medsurg\tele clinical a lot more than neuro. Each patient I had on neuro was total care and it was tough.