Hospital decision time...I need input please!

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Specializes in Emergency Department, Neuro ICU.

Hi everyone...the time has come for me in which I need to make a decision (very soon) about where I want to work after I graduate this May. I really would like to work in the PICU, ICU, or ED. My top three hospital choices are Scottsdale Osborn, St. Joes, and the VA. I was just offered a position at St. Joes in the Neuro ICU. I told them I needed to think about it. I have an interview with Scottsdale Osborn at the end of the month for a new grad position in which the different areas available to me will be revealed. I currently am putting in 156 hours at the VA in their ED for the last part of my schooling and I absolutly love it there and there may be a good chance that I could land a job there since I am completing my preceptorship with the facility.

Here are my concerns:

I live in the east valley, so driving to the VA and St. Joes makes me crazy sometimes. I have been stuck in traffic for over an hour at times. Scottsdale Osborn is much closer, but since I do not know what areas are available to me right now, I do not know if getting a job in the critical care areas as a new grad are even available right now. From what I know from doing clinicals at Scottsdale, the people there seem nice, but I have not worked closely for long amounts of time there like I have the VA and St. Joes. The VA and St. Joes have very nice people who work there and I am not sure Scottsdale will be as good as these two hospitals are concerning staff and co-workers. The pay is much better at Scottsdale than the other two hospitals so that is another factor. The ED is my top choice, but St. Joes won't take new grads into their ED and again, Scottsdale is a mystery as far as department openings for new grads, so the VA is my likely choice for that. If I leave St. Joes, I will owe them money since I am an extern there right now, and I would feel really bad leaving after everything I have learned there in my externship. The problem with the ED at the VA is that not a whole lot of assessments go on, and I feel that is important to gain strength in that area as a new grad, plus waiting for the opportunity to snag a position there is a big gamble since I do not have an official interview set up with them anytime soon and because they are overstaffed, there are no openings right now. Starting in the Neuro ICU makes me a little nervous. It is something I would really like to do, but as a brand new nurse I am scared that I will be overwhelmed. But, I am afraid if I wait to interview at Scottsdale or decide to risk the chance I could have at the VA ED that I will lose my offer to the Neuro ICU at St. Joes.

What would you guys do? What is your honest opinion about these hospitals, going into such areas as a new grad, and weighing out these pros and cons? Sorry this is so long, but I really would appreciate some input.

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Specializes in cardiac/education.

OMG!!!!!

DECISIONS.....DECISIONS......DECISIONS.....:no: :banghead: :bugeyes: :cheers:

Um, can't help you out, I am in the same boat. I was thinking about Neuro St. Joes too. ICU freaks me out too, but that is where I requested my preceptorship just so I could see it firsthand, atleast to r/o if need be. I have no other clue about specialties.

One thing I do say is don't feel guilty. St Joes knew when they hired you on as an extern that you might not stay there. You must have been receiving tuition reimburse? Most extern positions you don't owe any money back.??

Just remember that even if you did hold out for the VA, well, most of the jobs you are applying for right now are NOT going anywhere. More are continuously opening. The only thing I could see hurting is if all of us new grads rush out June 1st and apply for all the same jobs. ha ha. I'm your competition!!:angryfire ;)

I am going to let all the more experienced nurses answer your question cuz I just don't know! Congratulations though! :monkeydance:

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Specializes in ICU, Research, Corrections.

Do not work in the Medical ICU at the VA. Nobody likes to precept you in there and it is improtant you get a good orientation in an ICU. The surgical ICU is OK.

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Specializes in Emergency Department, Neuro ICU.

Thanks thrashej! St. Joes did not give me a tuition reimbursment. I didn't apply for one because I have a tuition waiver. However, externing there does require time for time and if I decide to leave them I owe them $600 for the six months I worked there.

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Specializes in NICU.

I can't speak for Scottsdale first hand, as I don't have experience there ..... but I do know it's a smaller hospital than St. Joes, so the orientation and experience won't be anything near what you'd be getting at St. Joes.

I live in the east valley as well and commute to Phx for work. Most likely you'll be starting on night shift. I know you say the traffic is terrible and yeah it is .... during the day. But honestly it takes me ~25 minutes to travel the 16 miles to work, working night shift as the traffic is going the opposite way. Granted there are times when an accident backs up the freeways, but I have NEVER (knock on wood) been late to work yet due to traffic. For me, working at a great hospital and getting great experience is worth the 25 minute commute 3 times a week.

The valley has so much to offer with some GREAT hospitals that will offer you so much and you'll be getting experience you won't be able to get except for a big city like this.

I don't know if that's helped or not, but my thoughts are, as a new grad, I would take the bigger hospital as you'll get the best orientation and the most experience out of it.

Good luck to you!

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Specializes in cardiac/education.

So wait......at St. Joes if you are an extern and you choose not to work there you have to pay ALL your paychecks BACK? what? that is crazy! One checkmark against St. Joes if so!! LOL.

Thanks thrashej! St. Joes did not give me a tuition reimbursment. I didn't apply for one because I have a tuition waiver. However, externing there does require time for time and if I decide to leave them I owe them $600 for the six months I worked there.
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Specializes in ICU, Research, Corrections.
So wait......at St. Joes if you are an extern and you choose not to work there you have to pay ALL your paychecks BACK? what? that is crazy! One checkmark against St. Joes if so!! LOL.

I second that one! What if you find you don't like it there as an extern and don't want to work there as an RN? That's just kukoo :trout:

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Specializes in Emergency Department, Neuro ICU.
I second that one! What if you find you don't like it there as an extern and don't want to work there as an RN? That's just kukoo :trout:

Well if you don't like it there as an extern you can quit and nothing will be owed. If you work for them as an extern 6 months or longer than you need to start worrying about time for time. They actually have the most at ease extern program I have come across because I know at Chandler Regional and Banner, if you become an extern you must sign that you will commit a few years to working there after you graduate. There is no leaving by paying back what you have earned. Plus, $600 isn't all the money that was earned. I make around $300 a paycheck with my weekend and night hours so pretty much the hospital is losing money if externs decide not to work for them. I could still quit externing now and not owe them money, but I am learning so much and I love my preceptor so I choose not to.

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Specializes in Pediatric ICU.

Gosh. I'm going to be in the same boat as you only in January. I have also considered the VA, St. Joe's and Scottsdale. I heard that they're in dire need of nurses in the VA at all levels. I loved my clinicals at the VA and St. Joe's so they'd both be players. However, my big hesitation is the drive. I commute to school with a friend (i.e. HOV lane all the way ;) ) so going to driving alone will be a big drawback for me.

Have you checked out the East Valley hospitals and their availability of openings? I'm hoping that there's going to be some great opportunities to NOT drive to Phoenix every day. A good friend said that after a 12-hour shift, you don't want a long drive home.:smilecoffeeIlovecof I can see the wisdom in that.

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Specializes in NICU.

Just remember that the drive on dayshift (or for day clinicals) is completely different than the drive on nightshift. You couldn't pay me enough to work dayshift and make the commute to Phx, no way. But it really does depend on if you'll be working days or nights. After working a 12 hour night shift, the 25 minute drive home doesn't bother me ...... but it might bother some people I guess.

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Well if you don't like it there as an extern you can quit and nothing will be owed. If you work for them as an extern 6 months or longer than you need to start worrying about time for time. They actually have the most at ease extern program I have come across because I know at Chandler Regional and Banner, if you become an extern you must sign that you will commit a few years to working there after you graduate. There is no leaving by paying back what you have earned. Plus, $600 isn't all the money that was earned. I make around $300 a paycheck with my weekend and night hours so pretty much the hospital is losing money if externs decide not to work for them. I could still quit externing now and not owe them money, but I am learning so much and I love my preceptor so I choose not to.

Hi,

I currently work at Chandler Regional as an extern and there isn't any obligation to work there after graduation. However, if I continue my externship after graduation and hire on as an extern II, then I will be required to sign on for a year. Maybe St Joes has the same policy? All in all I'm pretty happy there and will most likeley stay....Part of me would like to go to a bigger hospital with more specialties but I want to stay with CHW because they are one of the few companies that have a company paid pension plan in addition to a 401k/403b plan. There's always St Joes, but like you, I don't want to commute from the East Valley.

There has been a lot of talk about hospitals with good orientation programs. What constitutes a good orientation? At Chandler I beleive there is a 6 week orientation, longer if your preceptor feels that it is needed. Is this adequate?

Mary

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Specializes in NICU.
Hi,

There has been a lot of talk about hospitals with good orientation programs. What constitutes a good orientation? At Chandler I beleive there is a 6 week orientation, longer if your preceptor feels that it is needed. Is this adequate?

Mary

6 weeks for what kind of unit? As a new grad 6 weeks doesn't seem very long, but I guess it depends on what kind of unit it's on.

Length or orientation is just a part of what constitutes a good orientation program. Also, look at the orientation program itself. Do they have a planned out orientation program that the preceptors follow? Or do they just kinda wing it themselves as they go? Also, there should be hours spent in a classroom setting. Support with fellow new grads, support of mentors and other support groups are helpful too.

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