I am a new grad, and I've received an offer at a magnet hospital for IMU telemetry. I've also received an offer at an HCA hospital in my area for ICU. My ultimate goal is to become a CRNA.
I love the magnet hospital, and I can see myself growing there, but they aren't starting me at ICU. I've also heard bad stories at HCA hospitals-hence why I'm undecided. If I choose the magnet hospital, I'll have to wait at least one year before I can apply to an ICU position. HCA is about a one hour drive from my home, and the magnet hospital is about a 30-minute drive.
I'm just seeking some guidance on what path I should take.
From what experience I have, and what l've read from your post, I would 100% recommend the position at the magnet hospital...
I have worked at a HCA hospital and it was miserable. For whoever asked, it stands for Hospital Corporation of American and it is a for-profit corporation with healthcare facilities all over the U.S. My experience with HCA was awful (nurse:patio ratios, staffing, pay, culture, lack of management support, poor training) and would never recommend another nurse look for employment there.
The rest of my two cents:
You've already stated you love the magnet hospital--don't overlook the day to day happiness/joy factor in any job. It took me a couple of tries, but have found a great spot now.
The commute will be a factor--an hour difference EVERY DAY will wear on you.
Delaying your ICU start (and therefore CRNA school) will be a blessing in disguise. Your first nursing job is hard enough, to learn ICU on top of that takes an incredible preceptor (or several), an understanding team and a lot of luck--being put out on your own too early will sabotage your confidence and everything else that follows. A year on Med-Surg or Tele will FLY BY...it will take you a year to learn the door codes, phone extensions, printer codes and other people's name just on your floor, let alone coworkers from housekeeping, MDs, radiology, RT, ER, and surgery that you will interact with.
Learn everything you can about your job, and how the hospital runs in general--it will benefit you the rest of your career. Once you're off orientation and have a few months on your own, try and pick up some OT by floating to another floor to see what they do different/better and expand your learning. Your hospital should also have a lot of online learning opportunities and classes you can attend--you'll need to know your cardiac rhythms (and what to do about them) down pat. Then in 12-18 months you'll be coveted by ICU managers--DON'T mention your CRNA goal. It takes a lot of time (and therefore $$$) to train an ICU nurse, and if they think you will be there for 12 months then off to CRNA school, most would be less likely to hire you (although they realize this is a goal for several ICU nurses.)
In the mean time, you might decide you like where you're at (either the first job or ICU) too much to go back to school. Either way you'll be kicking butt at your current job and a great resource for the next group of new nurses to learn from.
I agree with a lot of the other nurses here. I also want to emphasize that I think the magnet hospital is the way to go because they will support your transition to another unit, another position, or higher education much more than a standard hospital.
Also you may get some experience in the hospital and decide you want to take your career in a different pathway, and the magnet hospital will support and nurture these aspirations.
Working in the ICU takes strong critical thinking, good time management, and decisiveness that doesn't come without experience. While it is possible to start in the ICU as a new grad, it doesn't do you or your patients justice to do so. A year sounds like an eternity as a new grad, I know this because I started in the ICU right out of school myself and felt the exact same way you do. Let me tell you, it was a STEEP learning curve starting in the ICU. I was very lucky to have many experienced nurses who were willing to help me learn, otherwise I would have not succeeded. I wish I had given myself a year to learn how to be a nurse, let alone a critical care nurse. Just my advice. It would be hypocritical of me to tell you not to take the ICU job, but take it from me it is a very difficult transition to make right out of school.
just wanted to offer a different perspective from the ones above. I started in an ICU as a new grad in August & am doing great. I don't think it is a detriment to patients that I didn't start somewhere else to "build a foundation." The ICU is a different skill set than med-surg or even IMC, and if you are wanting to start in an ICU don't let anyone tell you that you can't just because you are a new nurse! If you pick the right hospital they will train you to be successful regardless of prior experience or not. Again this isn't looking at the other factors of the jobs you mentioned, just wanted to encourage you that you can start in an ICU as a new grad and be successful if that is what you choose!
please let me know what decision you made and how it turned out, I am currently experiencing this same exact dilemma (& I want to be a CRNA, its the whole reason I went to nursing school) except I also have a third ICU offer for an LTACH with a better reputation than HCA but I’m not sure how helpful that would be for CRNA school.
maydaymalone, BSN, RN
1 Article; 14 Posts
From what experience I have, and what l've read from your post, I would 100% recommend the position at the magnet hospital...
I have worked at a HCA hospital and it was miserable. For whoever asked, it stands for Hospital Corporation of American and it is a for-profit corporation with healthcare facilities all over the U.S. My experience with HCA was awful (nurse:patio ratios, staffing, pay, culture, lack of management support, poor training) and would never recommend another nurse look for employment there.
The rest of my two cents:
You've already stated you love the magnet hospital--don't overlook the day to day happiness/joy factor in any job. It took me a couple of tries, but have found a great spot now.
The commute will be a factor--an hour difference EVERY DAY will wear on you.
Delaying your ICU start (and therefore CRNA school) will be a blessing in disguise. Your first nursing job is hard enough, to learn ICU on top of that takes an incredible preceptor (or several), an understanding team and a lot of luck--being put out on your own too early will sabotage your confidence and everything else that follows. A year on Med-Surg or Tele will FLY BY...it will take you a year to learn the door codes, phone extensions, printer codes and other people's name just on your floor, let alone coworkers from housekeeping, MDs, radiology, RT, ER, and surgery that you will interact with.
Learn everything you can about your job, and how the hospital runs in general--it will benefit you the rest of your career. Once you're off orientation and have a few months on your own, try and pick up some OT by floating to another floor to see what they do different/better and expand your learning. Your hospital should also have a lot of online learning opportunities and classes you can attend--you'll need to know your cardiac rhythms (and what to do about them) down pat. Then in 12-18 months you'll be coveted by ICU managers--DON'T mention your CRNA goal. It takes a lot of time (and therefore $$$) to train an ICU nurse, and if they think you will be there for 12 months then off to CRNA school, most would be less likely to hire you (although they realize this is a goal for several ICU nurses.)
In the mean time, you might decide you like where you're at (either the first job or ICU) too much to go back to school. Either way you'll be kicking butt at your current job and a great resource for the next group of new nurses to learn from.
Good luck, and welcome to the show!