Multiple offers and not sure what to do...help!

[hakunamatata, BSN, RN]

I have been an RN for 2 years now, just relocated to SC and I luckily have three offers that are all very different. My experience includes acute medicine (at a major teaching hospital), psychiatry at a few different places, home health, and clinical research. I have three offers now and all seem to have major pros and cons, and I'm completely stuck. I'd love some experienced nurses opinions if they can offer.

I did med-surg right out of school on the craziest floor of the hospital and I was not a huge fan. We had super sick people (tons of rapid responses and codes) so it was really hard in all ways, hated working nights- however, I loved the camaraderie and working 3 12 hour shifts and the flexibility (I love to travel so being able to make my own schedule with 4 days off was amazing... I did a lot). I also loved psych, I felt like generally it was an easy job with low stress levels (not always, but personally I'd just rather handle a psychotic person better than one coding).

Jobs I've been offered:

Surgical-oncology floor at a major teaching hospital (schedule is 3 12's)

Psychiatric charge nurse at independent mental health facility (schedule is 3 12's)

Ambulatory outpatient OR in major teaching hospital (schedule is 8 hrs M-F)

I am new to this city and would love a job where I could possibly even make a social circle, but it's of course not my biggest priority. As far as schedule, I was never a fan of working 5 days in a row, and up early everyday. I really like 3 12's and the flexibility, and I don't really mind working weekends or holidays (I'm weird, sometimes I like it). Another benefit to this schedule is I would likely pick up a PRN job and try to make extra cash. I used to do this my first year of nursing and it was not bad at all, as I'd still have a couple of days off a week if I picked up a shift or two. At a M-F job, I likely wouldn't get a PRN job, it's too much.

I would love to learn oncology and the hospital environment sounds the best for me socially. But, if I hated med-surg, I'm not sure if it's the best idea I go back to this. I've heard surgical floors can be just as hectic, and I don't want to get two weeks in and just want to leave. However, I'm a more mature nurse now and have great time management, so I think I may handle it better.

The psych job sounds great for the hours, and I love psych, but I personally feel like it can get redundant. I also don't feel like I could transfer laterally or upward from there...I'd just do it until I wanted to do something else.

The ambulatory OR sounds amazing as far as work environment. I like the fast pace, but I do like the more repetitive tasks and knowing what I'm getting into each day (I know all days can be totally different, but to me it doesn't seem like the same type of surprises as floor nursing). However, working M-F and five days in a row and up early just doesn't sound appealing...yes, I'm strange. I know this is also hard to break into without prior experience so I feel like I need to jump on the opportunity.

I'm very torn - I'm sorry for the long post. If anyone works in these specialties, especially ambulatory surgery or surgical oncology floors, I'd love to hear how your days go and what you think.

THANKS so much!

[Lev, MSN, RN, NP]

It sounds like you don't want to work 5 days a week. So full time ambulatory surgery seems out. Surgical units are very busy. What is the nurse to patient ratio on surgical oncology? I don't think you should base your decision to avoid the surgical oncology unit based on your new grad experience on a very high acuity med surg floor. As you mentioned, you're a more mature nurse now and have good time management. Rapid responses and code blues are not the norm on med surg. When I worked telemetry, there were code blues every 3-4 weeks and rapid responses every week or two. Now that I work med-surg, we rarely have code blues and we have rapid responses every 3 weeks or so. But then again, not all med surg units are created equal. Oncology patients can go unstable very quickly. Whatever specialty you decide to persue full time, you can always pick up a PRN job in the other specialty. Maybe you can see if the ambulatory surgery unit can take you on a PRN basis...