My first job was a mistake. Advice re: clinic nurse vs hospital nurse??

[Imgettingthere]

I am looking for a new job after "not cutting it" in ICU as a new grad. Gave it my best, but it wasn't good enough.

Our facility has started huge lay-offs, so there is no other job available for me. I am considering applying for a clinic job, but would appreciate your input. Am I really taking a step down doing this? Are clinic nurses considered "less" of a nurse? Will it be difficult to be considered for hospital work again someday? I have learned that there are so many cliques out there, I feel like I am considering uncharted territory.

Here are the big differences as I see them. I would work directly for a MD, so if he/she is good, the job might be good. No weekends/holidays/on call. However, it is 5 days a week. Days are 9 hours long instead of the 13 in the clinic. Job is non-union. Is this a big deal?

Any advice would be greatly appreciated.

[southernbelle08]

I don't think it is a step down at all. No matter what the area, all nurses have their own set of challenges. I know in my area clinic jobs are hard to come by and the pay isn't as much. Lots of places have gotten away from hiring RN's and hire LPN's as much as possible. That is just in MY area though. I think if you feel like that is where you belong, you should go for it. You never know, this could end up being your "forever" job and you may never have any desire to get back into the hospital setting. Or, you could always try to get some PRN work if you wanted to remain brushed up on the skills you might lose working in the clinic.

Good luck!!!

[RedhairedNurse, BSN, RN]

IMO, your experience should serve as a lesson to new grads, that is, don't start off in the ICU. I am still shocked at the fact that departments like this hire new grads. I think you should work on a regular medsurg floor and get your skills down before taking on unstable/critical patients. It's been extremely rough for me just learning medsurg, although, I think I'm starting to finally get the hang of things. I've had a pt start to crash on me before that had to be sent to ICU. Working one on one with these pts not and not having much nursing experience is a JOB in itself, very difficult. There is no way I would put myself in an ICU dept even now. I would want at least 2 yrs of general nursing experience first. I hear of a lot of new grads that have started in ICU that get fired or give up.

First and foremost, you are not a failure, I know you didn't use that word, but that's how I interpret your statement. And you mention cliques, they are more so at the clinics from what I've been told. I think you should go and work in medsurg and build your confidence back up and learn to be a nurse. Give it your best and you will succeed and be more suited for ICU at a later date.

Take care!

[SummerGarden, BSN, MSN, RN]

the word "step down" concerns me. did you pick the icu because you wanted to be a cc nurse? or did you pick it right out of school because everyone pats you on the back? i know an icu new grad that everyone pats on the back... fortunately she is humble or she would drive me nuts! i had the same grades and was as active a student nurse extern, but i did not get hired to work the main er like i had hopped. so i have taken another route to accomplish my goals.

i agree with the above post, maybe starting out in the icu was not a good idea. on the other hand, i feel if you truly wish to be an icu nurse, you should continue to strive for that goal!!! going to a clinic is no where near the same. a medical surgical floor is a good place to be! find one that is more of a step down unit so that you have patients that can become unstable. trust me, you will be delivering critical drips, blood, and titrating etc. i do it every shift!!

on the other hand, if your goal is to be a clinic nurse more power to you!!! nursing is nursing!!! no nurse is better then another because of his/her j-o-b. a good nurse is a nurse who is good at providing safe competent care. at least that is my opinion.

new grad nurse

[Ayvah, RN]

As others have said, it depends on what your goals are. If you would like to do cc nursing, then go to a med-surg floor or even a stepdown unit before trying again in critical care.

The clinic is very different than the hospital. Honestly you will lose a lot of hospital skills over time since you don't use them daily anymore. It will also be more difficult to get back into the hospital the longer you have been at the clinic, without a refresher course. I spoke with my family member's home health nurse who has been in HH for a while, and even she said she tried to get back into the hospital but was unable to get a position without a refresher course.

I enjoyed being at the clinic but went back to the hospital after a year as I was concerned about the above. Now I consider going back to the clinic again sometime in the future. While I like hospital nursing, my body isn't happy with that choice.

[Imgettingthere]

Ah, everyone has offered some really valuable advice, and in an ideal situation I would love to get med/surg experience. It happens that there are no positions available, and in fact there have been some lay-offs at my facility. I am now in a survival mode. I agree that I will lose my hospital skills, and not gain more, in a clinic setting. But for now I may just have to take whatever comes my way. Gotta pay the bills. Thanks for your thoughts.