Need advice on which job to choose as a new grad..........

[Sherbi5]

Situation:

I am a new grad with a BSN (2nd degree) that has been interviewing and have multiple job offers. I am looking for a position that allows me to grow and eventually work in an ICU. I am looking to be in this position for about years before I become a traveling nurse/move to a better city/CRNA option.

Job offer 1:

ICU nurse: Community ICU in a 200 bed hospital. State of the art equipment. 10 bed ICU. The unit averages 3-5 patients in it at any time. This is a non trauma level hospital and any patients needing more care are flown in the helicopter. This is a night position. 2 patients under my care when I'm in the ICU. Hospital is 2 hours away from a large city. When there is not enough patients the nurse takes patients on the PCU.

Job offer 2:

Solid Organ Transplant Nurse: Trauma 1 level hospital with 700 beds in a large city. Transplant unit is 48 beds. High acuity patients like ICU, however no ventilators. Nurse takes care of 2 patients at a time. Average length of stay of patient is 5-7 days. This is a day position Hospital has huge growing opportunity as it is the largest hospital in the city.

Job Offer 3:

Neuro Nurse: Same trauma 1 level hospital on a 48 bed unit. Nurse cares 3-4 patients at a time. Average length of stay of patient is 3-4 days. Same high opportunity for growth within this hospital. This is a day position Manager stressed how difficult and challenging this position was during the neuro interview. I am looking forward to a high level of challenge.

Questions - I want to end up in an ICU. I'm not sure the community ICU position (even though I will have ICU patients and my title will be ICU) will get me to where I'm going rather than the other options.

ANY advice would be great. Which job would you choose and why? Just give your background when you give it. Thanks a ton!

[Sherbi5]

I have called all my mentors, instructors, and fellow nurses as well as posted on this forum for advice.

Given that I have to make a decision by Monday I am heavily leaning towards the solid organ transplant nursing position. While an ICU position would be great, there is simply to much risk going into an all night, community, non-trauma hospital with an average census of 3-4 ICU patients on the floor at any given time. I may be stuck in the PCU for a while. The Transplant position affords me a larger network of friends in a bigger city, a day time position, and more opportunity to grow and learn.

I am favoring the transplant nursing position over the neuro because the nurse oversees 2 acute patients rather than 3-4 (acuity is higher). The neuro floor is also a young floor and I would feel my growth on the Transplant floor where the nurses have a greater age range would be beneficial.

The overarching theme to get to an ICU in the future by the ICU managers I talked to was not about which position I picked, but continuing my education and gaining ICU certifications (with the help of the hospital or without the help of the hospital) to show I have a passion for entering the critical care world.

[SAHMnurse]

Yay! In my opinion, this is absolutely the right decision. Let us know how it goes. Congrats!!

[maelstrom143]

This is really great advice guys, although it seems like the forum is split down the middle. I wish it was a clearer choice.

Maelstrom - Are you sure a non trauma level ICU does not have ventilators. I thought the basic definition of ICU no matter the trauma level always included ventilator.

I had not yet seen an ICU w/o vents; however, when you said "community ICU" I thought you had said it did not have vents. Sorry if I misunderstood. If they do have vents, then fabulous. However, how much actual ICU time vs PCU will you be working and will it transfer over to bigger facilities w/higher acuity? (Our facilities are snobby about taking RNs w/exp in smaller hospitals/ICUs due to they usually transfer anyone w/higher acuity needs and may not get the necessary experience the bigger hospitals require. Also, travellers coming to our facilities must have x years of solid ICU, not back and forth to PCU, esp if most time is in PCU, per mgmt).

The bigger facility would give you more opportunities and once your foot is in the door it might be easier to get where you want to go. JMO.

[TWUgrad2015]

I have called all my mentors, instructors, and fellow nurses as well as posted on this forum for advice.

Given that I have to make a decision by Monday I am heavily leaning towards the solid organ transplant nursing position. While an ICU position would be great, there is simply to much risk going into an all night, community, non-trauma hospital with an average census of 3-4 ICU patients on the floor at any given time. I may be stuck in the PCU for a while. The Transplant position affords me a larger network of friends in a bigger city, a day time position, and more opportunity to grow and learn.

I am favoring the transplant nursing position over the neuro because the nurse oversees 2 acute patients rather than 3-4 (acuity is higher). The neuro floor is also a young floor and I would feel my growth on the Transplant floor where the nurses have a greater age range would be beneficial.

The overarching theme to get to an ICU in the future by the ICU managers I talked to was not about which position I picked, but continuing my education and gaining ICU certifications (with the help of the hospital or without the help of the hospital) to show I have a passion for entering the critical care world.

I realize that this is a really old post, but wanted to ask how has your experience been on the transplant unit? I am a new grad with 3 job offers trying to make a decision between Surgical Oncology, Transplant, and Med Surg.