Need Career Advice

Published

Specializes in ED/CVICU/PACU.

I recently left my acute care positions (had a couple per diem jobs and full time), to go to outpatient dialysis. I left my per diem positions because I am in school and one of them I couldn’t complete my mandatory requirements because of personal issues but I really wanted to keep it just couldn’t make it to my classes at that point in time. I have changed positions almost every year Medsurg, Stepdown, ED, CVICU, PACU, and now dialysis. I have stayed on my previous unite as per diem, they all let me because they liked me (I think). Prior to accepting my dialysis position I had two other job offers back where I was per diem. I ended up choosing dialysis because it was something new, I love learning, and the pay is way better. I absolutely hate outpatient dialysis. The hours are ridiculous like 0430-2000, the staff ratio even with the techs is insane, I see about 35-45 patients a shift, the techs only help each other and there are tons of CVC’s. I cannot adequately and safely care for all these patients because I am too busy with all the tasks. I have been applying to acute care once again and have had a few interviews but no job offers. Most of them emphasize my movements. When asked my future goals I am honest and tell them I am in school for NP. Should I be lying in my interviews? I need out of dialysis ASAP and don’t know what to do. I keep calling in sick because I hate it so much.

When asked about future goals, I think they mean, within the company. For example: when a company asks what your 5yr plan is...and I probably would say something like, I would like to be a preceptor at one point within those 5yrs, become an advanced nurse and have more responsibilities, talk about how you would like to grow within the company, become part of a unit council to help the unit improve. If you’re applying for a per diem job (which I think is a good idea when you’re still looking to see if you like the company), say that your 5yr goal would be to obtain a full time job within the unit. They want to hire someone who is going to stay more than 2-3 yrs in the company. You just have to think outside the box, yes you want to be an NP but in the meantime, what would you like to do for the company? Keep in mind that It’s expensive to hire, precept and train nurses. If they know you’re going to leave within a year, I am not really sure if they will hire you.

Specializes in ED/CVICU/PACU.

Thank you for taking the time to respond. I live in a rural area so my options are limited to the hospitals I have already worked for. I like your idea of working per diem again but I am so exhausted from my long hours and school work, I may just have to suck it up and do it anyway. Thanks for all the tips, I will definitely keep them in mind.

Specializes in Med Surg, Tele, PH, CM.

Are you sure you're going to like being a NP?

Specializes in ED/CVICU/PACU.
1 hour ago, Katie82 said:

Are you sure you're going to like being a NP?

There are many different areas I can work in as an NP. I didn’t leave my positions because I didn’t like them or I would not have stayed per diem. I left them for more learning.

22 hours ago, Szzzz said:

I have changed positions almost every year Medsurg, Stepdown, ED, CVICU, PACU, and now dialysis.

If I were an employer or a hiring manager, this would raise huge red flags for me. I think you're kind of digging yourself into a hole here. Like @yournurse said, hiring/onboarding/orienting is a very expensive process (think $50,000+ for a new-to-specialty nurse), and managers are not going to want to hire you as an RN or a new graduate NP with that kind of track record.

The best thing you can do right now is to get a job you can tolerate and stay put. I'm guessing your best bet is to go back to the units where you've made a good impression and ask/beg/plead to get full-time employment (or whatever FTE status you prefer).

You say you want to learn--instead of bouncing around between jobs, can you focus on learning new things through your NP program and clincials? While you're so busy with school, perhaps you would be better off in a familiar specialty so you're not burning the candle at both ends.

You keep saying that you are trying out different specialties because you want to learn. That may be true; however, I'd caution you that from an outsider's perspective, it can come across as kind of flaky. Some of the fields you've described are highly specialized. After only a year in the ED or CVICU, you're only just becoming proficient; there's still a ton to learn without jetting off to a new specialty, and it seems a bit disingenuous to say that you had to leave in order to 'keep learning,' because surely you still had more to learn...

It seems like you perceive your diverse background as a benefit, but be aware that others (including hiring managers) may perceive it as a liability.

10 hours ago, Szzzz said:

There are many different areas I can work in as an NP.

That's true; however, if you continue to change jobs every year or two as an NP, you may find yourself in the exact same position, struggling to find provider practices that will hire you because of your track record.

I'm not trying to question your character; it sounds like you've moved around out of genuine desire to learn, and I'm sure you've acquired a lot of knowledge through the different specialties. However, it is going to stink if your past and current actions screw up your future job prospects as an RN or an NP.

Specializes in ED/CVICU/PACU.
1 hour ago, adventure_rn said:

If I were an employer or a hiring manager, this would raise huge red flags for me. I think you're kind of digging yourself into a hole here. Like @yournurse said, hiring/onboarding/orienting is a very expensive process (think $50,000+ for a new-to-specialty nurse), and managers are not going to want to hire you as an RN or a new graduate NP with that kind of track record.

The best thing you can do right now is to get a job you can tolerate and stay put. I'm guessing your best bet is to go back to the units where you've made a good impression and ask/beg/plead to get full-time employment (or whatever FTE status you prefer).

You say you want to learn--instead of bouncing around between jobs, can you focus on learning new things through your NP program and clincials? While you're so busy with school, perhaps you would be better off in a familiar specialty so you're not burning the candle at both ends.

You keep saying that you are trying out different specialties because you want to learn. That may be true; however, I'd caution you that from an outsider's perspective, it can come across as kind of flaky. Some of the fields you've described are highly specialized. After only a year in the ED or CVICU, you're only just becoming proficient; there's still a ton to learn without jetting off to a new specialty, and it seems a bit disingenuous to say that you had to leave in order to 'keep learning,' because surely you still had more to learn...

It seems like you perceive your diverse background as a benefit, but be aware that others (including hiring managers) may perceive it as a liability.

That's true; however, if you continue to change jobs every year or two as an NP, you may find yourself in the exact same position, struggling to find provider practices that will hire you because of your track record.

I'm not trying to question your character; it sounds like you've moved around out of genuine desire to learn, and I'm sure you've acquired a lot of knowledge through the different specialties. However, it is going to stink if your past and current actions screw up your future job prospects as an RN or an NP.

Sucks but you’re right, I am digging myself into a hole. My plan was to find one job and stay until done with NP school. Stepdown, ED, PACU were all within the same facility so they were more of transfers to different units but I do see where it raises red flags. I went per diem at my CVICU position that had so many learning opportunities. I didn’t want to leave that full time position, Unfortunately because of personal reasons I was in a position where I really had to. Yes it would totally reek if all this ruins my future prospectives. It’s good to hear from an outsiders perspective and I appreciate your feedback.

Specializes in Dialysis.

As a manager who is in charge of hiring my staff, if I see job hopping, it's a major red flag. I don't bother to call, I don't care who they know or what their experiences are. Why? Chances are that you will hop right out of this job as well. I know you say you hate clinic dialysis, but stay there 2 years if you can. If not, if you can find another job, go to that but stay until the end of your NP education. In some markets, NP doesn't equal a ready job due to market oversaturation, and I hope that isn't the case for you. In those cases, though, I hope that you haven't created an issue with getting that 1 year of experience with being an NP...good luck, wherever you end up

Have you looked into being a phone triage nurse? That could give you time to take care of business. If you spread yourself too thin, that could be treacherous to your health. I ended up in the ICU with a mega duodenal ulcer, I needed 5 units of blood and fought anemia for years, even now. I graduated to perforated bowel a couple of years later. Now working with my very own colostomy and fistula.

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