New Grad Needs Advice! ED or M/S?

SillyFever, ADN, BSN, RN · Aug 29, 2020

1 hour ago, Candykens said:

Hello fellow nurses!

I am a new grad RN who has been super fortunate to have been offered two positions:

1.) Med/Surg - big hospital group, decent pay

2.) Emergency Department - dream job! Level 3 trauma center, but the pay is not very good.

I'm conflicted because I know I'm super lucky to bag an ED offer, and it would be killer experience that would allow me to transfer anywhere. It's just the that other offer in medsurg pays a whole $20/hr more. That's a significant difference. My heart says ED but my wallet says M/S. Help, please!

I am also a new grad RN so this is simply my opinion. But if I was in your shoes I would take the job that your heart is in. Pay is a huge part of it but why take the M/S job if your heart is not there. You said your dream is the ED and you so happen to have that offer in your hands! Like I said, this is my opinion but I would take the dream job over more pay. Get experience there and see if thats what you want to do.

HiddencatBSN, BSN · Aug 29, 2020

$20 an hour is a huge difference. What do the orientations look like? The ER offer, what does their new grad retention rate look like? How do benefits compare? Can you support yourself on the lower salary?

If you’re looking at a pay increase with the lower paying job to begin with it might be better to go with that- you can’t miss salary you haven’t earned yet. Put in a couple of tears there and then leverage that experience for an ER job at the better paying hospital.

I’d want to know that the ER job has a solid new grad orientation plan in place though. If you’re going to struggle through a bad orientation for a low salary you might not benefit from getting specialty experience.

My current hospital starts new grads well below the market rate, BUT there’s an automatic pay grade bump after a year and our benefits are better than the other local hospitals. After a couple of years the pay ends up being better than other hospitals in the area. It’s still not a $20 an hour difference though. But I’ve also worked places that just pay below market rate because part of the salary is the “honor” of working at that hospital. Eyeroll.

Sour Lemon · Aug 29, 2020

6 hours ago, Candykens said:

Hello fellow nurses!

I am a new grad RN who has been super fortunate to have been offered two positions:

1.) Med/Surg - big hospital group, decent pay

2.) Emergency Department - dream job! Level 3 trauma center, but the pay is not very good.

I'm conflicted because I know I'm super lucky to bag an ED offer, and it would be killer experience that would allow me to transfer anywhere. It's just the that other offer in medsurg pays a whole $20/hr more. That's a significant difference. My heart says ED but my wallet says M/S. Help, please!

You can easily work your way over from med/surg to ER. A couple of dollars difference is one thing, but $20?

As a new grad, you probably won't be working on the most interesting ER cases, anyway. Get some experience in med/surg, and then look for a dream job that pays more.

JKL33 · Aug 30, 2020

For the better part of $35 thousand extra?

Med surg.

Mostly because I despise and hate blatant advantage-taking. Doing it right to someone's face is to tell them that they are already assumed to be either desperate, a fool or both. That's just my personality: If someone makes that assumption about me I will prove they are wrong.

If the ED is offering the world's most stunningly spectacular orientation and also significant raises at pre-planned progress reviews...well, okay. You should ask them if that's the case before making your decision, though. ?

speedynurse, ADN, BSN, RN, EMT-P · Aug 30, 2020

Honestly- for $20 an hour more? Go to med/surg, learn everything you can and then try to transfer to an ED in a year where you can challenge the pay with what you are already making. The higher paid nurses are the ones that start at higher pay, transfer out to a position of other higher pay, and keep doing this.....

NightNerd, MSN, RN · Aug 30, 2020

I would take the med-surg job. That is quite a pay difference, and as someone who started in a specialty area and then did med-surg later, I feel like the med-surg foundation is pretty great as a stepping stone to whatever else you want to do. There is plenty to cut your teeth on working the floor for a year or two, and you can take that experience with you to the ER later - hopefully commanding a better salary. As others said, though, take a look at each job's orientation process and benefits as well before making a final decision, and choose whatever will fit the best. Med-surg is just a really helpful background no matter where you end up in your career, and all that money won't hurt either.