New grad associate RN here who is fortunate enough to have two job offers. I have to choose before March, and I'm not sure what to do.
Choice #1: Telemetry at a veterans hospital (I did my preceptorship here, and it's very difficult to get into the VA system because people hardly ever leave).
Pros: Great pay (considerably more than choice #2), 12-week orientation, federal benefits, great retirement package (pension, 401k matching), possible student loan reimbursement, no layoffs, no call-offs, 26 days paid vacation, difficult to get fired, rare to have a female patient/no PEDS (never been comfortable with this population), difficult to sue the feds, I'll be working days.
Could lay a good foundation to get me into my unit of choice (ICU). I also LOVE this hospital, Love the mission statement, and enjoy serving our vets. Can't beat starting out with a cardiac background as I could go into the ER or ICU.
Cons: BUREAUCRACY, transferring to another unit may take 2 years.. if not more, needy long-term patients who don't really need to be an inpatient, I wanted to start in ER or ICU, I'll move up the payscale slower since I'm starting here as a new grad.
Choice #2: Emergency Department position at level 2 trauma center.
Pros: I get to start out in the ER which could change the trajectory of my career (at least I know I won't be stuck in tele for the rest of my life), 16 week orientation, good benefits (healthcare, pension, etc.), i'll be working with a lot of grads who went to my school, LOTS of learning experience (THE BEST), very supportive of new grads, and i'll be working in a specialty i've always wanted to work in. I feel like this is a better fit for me since I'm male.
Cons: Very low starting pay, 2 year contract, nights, what if I get tired in the ER but find myself stuck because ER is so different from everything else, this is an inner city hospital so the ER is always SLAMMED, oh and did I mention..low pay. I would finish out my 2 year contract and use the experience to get in a better paying hospital.
I think it makes more sense for me to start out in telemetry, and I'm excited about it. Although, I do feel like ER is the more 'manly' thing to do, haha..The reason hospital #2 has a contract is because of the pay. In the past a lot of people would get their training at this hospital and leave as soon as they were hired somewhere with better pay. I was told by one of the managers there that it takes 40k to train a new grad, so the contract is there just to make sure they don't invest their money into someone they won't get any return out of. They're aware that they pay less than other hospitals.
BTW, I live in CA where jobs are competitive. I just interview well is all, plus I made it a point to keep in touch with all the people I met at both hospitals. Networking is key to landing a job in ANY field, basically. Being well-received (eg. staying fit, being well-groomed, respectful, etc.) and professional is key because first impressions are EVERYTHING.
So here I am almost three years later. I can't move at the VA. Love my coworkers, bored of my job, and REALLY wanting to go to the ER. I interviewed for the ER at the VA, but administration (per the manager) decided they wanted experienced ED nurses and hired NO internal applicants for 4 spots. I think it's because my current unit is difficult to keep staffed and a lot of people have left because new management took over, and management on my unit has gotten borderline terrible. It's weird because I float to the ER and a lot of the staff were trying to get me in. However, I personally don't think VA ERs are the best for learning because of the limited pt population. Not sure if I would be able to hang in a private ER with VA ER experience.
I recently applied to a private hospital ER, and got the job. The benefits aren't nearly as good as the VAs, but man I want to work in ER. Should I take the job and follow my passion, or just ride it out at the VA for the benefits and hope I eventually get in ER or ICU??? It's not like I'm miserable or anything, I just feel stagnant. Private ER or VA??? I would love a federal retirement (30 years from now for the MRA of 57), but here in cali state and county hospitals have better pensions. Nothing beats the stability of the VA though. I just always feel like Ill have that yearning to move into a higher acuity area. Not sure what to do.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
So here I am almost three years later. I can't move at the VA. Love my coworkers, bored of my job, and REALLY wanting to go to the ER. I interviewed for the ER at the VA, but administration (per the manager) decided they wanted experienced ED nurses and hired NO internal applicants for 4 spots. I think it's because my current unit is difficult to keep staffed and a lot of people have left because new management took over, and management on my unit has gotten borderline terrible. It's weird because I float to the ER and a lot of the staff were trying to get me in. However, I personally don't think VA ERs are the best for learning because of the limited pt population. Not sure if I would be able to hang in a private ER with VA ER experience.
I recently applied to a private hospital ER, and got the job. The benefits aren't nearly as good as the VAs, but man I want to work in ER. Should I take the job and follow my passion, or just ride it out at the VA for the benefits and hope I eventually get in ER or ICU??? It's not like I'm miserable or anything, I just feel stagnant. Private ER or VA??? I would love a federal retirement (30 years from now for the MRA of 57), but here in cali state and county hospitals have better pensions. Nothing beats the stability of the VA though. I just always feel like Ill have that yearning to move into a higher acuity area. Not sure what to do.
I'm with the others, make the switch. Oddly it was harder than I thought to go from ICU to ER, finally found a job. 2 years later, still no peds or Triage experience in our ER. Great benefits, but I'm over being "stuck." Some things are worth more than long term benefits. Follow your way and the rest will follow later.
Thanks for the replies! @NickiLaughs: Do you like ER or ICU better?? I feel like ER nursing suits me better, but I feel like ICU would be a more natural progression. I guess it's just gonna be somewhat of a shock going from 3-4 patients to quite possibly 15 in a shift!
Oh..and being directly on the front line with ebola scares me too, but I'm hoping since this is a small-to-medium sized community hospital that's surrounded by a couple of level 1 teaching hospitals ebola patients will somehow end up there instead.
I'd definitely go with choice #1. It just seemed like you wrote it yourself with how many pro's you listed. Doing tele nursing on a med/surg unit is a very good foundation and, like you said, you can later transfer somewhere else if you wished. ER and ICU are specialty areas and you would benefit from having laid a good foundation of assessment, time management, etc. on a med/surg tele floor first.
However, you could always start off ER or ICU and do just fine. The learning curve would be greater. But why not start out making a much greater pay and benefits like you mentioned!?!!?
I chose #1 almost three years ago, but now I have another ER offer at a private hospital. LOVE the VA, LOVE the retirement and benefits, love my coworkers, but I'm stuck on my unit and nobody on my unit can get into ER/ICU for some reason. I'm also not completely sold on this new private hospital, but I REALLY want ER experience. Not sure what to do now!
Specializes in ORTHO, TRAUMA, MED-SURG, L&D, POSTPARTUM.
Follow your passion! Get into the ER ... I think you've waited long enough to follow what you REALLY want to be doing. If you spend 30 years in the VA for great benefits and never follow your dreams you'll regret it. Life is short.
The way I look at it is I would rather enjoy the ride than save up all fun for when I'm almost at the finish line. Things won't be quite as fun if I can't take some well planned risks. I'm going to get some tele experience than make a beeline for a level 1 ER position!!! :)
After you've got some great years under your belt you can reapply for the VA and be one of those "experienced ER nurses" they are stuck on hiring! Of course you are going to get a higher acuity level of patients at a private hospital...especially if you opt for a level 1 trauma center.
I'm going to get some tele experience than make a beeline for a level 1 ER position!!! :)
interleukin
382 Posts
Go to the VA, if it is one which is properly run. Quality really varies, VA to VA.
Also, new grad in an ER is scary thing....if not for you(it should be) then certainly for the patients.