new grad PICU job prospects - community hospital vs. children's hospital?

[benedetta]

Hello PICU nursing community! I have been reading this site like crazy lately trying to gain some insight into the PICU nursing world. I was fortunate to have the opportunity to shadow in a few different PICU's and I feel a calling to work with this very special patient population.

I just graduated in May and have been applying for jobs in my area. I am extremely blessed to have two very strong leads in two different PICU's. I am torn about which one I should choose. An offer letter is coming my way from hospital A, while the interview process is just beginning for hospital B. I shadowed both and I like both.

Hospital A seems more comfortable based on the staff I met and the types of patients I saw (less acute). However, hospital B seems to offer solid, high level, PICU experience. My goal is to find the best unit to learn and grow, without getting too overwhelmed. Below is a brief overview of each unit/hospital.

hospital A: Community hospital

pros: excellent benefits (especially retirement and tuition reimbursement), nurses seem very happy there, ability to transfer within the system, life flight program, trauma level I adults, trauma level II peds, 10 bed unit, nurses have been in the PICU for a long time, consistent night shift (so i don't have to rotate), 16 week orientation.

cons: smaller unit with lower acuity patients = potentially less ICU-type experiences, census on the unit varies & PICU nurses occasionally float to NICU or outpatient clinic

hospital B: Children's hospital

pros: well-renowned children's hospital, peds trauma level I, 20 bed unit, higher acuity/more complex patient care (my impression from shadowing), 16 week orientation + a year of classes and projects

cons: benefits not that great, salaried position, PICU nurses are mostly young, rotating shifts

If you have an advice to help guide my decision that would be wonderful. This is a very exciting and crucial time. I want to make a good decision about my first nursing job. I've watched too many nursing friends get burned out and I believe it has a lot to do with the environments they worked in.

My long term goals: I am open minded and will see where life takes me. Potential paths could be PICU for my whole career, nurse educator (far down the road), or maybe even life flight (in some wild dreams).

[Kidrn911]

I would go with B. They bette exposure of more stuff will be invaluable.

[umcRN, BSN, RN]

I agree. Hospital B will give you a good solid ground to build up from. Work there and you could potentially go anywhere you wanted to go, back to school, research, life flight, and will also give you the opportunity to develop more skills, especially if they do ECMO and dialysis. Youwould also be at the front lines for any new treatments/technologies that come out

[PICUisforcoolRNs]

I also believe Hospital B would be best. As a student, I worked in a level one trauma PICU that did everything under the sun except lung transplants. I moved after graduation to another state. My current location does not have the same level of acuity and I miss it!

[benedetta]

Thank you all so much for your input! I am more nervous about the higher acuity, but I think it would be a great place to work and gain experience. This forum has been so helpful for me to learn more about PICU nursing. I really appreciate your comments! :)

[meanmaryjean, DNP, RN]

I would pick B EXCEPT ??salaried?? - I would never work a salaried job.

[benedetta]

Yeah, salaried. Doesn't that stink? The hospital would honestly be great experience but the benefits and salaried pay are major drawbacks for me.