New Grad RN in California with 4 different unit offers, seeking opinions on which to choose?

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Hello allnurses,

I am located in California and graduated with my BSN last September. It's no secret the struggle that is finding your 1st RN job after graduation, especially in California and just as I was mentally and emotionally preparing to have to leave the state, I was fortunate enough to be offered a position in 4 different units. The problem is, I like all 4 and don't necessarily have a preference.

The units are:

  • General Telemetry
  • Cardiac Telemetry
  • Stroke Telemetry
  • Med/Surg Ortho

My overall goal at the moment is just to become a safe and competent nurse and learn as much as I possibly can.

I know there is no such thing as a "best unit" and I will learn a lot wherever I go. However, I wanted to seek your opinions on what YOU would personally choose and perhaps share your thoughts if you have any personal experience on one of the respective units.

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Specializes in Oncology, OCN.

I graduated back in August and also had a long journey towards a job offer but I just got the one and jumped on it myself. I start hospital orientation on Monday for a new grad Oncology fellow position. My perspective is not from the experienced side so take it with a grain of salt.

Personally I’d go with the cardiac telemetry unit simply because that’s what I really wanted in my own job search before it became pretty much anything but OB or psych. My “medsurg” rotation in school was on a cardiac telemetry unit, my preceptorship was on a coronary care unit (ICU) and I really enjoyed both. So my focus was on cardiac units.

Really I think any of the telemetry units would be a good place to start and build a good foundation as a new nurse. With your options I’d skip the medsurg ortho unit. I did interview for two units like that and they impression I got is you’ll be doing a whole lot of patient admits and discharges most days due to the high patient turnover. That’s a lot of paperwork and charting vs. patient care and learning. Plus at least on the units I interviewed on most of those patients are knee and hip replacements on generally stable patients. You should get a more rounded experience on any of the telemetry units I’d think.

I’d also take location, pay, and benefits into consideration if they are different between the four positions. If you had the chance to shadow on any of the units that helps too.

Congrats on the multiple offers, I hope you enjoy whichever unit you decide on.

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Specializes in ICU.

I would say unless you have a specific interest in either cardiac, neuro or ortho I would take the general med/tele position. You'll see a little taste of everything in a unit like that, including the other specialties. I.e. a patient admitted for a respiratory issue but who has an extensive cardiac history, etc.

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Since each of these choices could provide a great foundation for your nursing career, my advice is that you make effort to discover which of the units holds the most promise as far as healthy culture where patient care is prioritized and where others are willing to invest in your success.

Then, put your best foot forward and learn all you can knowing that it will serve you well for decades.

(I would avoid contracts/(financial or length-of-service commitments) if at all possible.

Best of luck ??

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Specializes in school nurse.

I would go with a tele floor.

I do have a question though- what is the difference between "general telemetry" and "cardiac telemetry"? Thanks!

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Specializes in ICU.
21 hours ago, Jedrnurse said:

I would go with a tele floor.

I do have a question though- what is the difference between "general telemetry" and "cardiac telemetry"? Thanks!

I would assume the difference is the cardiac tele floor patients are being admitted with a cardiac issue, whereas the general tele floor they are being admitted for a non-cardiac issue but require tele monitoring.

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Specializes in school nurse.
13 minutes ago, EllaBella1 said:

I would assume the difference is the cardiac tele floor patients are being admitted with a cardiac issue, whereas the general tele floor they are being admitted for a non-cardiac issue but require tele monitoring.

Probably so, I've just never heard of a separation like that...

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Specializes in ICU.
1 minute ago, Jedrnurse said:

Probably so, I've just never heard of a separation like that...

In larger hospitals the floors tend to be split by specialty. You'll have a cardiac tele floor, a cardiac step down, a cardiac ICU, and so on and so forth. That way the nurses on each floor are more specialized in the area in which they work.

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Specializes in Stepdown . Telemetry.
On 1/31/2019 at 10:45 AM, JKL33 said:

discover which of the units holds the most promise as far as healthy culture where patient care is prioritized and where others are willing to invest in your success.

This! It makes more difference than I could have imagined! Im on tele that is basically housing all tele - neuro, cardiac, and all the rest! From my experience the “general” tele has less restrictions on who they can bed and the patients can be very heavy. Things get crazy! And not in a good way. I think cardiac would be good, because you will have skills with rhythms, but sadly I hardly ever have the straight forward post cath patients anymore! The neuro will have a more specific population: stroke, post crani pts, etc.

Try to find out the unit cultures...with all else being similar this is a major factor.

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