New Grad RN Job Advice

[ngnurse]

I’m a new graduate nurse, and I need some advice.

I interviewed on a med/surg unit 2 weeks ago through a friend who gave my resume in and haven’t heard back, but likely got the job (nurse educator told my friend I did very well, hospital is notorious for taking a long time to get back to applicants, and I'll likely hear back this upcoming week). The job is 13 days a month, great benefits, level III trauma center but part of a large network of hospitals, so I’d have an easy time getting other positions within the hospital network. Up to 1:7 ratio (14 beds) if the unit is full (nurse manager said it’s not frequent, but a colleague brought up the possibility of a 1:8 or 1:9 ratio with an extra CNA if there are only 8 or 9 patients). However, I hate med/surg, and should stay in the position for about a year to be courteous to my friend for getting me the interview and to make a good impression if I choose to apply elsewhere within the hospital system. Overall, nurses are very satisfied at the facility.

I got an offer for an ICR float pool position at a level I trauma center, and I want to be an ICU nurse one day. The orientation is 4 weeks of classroom and 5 months on different ICR units, and I love the idea of getting a well-rounded experience - cardiac, surgical, etc - and an extensive orientation. 1:3 ratio. Day shift. 14 days a month (12 12s and 2 8s). Would make $8,000-10,000 less than the above listing. "Easier" to leave if I want to because I got the interview from applying and not by recommendation. I have to give a response by Monday.

Thoughts? Conflicted because I will likely get an offer from the first job and it's a great position to get me to where I want to be in the future (and with amazing pay), but obviously the second job is an official offer ready for me.

[Been there,done that, ASN, RN]

Think about the med-surg position. Would you want nine patients.. without another nurse for a resource?  Chances are you would have 1:7  as a baseline assignment. I had 30 years experience and 7 patients was too many to manage.

ICR position ( what is ICR anyway?) "The orientation is 4 weeks of classroom and 5 months on different ICR units" . Must wonder if you would get that full 5 months.  Floating to different units is NOT easy. No matter how much training you get, floating requires an experienced nurse. Been there done that too. Going to a different unit everyday requires another level of concentration.

You do NOT have to give a response by Monday. Tell them you are considering other offers.

[ngnurse]

7 hours ago, Been there,done that said:

Think about the med-surg position. Would you want nine patients.. without another nurse for a resource?  Chances are you would have 1:7  as a baseline assignment. I had 30 years experience and 7 patients was too many to manage.

ICR position ( what is ICR anyway?) "The orientation is 4 weeks of classroom and 5 months on different ICR units" . Must wonder if you would get that full 5 months.  Floating to different units is NOT easy. No matter how much training you get, floating requires an experienced nurse. Been there done that too. Going to a different unit everyday requires another level of concentration.

You do NOT have to give a response by Monday. Tell them you are considering other offers.

My apologies - ICR is step-down!

I wouldn't want up to 7 patient in med/surg. I've heard even 6 can still be a lot to manage and I don't want to spend the majority of my shift passing meds, but I'd leave the position after about a year (assuming I secured something else). The nurses at this hospital overall, however, seem very happy and satisfied. There's VERY LITTLE nurse turnover.

I think I'd get the full 5 months - it's split up into 4 weeks on various units. I had a friend who recently started at the same hospital (different position), finished orientation, but was having trouble managing the full load of patients, so they gave additional days with a preceptor to work on time management. It's a large and well-known teaching hospital. I completed several of my clinical rotations there and graduated from the affiliated nursing school. I'm also required to pass their competency "test" (not sure what it entails - written, performance as critiqued by a preceptor, etc) before being given the OK to float.

The electronic offer they sent me through their job portal has a "due date" of November 9. Not sure how, exactly, this works since this is my first job offer at a hospital. I imagine this offer "expires" and before the expiry, I can counter-offer or ask questions about the terms. I'm new to this LOL

[BONBON, BSN, RN]

The step-down position sounds a lot more appealing and you would get great experience if it is at a teaching hospital. I'm working at a level I trauma center at a teaching hospital on a busy transplant surgical unit and max out at 4 patients. These patients are busy and I could never imagine going over four patients let alone 7. If you are on a step-down unit you may have an easier time transferring and securing a job in the ICU, you'd make a lot of great connections, and you would get a taste of different units! 

[ngnurse]

30 minutes ago, BONBON said:

The step-down position sounds a lot more appealing and you would get great experience if it is at a teaching hospital. I'm working at a level I trauma center at a teaching hospital on a busy transplant surgical unit and max out at 4 patients. These patients are busy and I could never imagine going over four patients let alone 7. If you are on a step-down unit you may have an easier time transferring and securing a job in the ICU, you'd make a lot of great connections, and you would get a taste of different units! 

Yes! The only reason I haven’t turned it down is because of the ratio, the exposure I’d have, and the extensive orientation. It’s the only Level 1 trauma center in my county as well. But the cons are the shifts, the pay, the paid time off/vacation time is about half of the other hospital’s, and I wouldn’t be in the hospital network that the other hospital belongs to (making it more likely to get jobs in that network in the future).

[JadedCPN, BSN, RN]

Its been two weeks since the other interview and you haven't heard a peep at all, not even a reach out from HR, just word of mouth from a friend? I would not be putting any eggs in that basket; the educator might have felt obligated to say something positive to your friend.

[ngnurse]

4 hours ago, JadedCPN said:

Its been two weeks since the other interview and you haven't heard a peep at all, not even a reach out from HR, just word of mouth from a friend? I would not be putting any eggs in that basket; the educator might have felt obligated to say something positive to your friend.

Yes, but this is typical of this hospital in particular to take long, but I understand you could be correct about the last part

[Hoosier_RN, MSN]

I would take the sure thing, if you haven't already. Even of they take long, what if there is no offer after you turn this one down? Let us know what happens

[ngnurse]

7 hours ago, Hoosier_RN said:

I would take the sure thing, if you haven't already. Even of they take long, what if there is no offer after you turn this one down? Let us know what happens

I accepted the step-down float nurse job offer because I need to secure something. After accepting the job, I learned from a friend that works at the hospital that this cohort of nurses is being hired to help with Covid, so I'll likely spend a lot of time floating to the Covid unit since we're expecting a big surge. This was not mentioned during the interview, but I understand they can get away with not mentioning it because it's sort of expected given the conditions of the job.

My friend is encouraging me to follow up with the nurse manager of the hospital I haven't heard from yet regardless of my accepting the position elsewhere.

Finding myself in an even bigger predicament than before.

[Hoosier_RN, MSN]

Good luck. We just didn't want you to be without a job. And, in healthcare, CV can definitely be part of the job, it goes without saying. The other job could end up the same way, if the need is there. 

[ngnurse]

On 11/11/2020 at 7:49 PM, Hoosier_RN said:

Good luck. We just didn't want you to be without a job. And, in healthcare, CV can definitely be part of the job, it goes without saying. The other job could end up the same way, if the need is there. 

Exactly. I've been in regular contact with one of my clinical instructors post-graduation, through passing the NCLEX, and now through this. She said the same thing when I relayed the information to her - I'll likely encounter it anywhere I go. My friend said the same about her hospital and that I'd have CV patients.

As a new grad 6 months post-graduation, I didn't want to be without a job either! I am so eager to work! Thanks for all your help everyone!