New nurse needing advice

[lizzelizard]

A little back story: I am a "second career" nurse, in my late 30s. I graduated in December and got my RN in January. I immediately started working in a local hospital and a month in, I switched to nights. I was trudging through and soon realized that nights were (to put it lightly, and not to get into too much detail) affected my hormones. It became very apparent that it would not work out. I then talked to many hospital staff (manager, GNDP coordinator, employee health office, HR) and it was all decided that I would not be able to do nights. They told me to transfer. Unfortunately, this all happened when COVID was picking up steam and I was put on a "hold". I was no longer scheduled for my unit, but because all the other units were on hiring freeze, they kept my place, but I was sitting at home (not getting paid, obviously). I ultimately asked for a "termination with possibility of reinstatement" to see what else is out there, since I was stuck. I tried other local hospitals and the units that I applied for either had rotating shifts, or their day shifts were filled. I decided to look outside the hospital to see if they would hire new nurses.

This leads me to the present. I am struggling between a large GP clinic and dialysis (both I would be incredibly busy at). My end goal is to be a FNP working in a clinic. There are so many perks to both, but I am struggling, being a new nurse, to know what is right for the end goal.

My husband wants me to work dialysis because it is more money, less days of work, bigger company, and has better tuition assistance/reimbursement so I can work on my FNP; I also see these as bonuses as well, but I am afraid I am going too deep into a specialty it will hinder me. I am also afraid because the retention for nurses in dialysis is quite low that I will be running for the hills because of whatever reason is making everyone else run for the hills.

And for me, I feel the GP is right in line with what I want to do, I can learn everything from "womb to tomb", learn the flow of a clinic, and have steady hours...this particular clinic has great retention and does not lose nurses. They do have tuition assistance, but it is after several years of working with them. The downside is, the pay is lower, poor tuition assistance, and I am nervous about losing the IVs/machines and acuity.

My question(s): is dialysis nursing good experience for going into an FNP program? Would any of you decide to take a pay cut in order to have a more steady/balanced life? Are either of these positions better for new nurses? I understand hospital nursing is ideal, but I am talking about, knowing the circumstance (as mentioned above), if these are a good "next-best-option" sort-of-speak.

[Sweetheart2005, ASN]

How long were you on night shift? I wouldn’t give up on the hospitals that are only hiring nights on med surg. Med surg is often a lot of turnover. I’ve seen coworkers hired nights as my manager never hired for days and then offers open day to night shift. The night shift crew never wants it so it goes to someone on orientation and some never see a night shift. Talk to managers before ruling out applying.

I worked at family practice for seven years. I started as a medical assistant, then stayed with my LPN and worked a little there as an RN. My role didn’t really change except being allowed to do triage more independently once I got my LPN. I don’t feel like I used much critical thinking and most of it was very routine. You will lose a lot of your hospital clinical skills.
I’ve never done dialysis but a lot of what I’ve seen on here is very long hours, often longer than scheduled, short staffing, and on call which turns into more long hours. It’s also very specialized. If affordability works and goal is family practice, you could always try the GP route.

[LibraNurse27, BSN, RN]

If your finances are not the deciding factor I would go with GP. It is related to what you will do as an FNP and you will get to work with FNPs and see what they do, plus learn about the conditions you will be treating. You will lose hands on hospital skills, but FNPs don't start IVs or use hospital equipment. It's a different skill set.

Dialysis would not teach you much that you will use as an FNP, but you would learn about kidney disease (of course) and all of the other body systems as they are all affected by kidney failure. My opinion is GP would give you more relevant experience and be more enjoyable place based on your interest in family practice. Dialysis can be sad and the hours can be long, but some nurses find it rewarding.

Of course if the job pays a lot more and you need the money and tuition assistance that is something to factor in. Just my 2 cents! Good luck ?

[DSCH]

This is a tough choice and I agree with other comments that you need to carefully balance all the pros and cons. 

[klone, MSN, RN]

If your goal is to become an FNP in a primary care clinic, then you should definitely take the primary care clinic position.

Also, FNPs who work in clinic don't start IVs, so does it really matter if you lose that skill?