2 NICU Job offers, need opinions on offers

[K.Alva]

Hello, so I recently was offered 2 positions in 2 awesome NICUS and now need to decide which one but its really hard.

1. NYU Winthrop: Full time, level III, benefits 403B, tuition reimbursement is $6000/yr, environment is great, perks-minimal, exposure- good, problem- I love this hospital, it offers a small/warm environment and currently work as an NA on a tele floor BUT I feel like it offers minimal growth, unit is older and very super crowded.

2. Cohen Children's Medical Center- Northwell: this is tricky, so its the best NICU has super high rankings and gets the craziest cases (so my exposure and learning would be great here), Position- they start me in a perdiem spot guaranteeing me 36 hours per week but no benefits until I progress to FT position, when asked...they said positions always open up & that they did this last year with new grads and they all already progressed to FT positions. salary-5-7K higher, benefits- same once they are available to me, tuition reimbursement is $5000/ yr, Environment- I got to shadow nurses on the unit as part of my interview and fell in love with the culture/nurses, perks- endless (clinical ladder with monetary incentives, ECHMO training, tons of committees etc ), problem- this is a the dream hospital for peds nurses, specific peds hospital and offers lots of growth opps, has brand new beautiful spacious unit and an environment I got to experience BUT the perdiem start is risky...

WHAT DO YOU THINK, WHAT WOULD YOU PICK AND WHY?

[KelRN215, BSN, RN]

You obviously want to do option 2, but say the "per diem start is risky". Maybe I'm missing something. What exactly is so risky? What's the worst that could happen?

There is no guarantee which ever way you go. Go with what has the best possible upside.

No full-time position opens, per diems are canceled first and don't get paid when they don't work so end up only working a few days a month and can't afford to live?

[AnnieOaklyRN, BSN, RN, EMT-P]

I would go with the one that offered you full time hours, and the benefits the go with it! Get some experience and then work per-diem on the side at the Children's Hospital and take a full time slot when it opens!

Annie

[Ruby Vee, BSN]

I'd say go with the first. Yes, you'd be exposed to zebras and unicorns at #2, but you'll learn and understand so much more from the exposure if you have the basics down first. For your first job, you want to work full time. You'll get more support in a full time position, and the consistency of going to work 36 to 40 hours a week will help you to develop routines, time management skills and good working relationships with your colleagues.

Plus I wouldn't trust an institution that told me they could only hire me per diem, without benefits and that full time positions "always" open up. That might be true, but would you be in the position of interviewing again when it did open up? I've read posts from people who took positions like that, interviewed every time a position opened up and were still per diem years later because someone else always got that position that opened up.

[adventure_rn, MSN, NP]

I can't tell you what to do, but as a NICU nurse I will say this:

With one year of experience at a Level III NICU, I found it incredibly easy to find a job at a Level IV. I applied to over a dozen NICUs to get my first new grad job (only two even called me back for an interview), but since becoming an experienced NICU nurse I've gotten an offer at every job I've applied to within a day of the interview. Even if you start out in the Level III, I doubt you'd have any trouble transitioning to a Level IV if that is your goal.

Also, to reiterate what others have said, I'd be skeptical about the PRN job, especially if you have any financial concerns. You may be guaranteed to be put on the schedule for 36 hours a week, but PRNs are always the first to get canceled when the census drops. Not only will you be unpaid for any hours that you are canceled, but that can make it very difficult to consistently build your skills when you are starting out (for instance, if your census drops off and you go several weeks without working in between shifts). If possible, I would ask the Children's Hospital what your orientation would look like, and if you'd be guaranteed to work for all of those hours.

What I mean to say is that only you can decide which option will work best for you, but if you do choose to go with the Level III it would still be a valuable experience, and it would probably be quite easy for you to get Level IV experience down the road if you still want it.

[JKL33]

The crucial point is whether the second place would plan to offer you a FT, well-organized, new-grad orientation as a per diem employee (which, historically-speaking, would be unusual). If their offering is anything less than that - - no way. Go to the place where your interests (your general well-being and your knowledge foundation as a new nurse) are somewhere on the radar. The place who offers to hire you "full-time with zero benefits" is getting a deal; you need to be getting a deal, too - - and that would be an excellent orientation. If they are willing to invest in an excellent orientation for you, I would feel more confident about their intentions.

Good luck!

[RNperdiem, RN]

Something sounds strange about a department hiring a new grad per diem. If there is enough work to staff 36 hours a week, why would they not hire a full-time nurse? What would your hours look like? Per diem staff sometimes schedule themselves with the schedules they want, with the understanding that they are the first called off if not needed. Other places only use per diem staff to fill holes in the schedule, which might mean a very random day/night/weekend schedule.

Do per diem staff really get the benefits of the unit? Where I work, per diem nurses do not get ECMO training, charge nurse training or any tuition reimbursement.

Personally, I would go with a unit willing to make a commitment to you and offer full-time benefits.

[K.Alva, BSN, RN]

Well it's risky because I don't know how long it will take for a FT position to open & I don't have access to all the wonderful perks until I get FT. I'm nervous about getting stuck in limbo... although they said last year they did this with a group of 5 nurses and they all progressed to FT positions within 1 year.

[K.Alva, BSN, RN]

They told me that they will guarantee me FT hours... their reasoning for doing this perdiem start is to train me and make sure I'm serious about the NICU. They told me positions are opening up bc most nurses are in school and graduating soon, & they're a large unit (150+ nurses) and that due to budgeting issues they can't keep opening FT positions. They did tell me I'd have a set schedule and they also told me that every nurse is strongly encouraged to join a committee and have to be on at least 1. The echmo training would not be availble to I progress to FT.

[K.Alva, BSN, RN]

They're making me agree to work FT hours with a Perdiem label

[K.Alva, BSN, RN]

They said my orientation would be 6 months w 1-2 preceptors and once on my own I would always be paired with a senior nurse. They told me that during my 6 months I will get experience in the lower acuity all the way up to the highest acuity neonates (1-1), they said there is a resource nurse on the unit always availble for me if I need it once I'm on my own too

[SC_RNDude]

Well it's risky because I don't know how long it will take for a FT position to open & I don't have access to all the wonderful perks until I get FT. I'm nervous about getting stuck in limbo... although they said last year they did this with a group of 5 nurses and they all progressed to FT positions within 1 year.

Fair enough. And some others have made some good points.

In my experience, in a unit that big, there are always people leaving. Even in the best places to work. People move, cut hours, go back to school, get jobs in different areas of the hospital, etc.

As for the "wonderful perks", while you have to wait until you are full-time, you certainly aren't going to have access to them working somewhere else.

[KelRN215, BSN, RN]

They're making me agree to work FT hours with a Perdiem label

They're making you agree to be available for full-time hours, doesn't sound like there's any guarantee that you'll receive them. Once you're done with orientation, if you're scheduled to work and someone needs to be canceled, it's always the per diem who's canceled first because no work = no pay. I'd take the full-time job but PTO and health insurance are critical to me.