Not the new grad problem I expected..

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Specializes in Emergency, Critical Care (CEN, CCRN).

I had a very similar choice when I graduated school (and I'm in Metro Detroit also): full time nights on a neuro floor at a large, prestigious teaching hospital, or full time nights in the emergency department at a community hospital within LTH's system. Also much like you, I had an old instructor championing me for one of the positions, and being in the same system, the pay was the same for both. In my case, drive time wasn't a factor, since both hospitals are more or less equidistant from my home. (LTH is 15 min by freeway or 25 min by surface streets; CH is 7 min freeway or 15 min surface streets, but that freeway is home to a large, old-growth stand of orange barrels :devil:, so it's largely not worth the bother.) I had family connections at both hospitals (father at CH, mother at LTH). Emergency was what I wanted; neuro I knew I could do, but it wasn't my cup of tea. Both jobs came with a 15-month commitment, so if I hated it I'd be stuck for that long.

In the end, it all boiled down to prestige and culture. Large Teaching Hospital is a very well-known and well-respected institution, one whose credit would get me in the door just about anywhere in Michigan. Community Hospital's quality of care is just as good, but it's much overshadowed by its parent organization. Likewise, people at LTH are justifiably proud of themselves, but rather prone to backbiting and belittling everyone who isn't them, while CH is a much smaller environment but offers a much more cohesive, supportive atmosphere.

I went to Emergency at CH. Best decision I ever made. I work with some absolutely amazing people, I've had the opportunity to develop leadership skills and help improve care standards that I never would have had at the big hospital, and I can honestly say that I love going to work every night. And - in a case of it all coming full circle - I now have people from LTH actively recruiting me to go work in Emergency there, as well as recruitment offers for the Level 1 trauma center at Huge University Health System (major boost in prestige and slightly better benefits, but less pay, a very restrictive union and a 1 hr+ commute, such that I'd more or less have to move). I don't think I'll ever leave CH entirely, though - quite honestly, I like the place too much to leave! :)

In the end, you have to do what you think is best for you. It may be to your advantage to start in emergency at the smaller hospital, get your skills honed and work your way to a larger institution. On the other hand, as others have said, you don't want to burn any goodwill you may have accrued at the larger hospital, and depending on where you are, the job market may be such that you'll have much more difficulty getting back in the door. I'd also tell you that in either instance, you can stick anything out for a year if you turn out not to like it. (What I don't think I'd place too much emphasis on, though, would be the driving distance. As you're no doubt aware, between snow and construction, any commute can turn into a hour-long adventure...!)

Wherever you go, I wish you the very best of luck - and do let us know where you end up. :nurse:

MInurse.st

181 Posts

Thanks so much, everyone! I'm leaning towards the job at the larger hospital because of the opportunities I will have after my initial 18 months, but it will be very difficult to turn down the ED right now. I will update and thanks again. :redbeathe

NeoPediRN

945 Posts

Specializes in Pediatrics, ER.

I commute 1 hour each way to work in a small community hospital in the ED. I'm working 9p-9a. I also live in New England and have never lived closer than 40 minutes to any job (I work at 4 hospitals). That said, it's soooooo worth it to me. I LOVE ER nursing, love my coworkers, love it all. Working a distance from home does take preparation, though. I have an AWD car and if I have to work on a day that a snowstorm is supposed to hit then I sleep at work. It's really up to you whether or not you feel you can make it work.

tojal1989

47 Posts

I would take the first. Personally I despise driving, even worse in the snow. Though it's not exactly what you want, you will still learn a great deal. 18 months will fly by and if you transfer (you could end up loving it), you'll know all the tricks and info needed to be a pro.

Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.

If you want the ED, go for the ED job and move if you have to. It's a completely different type of nursing than what happens up on the floor, and the experience transfers well should you decide to look elsewhere.

Specializes in Emergency Dept. Trauma. Pediatrics.

I have the same commute and we have tough winters here as well. Something to think about. If you are worried about the drive and commute. See if there is a way you can get your 3 12's scheduled in a row and stay in a hotel for 2 of the nights so you are only commuting on day 1 and 3. You can find nice inexpensive hotels and it would probably come close to evening out on the gas you will save.

If I didn't land the job I did which is at a hospital I wanted, I was going to have to maybe face a really tough commute. But I had a connection at the hospital and was guaranteed a job. Problem was it's up a mountain in a very big tourist mountain town. It's one road in and one road out and single lane. So in the winters I would be looking at one hellish commute. If I would have had to go this route I would have done what I just suggested. For now though the hospital I work at is 35-40 min drive on mostly hwy and freeway which they are pretty good at plowing. I always leave an hr early though to be safe and it's saved my butt a few times when there was an accident on the road.

Me personally if I had to chose between the 2, I would go to the ED. But I really love the environment of the ED and GI is probably the worst place you can stick me. LOL Granted, if that was the only job I was offered I would have taken it with a big smile on my face. :p

mstacyi

89 Posts

ED/ICU is where I want to be too, but sadly where I lived I havent even gotten an interview yet.

I would pick bigger hospital and ask to be floated to ED every once in a while so you'll still get the ED experience. I would rather be in a bigger hospital, closer to home, and not worry about the winter weather. Also bigger hospital means more diverse patients=more experience and more opportunities once your 18months is over.

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