I watched my cell phone turn black as the call with my friend ended, and I felt my mood dim, as well. She had been excited about finishing up her nursing degree six months prior, and took a job in a step down unit, launching out as a new nurse full of idealistic fervor. Now, just a few months later, she quit her job, felt depressed and wondered if the whole decision to go to nursing school had been one long, expensive mistake.
I felt bad because I had not been able to help her avoid this common dilemma: a bad match for that first job. As it turned out, her personality did not mesh well with the fast-paced unit and the expectations of the leadership were often expressed with sarcasm and passive/aggressive tones. To further complicate things, the EMR of the particular hospital system did not lend itself well to passing on valuable patient care information, leaving her to spend time trying to figure out where things stood with her patients, sometimes causing her to lag behind in timely completion of nursing duties.
I wondered if I had a "do-over" what would I have said for her to watch out for?
What to Look For
Look carefully at the leadership of the unit.
In real estate, there is a saying about what really matters, "Location, location, location." In nursing, the appropriate way to say what is important in order of the top three things is: "Leadership, leadership, leadership." A unit and its staff will follow the lead of the manager. If he/she is kind and efficient, the unit will likely reflect those qualities. If the manager is fearful and paranoid, then expect that leadership to bleed all the way down to the housekeeping staff. If the unit's leaders focus on high quality, compassionate care with a strong emphasis on continuing education, then the schedules and staffing numbers will end up supporting those goals. This characteristic holds true whether you are looking for a job in a hospital setting, in an outpatient care center or in a long-term care facility. Wherever it is, the tone of the leadership is central to ultimate job satisfaction.
Know yourself when you are looking
If you are hard-driving, love a good dose of adrenaline, and are easily bored, then you know you need a job that will match those personality traits. If you are quiet, reflective, more cerebral, more of a student and an intellectual, then a different sort of setting will suit you. While we can cross over and do the extrovert's job well for a while, the true introvert will find more long term satisfaction in a setting that plays to those innate traits a little better. And no, we don't all have the luxury of waiting for that "perfect" job to come along. Everyone understands that. But when there are two to pick from, we do well to know ourselves and listen to what feeds our spirits. It is the only way to stay with it for the long haul.
Ask others how long they have worked there
No manager or unit is perfect, but if people hang around for long periods of time, then something is going well. When you interview, take in the general "vibe" of the place. I had a friend that told me that she recently went to a new doctor's office. While the set up was beautiful, the staff seemed harried and inattentive to the patients. They buzzed with conversation among themselves, and she noted that they didn't make eye contact with her, that they stared at their computer screens and when they did address a comment to her, it was to complain. It is possible, this was an "off" day there, but if looking for a job, those might be signs to take into consideration.
Check out the EMR or documentation system
In modern medicine, EMRs are a must. But there are real differences in how helpful they are. If you are comparing two jobs, one of the important considerations has to be how satisfied the staff is with their EMR. The EMR can make or break a job!
Don't let money do all the talking
This may be the most common pitfall. Having loans to pay, dependents to get through school, commutes to consider, we will sometimes pick a job based heavily on how much it pays. But no amount of money can reimburse you for your life. While having shelter, food, and transportation are pretty important matters, the hourly pay should not speak more loudly in our decision making than it has a right to. If we are happy and fulfilled, we will find a way to make things work. If we are unhappy, then no amount of money in the bank will please us, because we will, ultimately feel cheated by our choice.
After a few weeks passed, I checked back with my friend. She had just landed a great job as a liaison, a position that promised to utilize some of her best skills. As I congratulated her, I breathed a sigh of relief, thankful that she was feeling hopeful and that she was looking forward to a much better fit this time!
