Reflection of accepting a job offer for North Dakota

  1. This review is for St. Alexius in Bismarck, ND.



    I would like to say I am a new grad BSN-RN who applied to every place but my home state. I moved from Hawaii to any place that would take me other than Texas. Texas is known for taking their own new grads.

    Why you ask? I wanted experience of living somewhere else. I applied to 15 hospitals across the US and even in small towns. I had a generic cover letter and resume for the ones that were "Whatever" applications.

    I applied to 3 in North Dakota and they all called me.
    There is a true nursing shortage in ND along with a shortage on every possible job you can think. Many people do not want to think about relocating for their first new job, but if you have no ties and are losing more and more time away from the hospital, then I would highly recommend you consider this decision for your career. I am currently located in Bismarck and there are some upsides and downsides to my experience at my hospital/area.

    1. This place is booming, many new jobs.
    2. Other transplants are here
    3. Progressing my career and being trained in WHAT I WANT
    4. Small town, easy to get to work
    5. My housing is cheap for what I am paying.(Although you have to really look)
    6. Best nurse aides I have seen yet!
    7. Compact state, I have a Texas nursing license.
    8. Even though pay is low they are in need and you can rack in quite a bit of overtime and incentives.
    9. People here are very friendly
    10. Some LPNs are still active in the hospital, and they are a great asset to have. These are old school LPNs who will help any new grad that comes across their path. I have had 5 shifts so far and am grateful they are there for me.

    1. I wish food was cheaper(Texas food is dirt cheap)
    2. Small town
    3. Not very multicultural
    4. I don't like my hospitals charting system
    5. Cold weather(It snowed yesterday)
    6. I moved here not knowing anybody.
    7. I wish pay was better

    ND Has a true nursing shortage and if your career progression means anything to you, you should send an application out here.

    I would also like to add even though I get paid 22.79 an hour.

    I am still making 44k+ a year before overtime. Every week you do not work you are losing your grip on your skills, experience(whatever we do have), and about 1k a week.!2e0
    Street view of the hospital.

    Talent Specialists Help Keep Bismarck Hospital Staffed on Vimeo - This is a video online that was posted on the local news in regards to needing nurses
    8/7/2014 so I am reaching 4 months soon. My experience here has been fun, Learning everyday and the doctors, lpns, and experienced nurses have been pretty helpful in teaching me. I deal with hospitalists and oncologists frequently. I picked up a 12 hour today. which is actually 2x my hourly wage.(OT+pick up incentive).

    My Personal life? There are more transplants than expected. My coworkers invite me out for a beer after a long chain of shifts. So I have been having a good time out here.
    I have 0 regrets
    8/11/2014 I was told that ER does not take new grads, ICU does in some situations.
    9/16/2014- Today is the 5 month mark since I have came to North Dakota. I am currently in Houston visiting family and am always amazed by the Houston Medical Center. However... I hate the weather here and the traffic.

    I sometimes wish I could see different procedures/get into ER, but I am not in any place to request such a thing.... atleast for now... I do not miss the humidity of Houston, nor do I miss the traffic. I have friends already giving chemo after 6 months of training but they follow particular protocols and standing orders which I noticed my hospital lacks. She does work in a top 10 pediatric hospital though... So there are differences. My cousin has also said she could get me a job in Oncology ICU(MD Anderson), however I do not think I am ready to come back to Texas anytime soon. As I have said in the past. If I wanted just a job, I would have stayed in Texas. I have had many personal hardships of why I moved to ND to try to escape some of my past problems(I had 3 family members that have died).(2x cancer 1x Suicide). The world is such a big place and it would be an insult to limit it. I had a long talk with my cousin and my friends who participated in formal residency programs versus mine. one is a nurse for 4+ years and the other is a nurse of 8 months. You learn on the job, regardless of how much learning you have. Especially in specialization like Oncology. Entering medical oncology has not been anything I have regret. If anything, their talk has reinforced my outlook on this experience of medical(jack of all trades) and being able to take care of oncology patients which is the core reason of why I became a nurse. The point of this thread was to help people get a job, and to show my appreciation of the hospital and their staff.

    To sum it up. Month: 5.... No regrets... although... Winter is coming....
    So a little update. My competence has been rising and I feel much better about my job. There are always things I am going to feel uneasy about but that is normal for everything. So I Just ask my TL or coworkers for help. I never ever feel uneasy to ask them about anything, regardless of how minor or major it is.

    I am moving into my 6th month. The nursing direction of my unit and dialysis walked up to me and said my name was mentioned in a survey from patients. So That made my day. I try to have great bedside manner and make sure the patients are well up to date with their care and knowing what meds they are taking, rather than blindly sitting in the hospital room. We currently have 8 people on orientation on my floor. This is a huge wave and it seems like it will be much better for the local nurses here. The hospital is trying to expand but they do not have the staff # to make up for it. Chemo training starts in a week and a half. I took my provider card. Time flies and I feel like I am gaining a skill that finally separates me as a specialized nurse vs my friends in other floors such as Tele(cardiac drips), ER,& icu(Critical care)
    So it does feel weird moving into my 7th month, I really do enjoy my floor. I do have an awesome workplace and am very happy about it. We had a huge wave of transplant new grads that just came in where there were about 9 people that started on my floor. Some of the other local new grads were a little shocked about being assigned to areas where you go when you are "ready to fly on your own". I do enjoy my job as days go on, but I feel burned out when I bust out 60+ hours in a week. I start getting aching pain on my back. I do pick up quite a bit of shifts still. I have worked maybe about 160+ extra hours over the past 4 months. Everytime I pick up an additional shift I feel that I still do learn even more.

    I honestly think the fact I enjoy my job, makes it easy to pick up additional hours.

    I do have the standard "Monitor patients" days, but the ones that keep me busy are the ones when we are forming the plan of care and whats wrong with the patient. Diagnosis is the hardest time of treating the patient.

    Sometimes I ask the attendingwhat the plan is? and he responds.... "I dont know, I am getting some consults". Thats when I know it will be alot of work.

    We have other times when I ask him what the plan is. He may say "Standard pneumonia patient" which is usually easy. I feel that I am very easily able to function on my own. However, there are still many things that I need to learn.

    Example: I was wondering where all the COPD patients have been, but when the cold dry air comes... The COPD patients come out and play.
    I am approaching my 10 months.

    I have grown tired of taking care of medical. It isn't for me, I do like the oncology side and I have been doing chemotherapy administration for nearly 3 months. I am happy with my decision of coming to North Dakota still, but I am ready to move on. My floor is still short on staff and they need people. It gives us a lot of opportunities to pick up and make extra money. I have made 45k over 7 months last year granted I did work a lot.

    I have traveled to Houston, Fargo, Seattle, and New York since I have been here. I plan on going to Denver in maybe a month.

    I have already have 2 phone interviews for Seattle. They called within a week, I am honestly kind of shocked. I didn't think I would get a call back that fast and decided to apply a little early. I am excited about the move but a little sad about all leaving all the people I have met here.

    However North Dakota is not for me, it has never been for me, but this has been a great learning experience. I know that my learning is still not over. I am getting a little ancy and feel that I need to look into my Master's or become a CNS.
    I am in my 11th month now. I have put in my verbal notice that I will be leaving in mid April. I told her I would still continue and try to pull more people for the hospital. I have applied for countless places. Many people are surprised that I would be taking care of septic patients, chemotherapy administration, and the fact I went out of my way and on my own terms took my ONS Chemotherapy/Biotherapy course. I have had a number of call backs with atleast 50%+ call back for interviews. It is truly amazing to be getting all these calls.

    I am leaning toward more of a travel position but this BMT unit in Denver sounds amazing.

    I have had a total of 6 interviews(another in a few hours) I have turned down 2 reference checks parts of the app because I wanted oncology. I have also turned down an interview with the VA hospital, it sounds sweet but I still want oncology.

    Acute stroke intervention, Chemotherapy, sepsis, Oncology are big things to take care of. You start realizing how crazy your experience is when you start to leave.
    I have now accepted a travel job in University of Iowa in a BMT unit. I will be there for the next 3 months. It seems like a solid facility and really amazing. I will have to do quite a bit of reading on BMT patients.

    It was pretty much an instajob offer. I am looking forward to it. I am glad I came out here for this job experience.

    For any more information I can answer it. There is another biography thread about the hospital being continued on from whatsmyusername at
    Iowa fell through, which I am glad about... because I signed a contract for a travel position at Stanford Hospital in Palo Alto, CA in Oncology which I am going to pursue as a perm. I never thought a hospital such as that would consider me. The contract has been signed, I have been flown out there to obtain my CA License. It is kind of shocking that all of this is falling into place for me.
    Last edit by DatMurse on Mar 29, '15
  2. Visit DatMurse profile page

    About DatMurse, BSN, RN

    Joined: Nov '09; Posts: 798; Likes: 522
    RN OCN; from US
    Specialty: 3 year(s) of experience in Hematology/Oncology


  3. by   pauldean
    Thanks for your great post. Would those hospitals hire RN-ADN? Job market is too rough in CA.
  4. by   krisiepoo
    SOOO Happy for you! congrats on thinking outside the box

    @pauladean, they will hired ADN's as I had applied in ND as well and got a few calls for interviews

    ETA- take a look at when your pension is vested and think about staying for that (fi your hospital offers it). mine is vested after 3 years so plan on staying at least that long, silly to throw that money away
    Last edit by krisiepoo on May 5, '14
  5. by   DatMurse
    Quote from pauldean
    Thanks for your great post. Would those hospitals hire RN-ADN? Job market is too rough in CA.
    Yep, They take ADNs
  6. by   ceebeejay
    Very brave to move somewhere that you don't know anyone. Congrats to you.
  7. by   BigBrownPotato
    May I know what hospitals you applied into?
  8. by   Wrench Party
    Congrats to you on your decision! I hope you have a long and fulfilling career ahead of you. The opportunities
    are there for those that want them.
  9. by   DatMurse
    Quote from BigBrownPotato
    May I know what hospitals you applied into?
    sanford, st alexius, and trinity.

    3 locations of sanford called me.
  10. by   PedsHopeful
    Does the hospital offer shift differential for 3rd shift, weekends? How are the benefits? Why did you choose the hospital you chose, what appealed to you out of the others? Thanks!!
    Last edit by PedsHopeful on May 10, '14
  11. by   annie.rn
    Congratulations and good for you for venturing out of your familiar zone.
  12. by   PedsHopeful
    What is housing like out there for rentals? From what I can find, looks like housing costs are really high. Combining that with low pay doesnt sound like such a good idea. 3 bedroom places seem to be 1200+ minimum.
  13. by   DatMurse
    Quote from PedsHopeful
    Does the hospital offer shift differential for 3rd shift, weekends? How are the benefits? Why did you choose the hospital you chose, what appealed to you out of the others? Thanks!!
    Benefits are good. I picked mine because they offered medical/oncology. I told them I mainly wanted to come for oncology and I will be there for atleast 2 years. I am going to keep my promise if they atleast give me a reasonable of oncology shifts so I can atleast apply for OCN.
  14. by   DatMurse
    Quote from PedsHopeful
    What is housing like out there for rentals? From what I can find, looks like housing costs are really high. Combining that with low pay doesnt sound like such a good idea. 3 bedroom places seem to be 1200+ minimum.
    Thats about how much it costs. its a first time job. Can't complain tbh. Better than not progressing your career at all.