Nursing in NC - considering moving

Not sure about market for FNPs but Duke is hiring and I would think you could transfer into their FNP program.

I dunno about FNP's but having just left the same state I gotta say, be prepared for a BIG drop in pay (was just offered a solid $8/hr base pay less than I made up north with 2 yrs experienc, and it's slightly less than I made as a new grad in a much smaller town in the South...trying to get ahold of HR to see if I can negotiate at all). Charlotte seems to pay lower than other cities, far as I can tell, which is silly because I don't think cost of living (housing, etc.) is all that much cheaper than up north. Housing seems to have gone up significantly in the last few years in Charlotte. Maybe look at Greensboro or Winston-Salem as well, or if you prefer a smaller city, check out Greenville in eastern NC. Only one hospital there and the land is flat but I liked the town, was very friendly in my opinion. Asheville if you like the mountains, it's very eclectic and interesting there.

The biggest change in cost of living is property tax. If I owned the house I have here in NC, and moved it to Chicago, where I am from, you could almost count on adding a zero to the property tax. We pay less than $2K for taxes on a 3000 sq foot house on a 1/2 acre. My brother lives 75 miles from the city and their taxes are about 12K a year in a unicorporated area. He and his wife spend more than an hour each way to work driving.

There is a difference in cost of living. I love the Raleigh-Durham area. Lots to do and close enough to drive to DC or Atlanta or the mountains or the beach.

Thank you so much for sharing, guys! How are the staffing ratios?

I am on an intermediate ortho floor. Staffing is 4-5

I am on an intermediate ortho floor. Staffing is 4-5

Thank you for your response. I've never heard of intermediate ortho. What level of care is that? Is that an ortho stepdown (never heard of that either)?

Want to clarify, because if this is a regular ortho floor then 4-5 is reasonable. If it is more like a stepdown, 4-5 is very high.

Thanks, Y

I'm following this thread as I appreciate any advice in this topic... I am also planning on moving to NC in the next few years and appreciate anyone's advice. I live in Western NY currently and am downright tired of this ridiculous state and that's saying a lot since I've lived here my whole life (29 years) and it's all I know. My cousin who is also an RN lives in Raleigh and works at Duke in the NICU, she's already prepared me for the cut in pay but also assured me the cost of living/housing is significantly less than here in WNY. My background is 1 year of experience on a med/surg orthopaedic floor, 2 years in acute psychiatric inpatient, and I've just recently started in home health care. I'm hoping to spend a year or two in this position as a home health nurse, get comfortable in the home care setting, and then move down to NC and work in home health there. The Asheville area sounds really nice, I'm actually going down to visit family in NC next weekend, maybe I'll swing out that way and check out that area :-)

I am at a large teaching hospital and it is an orthopedic unit that takes only intermediate patients (although most hospitals they would be considered step-down, we do PCA, regional nerve blocks, ketamine drips, lidocaine drips, heparin drips, and insulin drips). We end up with gen/med on the weekends because most of the total joints have gone home by the weekend. Some of the ortho goes to step down if they have cardiac issues or other issues that are not within our floor scope).

I absolutely HATED living in Greenville. Even when I go back now occasionally I can feel it in my personality, that dread of how much I loathe that town. It was in my top 2 cities I have hated living in.

The ratios vary greatly hospital to hospital. I live in Wilmington and the Floor nurses feel it's a great hospital. New Hanover. Their ER however needs a lot of work on staffing and safe scenarios in comparison. Pay is average for the area. NC does pay less but cost of living outside of the Major cities is a lot cheaper as well. Vidant in Greenville did just do a significant pay increase last year. But it still wasn't enough to keep me there.

Thank you for your response. I've never heard of intermediate ortho. What level of care is that? Is that an ortho stepdown (never heard of that either)?

Want to clarify, because if this is a regular ortho floor then 4-5 is reasonable. If it is more like a stepdown, 4-5 is very high.

It is stepdown, higher acuity then regular floor and lower acuity then ICU.

However keep in mind in a large teaching hospital like that. (Like Vidant in Greenville) where you have half a dozen ICU's and stuff, what they send to Step down is a lot different then smaller hospitals.

We would send a patient from the ER that in most hospitals would be considered an ICU patient, but there it would be intermediate. Where the nurse would have 4 patients on days. I felt bad for them sometimes because I would be giving them a severe DKA patient requiring constant monitoring and blood sugar checks and on multiple drips that need close monitoring for example, and she would still have her other 3-4 patients.

I worked at Duke as well.

our stepdown is usually 2-3. Our sister unit does both intermediate and stepdown. Their intermediate pts are 4:1. ICU is 1-2.

Usually if I start with 5, at least one of them is a discharge. having a high turnover, though, I might have 3-4 discharges and 2-3 admissions in a shift. Those are the days that are tough.

Thanks all! Helpful!