Offered position.... Bad career move?

[XmasShopperRN, ASN, RN]

I was an ER nurse for 3+ years until the hospital canned me 2 months ago after hand surgery. It's a long story, so I'll spare you the details. But basically I really, really liked what I was doing, the autonomy, the massive amounts of knowledge I gained while an ER nurse. I love to learn, and was in the process of obtaining my CEN before my unexpected termination. I've spent the past 2+ months submitting resume after resume, application after application. I finally got a hit last week for a pediatric office RN position. I interviewed and shadowed a nurse yesterday, and was offered the position immediately afterwards.

While I'm stoked to have a job offer, there are a few things that worry me. First, the pay is significantly less (up to -$13/hr). For an office setting the pay is competitive according to the nurses. Secondly, the practice doesn't seem to be very pro-education. I would be the only PALS certified nurse, and some of these RNs have been there for 20+ years! I get that emergent patients get shipped out via EMS asap, but I would think at least knowing what to do in an emergency might be of some benefit in any kind of pediatric setting.

I learned a lot in the ER, and I'm not sure if I'd be committing career suicide by accepting this position. Any input would be greatly appreciated!

[nitasarn]

Well the saying goes that a job is still a job...but an pediatric office outpatient setting is going to be a VERY different environment than what your use to in the ER. Your not going to be seeing MI patients, your going to be doing well exams and immunizations,school physicials, etc, these arent emergent issues, and like you said if an emergency does happen theyll get shipped out EMS(which would explain the lack of education). What did you feel when you were shadowing? If your going to accept the job,I think your going to have to change your mindset, or keep looking. Good luck in whichever path you take.

[T-Bird78]

The pay is going to be much lower but you'll get evenings, weekends, and holidays off. Did the office have a crash cart just in case? Maybe you could ask about overseeing that aspect of it. Yes, they'll call 911 but being prepared is fine too. Both offices I've worked in had a fully-stocked crash cart, complete with AED, as we had allergy and asthma pts. There should be pt education, whether it's proper medication administration to diabetes management to infant milestone markers. It'll take some adjustment but you should enjoy it. You'll see a lot of pts, some sick and some routine well-child visits, so you'll get your autonomy (vaccinations and vision/hearing screenings) and setting up the nebulizer for the asthmatic pts coming in during a flare up. Plus, seeing the same pts is nice and you get to know them and they appreciate you, especially if you give good shots that don't hurt! Many of our pts would bake cookies and bring us a batch or two around the holidays, kids will draw pictures in the waiting room and give you their artwork, it's a different feeling. I love the office setting. Go for it!

[XmasShopperRN, ASN, RN]

The pay is going to be much lower but you'll get evenings, weekends, and holidays off. Did the office have a crash cart just in case? Maybe you could ask about overseeing that aspect of it. Yes, they'll call 911 but being prepared is fine too. Both offices I've worked in had a fully-stocked crash cart, complete with AED, as we had allergy and asthma pts.!

That's one of the things that concerned me. When I asked where their Braslow cart was, the nurse looked a little puzzled. Their crash cart was a tackle box. I looked in it and saw a few Epi pens, some neb treatment equipment, but not much else. Didn't see a Braslow tape either. I know I'm coming from an ER mentality, but I was a little shocked that the office doesn't maintain a glucometer because of the additional lab certifications one would require. I really like the idea of overseeing their emergency equipment, and even thought maybe I could suggest coordinating a voluntary CEU and/or informal education program for the nurses. The practice employs around 18 FT/PT/PRN RNs and LPNs, and literally no one is PALS certified; nor does the office require any continuing education of any kind. I was thinking of getting started and maybe throwing that idea out there in a few weeks/months. How could I go about that without insulting the senior nurses or stepping on any toes?