Older new grad- career advice, plz

Nurses General Nursing

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Hi all,

First, thanks to all of you out there; you are such a wonderful resource! I will be graduating this June from an accelerated BSN program. With the economic downturn, my job choices may be limited. In addtiton, there are 6 nursing schools in this area, so lots of new grads looking for jobs will make it harder to find a job here in NE FL. (especially since I'm about 25 years older than most of them! lol) I would consider relocating if I could find (1) a reasonable salary/cost of living, (2) education reimbursement - tuition/ loan forgiveness (3) MSN NP program nearby and reasonable $. I have done well in school and hope that maybe I can get some help in furthering my education. I know everyone says med-surg is the way to go for a new grad, and I will gladly take whatever I am offered, but in my clinical rotations, I have found ICU to be the most interesting (and challenging!). At this point, I am leaning toward eventually being a family practice NP. Since I am older, I need to be efficient and smart about my choices. So, I'm asking all you experienced smart nurses for your advice as to how to proceed. I would love to find a great hospital to learn nursing skills, and the opportunity to progress in my career in a nurturing environment. A progressive city/area would be the icing on the cake. I am so excited to begin my new career!Thoughts and advice are gratefully welcomed!

Baltimore Shock Trauma would fulfill your requirements.

Specializes in Family Nurse Practitioner.

Yes, I think the Baltimore/Washington DC area is fabu. Not terribly expensive to live, great rates of pay and enough hospitals for us all. :D

....and the opportunity to progress in my career in a nurturing environment. A progressive city/area would be the icing on the cake. I am so excited to begin my new career!Thoughts and advice are gratefully welcomed!

You will find it very hard to find a truly 'nurturing' environment for an ICU. Shock Trauma has a drop out rate of six months. Grow a thick skin and you will do great. Don't expect too much coddling in a critical environment--there simply isn't enough time for the pleasantries, unfortunately.

Specializes in Emergency Department/Radiology.

At the risk of sounding like the "old" person in the group, let me say that the drop out rate of new nurses who have been plunked down into an ICU, ER, Trauma environment, without having the opportunity to hone their assessment, prioritization and general nursing skills is outrageous. I work in a 900+bed teaching institution and this is what has been happening here. It doesnt matter how old you are, the point is, you need to get some time to sharpen up your skills, get use to the environment or nursing in general. We are doing our new graudates a large diservice by pushing them into these critical environments right out of school. I could only support this if a nurse had a very long, and very specific orientation with a preceptor.

Thanks- you bring up good points. Your point of a long, specific orientation with a preceptor is my idea of "nurturing." Could this happen in an ICU for a new grad?

Also, how can I learn more about the Baltimore Shock Trauma Unit? Does anyone know anything about Inova Fairfax? I believe that is in the DC area?

Anyone know anything about Duke University Hospitals? Thanks, again!

At the risk of sounding like the "old" person in the group, let me say that the drop out rate of new nurses who have been plunked down into an ICU, ER, Trauma environment, without having the opportunity to hone their assessment, prioritization and general nursing skills is outrageous. I work in a 900+bed teaching institution and this is what has been happening here. It doesnt matter how old you are, the point is, you need to get some time to sharpen up your skills, get use to the environment or nursing in general. We are doing our new graudates a large diservice by pushing them into these critical environments right out of school. I could only support this if a nurse had a very long, and very specific orientation with a preceptor.

Is it this way even if the job included a several month fellowship training period? I haven't started n-school yet so this is still a few years down the road for me but ER is one of the areas I'm interested in to start.

To be honest the amount of nurturing for newbies outside health care is little to none - so for those of us who are transitioning in after years in other fields I would think we would tend to have thick skin or we would have starved to death long time ago. Civility and nurturing is always nice in a workplace if/when you can get it, but it would seem to me that this needn't be a deal breaker in an environment that is supposed to be all about the patient.

Specializes in LTC, Med-SURG,STICU.

I worked for seven years in a factory as a general laborer before going back to school to become a nurse. Believe me I have a very thick skin. I can assure you that while I was not thrilled by the idea of little to no nurturing at the factory I knew that I was not going to kill someone if I messed up the part that I was working on. I can tell you that it hit me hard the first time I was on my own as a new nurse that yes I could very easily kill someone with my mistake. I started on a tele unit and I had a terrible orientation.

My point being that how nurturing the environment is for a new grad should be a deal breaker. You will learn more the first year being a nurse than what you learned the whole time you were in school. You want to work with a great group of nurses that will be willing to teach you and help when help is needed. Believe me you will need alot of help at first. Be sure to look at the place's new grad orientation program closely before taking the job. Looking back I would take the job on the med-surg floor with a great orientation rather than the job that I think that I want, but offers a terrible orientation.

All of this is just my opinion and you can take it or leave it. Good luck in whatever you decide to do.

Thanks- you bring up good points. Your point of a long, specific orientation with a preceptor is my idea of "nurturing." Could this happen in an ICU for a new grad?

Also, how can I learn more about the Baltimore Shock Trauma Unit? Does anyone know anything about Inova Fairfax? I believe that is in the DC area?

Anyone know anything about Duke University Hospitals? Thanks, again!

Google The University of Maryland Medical Center which is home to Shock Trauma. It has the nation's only free-standing ICU hospital and separate trauma building. The fellowship is very long; I believe it's 20 months? Shock Trauma has its own TV show on Discovery Health which you could watch. If critical care is what you really want to do then there is probably no better place. The Washington Hospital Center in DC is a level one trauma hospital which is unionized and has the highest paying rates in the metropolitan area. It is located in a bad area of town though, and it is immediately next to a couple of other good hospital too--Children's and The National Rehabilitation Hospital. Fairfax is the only level one trauma center in Northern Virginia and has 900+ beds. They can handle everything except for burns which have to be flown to The Washington Hospital Center. FFX new grad pay is $25 and WHC is close to $28. I think Maryland is either $25 or slightly less for new grads. FFX has a 6 months critical care fellowship followed by individualized preceptorship. INOVA currently has a hiring freeze and will let go of all LPNs by May 1st. They want to be an all-RN staff, with preference for the BSN since it is a Magnet facility. Duke starts you out at $20.50 I believe, but the cost of living is so much less in Durham. You can't go wrong with any of the mentioned hospitals. Apply to them all, and good luck.

Wow! How do you know so much?! I will take your advice, and apply to them all. I did check out the website for UMMC Shock Trauma- it looks great! I just don't think I'll be able to get the same quality of experience here in NE FL. Too bad about the Inova hiring freeze, but I'll bet the COL is pretty high there. Thanks for all your input!

I feel like what you have said is so important. I hope I can find a place where I can feel free to ask questions and learn from experienced nurses (or CNA's). In my clinicals, I have already experienced the difference between a positive and a toxic environment. As a new nurse, the pressure of inexperience and the gravity of possible mistakes is plenty enough to deal with; feeling hesitant to ask questions or for help because your co-workers have attitude is not conducive for learning. I can grow thick skin; I just don't want my patients to suffer....I have found that most nurses have been most helpful and patient; after all, isn't that a big part of being a nurse? This forum is proof of how wonderful nurses are!

Since you've lived a little, I think you can trust your instincts. You'll interview and get a feel for the hospital and the different units. The rest will fall on luck and timing. The area where you'll choose to live is very important too. Virginia, Maryland, DC, and Durham have distinct personalities.

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