Please Help me decide

[amzyRN]

I am torn between two opportunities and need to make a choice by Monday. I have offerred a job in another state in a small town rural hospital in there ER. I think it's a level V ER. There's a lot of sub acute patients there, all other acute patients are transferred out to a larger hospital. I'd get lots of experience there, however. Plus they are nice and invested in my learning. Where I currently live I just started an on call position in a SNF locally and work another on call job locally doing flu shots and health screenings. I'm a "new grad" with some recent acute care experience in a residency program, it wasn't paid. My family and friends are here. The out of state position is full time, I would have to stay there most of the time, and not commute back, because the sallary is low. My goal is to work in acute care, probably in CA, no particular specilty in mind yet. What experience do you think would get me to my goal, the experience in the rural hospital or the SNF? The SNF could lead to more full time SNF work and I know some nurse have gotten into hospitals after SNF. Any advice is greatly appreciated.

[dandk1997RN, MSN, RN]

Definitely the ED position!

[amzyRN]

One thing I forgot to mention is that I am married and my spouse cannot relocate and I would have to commute back from time to time and the job is full time. I also have a grandma that partly depends on me to help her with things. Maybe I can talk to the DON and explain this to her.

[Tragically Hip]

One thing I forgot to mention is that I am married and my spouse cannot relocate and I would have to commute back from time to time and the job is full time. I also have a grandma that partly depends on me to help her with things. Maybe I can talk to the DON and explain this to her.

Now you're talking about personal rather than career issues. It's hard for anyone else to climb into your head, or know all the details of your personal situation. As far as the professional considerations are concerned, there seems to be unanimity among those who have knowledge and experience in nursing.

[amzyRN]

Yes you are right, there are personal issues at hand. I just wanted to know that in fact it was a career booster (as I had suspected) and that I would learn more in the rural setting. Now I have to see if I can balance my personal life to allow me pursue what I am truly passionate about.

[sauconyrunner]

I would think after your orientation period, you may be able to work something out where you work 3 days say M,T,W and then have T,F,S,S,M,Tu,W off and work TH, fr, sat, and so on. Of course it wouldnt always be that perfect, but It sounds like this hospital wants to work with you. DO they have self scheduling?

[amzyRN]

I'm not sure if they have self scheduling or not, but I would be doing 8 hour shifts, 40 hours a week. They might be open to me doing more than 40hrs per week and then at the end of the month doing less. I will have to ask about that.

[sauconyrunner]

Oooh ask about 12 hr shifts.

[amzyRN]

I have another area of concern. I've read some things about new grads in the ED, and it's not always a good idea for many. I thought that this being a rural ED and I think a level V trauma center, wouldn't be so overwhelming. But I've come across a couple posts that say that new grads in a rural critical access hospital might not mix. I am worried about moving several states away and not being able to handle the greater autonomy. They want me to be able to rotate to do Charge after orientation, which they initially said would be 4 weeks. I aked the DON about an extension and she said they woud extend it until I felt comfortable, but I would feel stressed if I was taking a long time. My plan is to talk to the DON re extending the orientation to 12 weeks, but I don't think I would feel comfortable as a Charge nurse. Anyway, if you have any more thoughts on the matter, pass them along. Thanks.