Please help, I can't decide

[yolie672]

I interviewed for a school nurse position recently and today for an ICU nurse position at a hospital I used to work as a Nursing Assistant for... (I've been a nurse since May 2012, still pretty new and I work as an RN on an intermediate/progressive care/telemetry step down floor).

The school nurse job would be much better hours, all holidays and weekends off, home earlier, and generally less stressful (so it seems -- this is at a Special Ed. school). The pay would be $35K annually, as opposed to around $75K that I'm making in the hospital. They told me that it can be difficult because I will be working more independently, that there would be times in which I would be the only medical professional in the building and have to use my own judgment for things.

The ICU nurse job would definitely be stressful (because the patients are critical/unstable), but the learning experience would be incredible (to me). Critical care was my favorite rotation in nursing school & I did my senior practicum in the ICU (very much enjoyed it). And on top of that, the pay would be great.

The nurse manager was very honest with me and said that the other ICU nurses can be intimidating, and his only fear would be that I would get taken advantage of because I'm more soft spoken.

He said that he's seen people fail after 6 months because they couldn't deal with the "personalities" on the floor and that some of the nurses act entitled to certain things because of seniority, the union, etc. He said it very objectively, like that's just the way it is in there, not in a negative way necessarily...

I really don't know what to do. I was offered the school nurse job for sure, and have to let the principal know tomorrow if I want to accept the position. I wasn't offered the ICU position, I only interviewed for it today, but it definitely seemed like I have a very strong chance of getting it. I do know a lot of the nurses on the floor already from having been a float nursing assistant at this particular hospital. I don't know how they'd treat me as a nurse to be honest.

Any input on the pro's and con's of both school nursing and ICU nursing would be very helpful. Thank you very much, because I'm wracking my brain trying to decide what to do and I just can't right now. This is like the worst timing and I have to either accept or decline the school nurse job by tomorrow.

[yolie672]

Bump?

[melizerd, ASN, RN]

Sounds like something only you can decide based on your personality. I would not want to work in a school with kids. It's not my cup of tea. I'd rather take the hospital icu position because it's what I love. That's also a huge pay difference and you need to decide how much that matters to you, it might be a bigger issue for some people than others. I'm the sole bread winner so I couldn't afford to take that kind of pay either.

[Nonetheless]

eh, where I live 35K would not cover rent so I would take the higher paying job. But the cost of living is very high in my state. Nurses aides make more than 35K where I am from.

[HouTx, BSN, MSN, EdD]

You may want to do some further investigation of the school nurse job because the overall workload/stress can somtimes be very misleading if there are any 'medically fragile' children. In my state, 'mainstreaming' means that kids with all sorts of fairly severe health problems are now attending school. School nurses are maintaining trachs, doing straight caths, tube feeds, etc. You may want to check into this.

As for the ICU job, I think it's admirable that that hiring manager is being so frank with you. I'm also a member of the "ICU tribe", so I'm not without my own biases but I totally agree with his assessment of typical ICU personality types.

[yolie672]

I'll be honest here, I loved ICU as a nursing student, but I don't know if I'd be able to "cut it" per se on my own now as the licensed nurse taking care of the patient. I know I'll have orientation and take critical care classes, but once you're out there on your own, they'll expect you to function independently. It's a little scary to say in the least. And I keep reading about things that could go wrong in the ICU if it's very busy, ex. pt self-extubates and decompensates, pt exsanguinating from a-line that dislodged, vasoactive drips running out (while you are busy with coding pt) and now other pt starts to code because their levophed ran out, etc.