username2008

1. City of Los Angeles Jail 2. LAC+USC Clinic (via Maxim Healthcare Services) 3. Kaiser Los Angeles (Sunset) Clinic In terms of overall work environment, workload, stress level, co-worker (physicians/nurses/staff) relationships, etc., which facility would be best to work at? Which would you work at if you could choose, and why?

NO unsolicited advice, please, especially if you're not even an RN to begin with. i'm looking for a quick solution, not a lecture, not a putdown, not what i should have done, not what i should not do, etc. a hospital is also a business, and in business situations, anything goes, and if there's a will, there's a way. if nurses can swap work schedules, they certainly should be able to swap jobs. i know there's plenty of new nurses who would die for a rare day shift. i'm serious and willing to trade, and by the way, if you're not from this area, please don't respond. thank you.

this is important to me and i'm obviously getting pretty desperate. i'm a new grad licensed RN scheduled to start a day shift in the Definitive Observation Unit (DOU) at Good Samaritan Hospital on july 14. i'm willing to swap for a position in the ER, preferably in a hospital that offers the Versant RN Residency Program for new grads, such as White Memorial (i had regrettably resigned my ER position there last week), Hollywood Presbyterian, and Torrance Memorial. if any of you would like to swap, or know anyone who might want to swap with me, let me know ASAP so we can get this going.

...look it up. kick back: Informal To take it easy; relax: kicked back at home and watched TV.

what's a more kick back unit, ER, Telemetry (DOU, Stepdown ICU, etc.), or ICU/CCU? Please don't stay that none of them are kick back. There has to be one more kick back than the other. Please rate these 3 units in order of most kick back to least kick back, on a scale of 1-3, 1 being most kick back. ER Telemetry (DOU, Stepdown ICU, etc.) ICU/CCU

sorry, let me clarify. i do realize that medical insurance is a necessity and i currently purchase my own insurance with Blue Cross for $800/year. it is not comprehensive and only includes hospitalization (in-patient only, i believe. i've never had to use it and that's why i'm not even sure what my exact coverage is). if i waive my benefits at work, of course i'll plan to buy my own coverage outside the hospital's. i dont know how much the rest of you spend on insurance or what type, but isn't thousands of dollars a year a little excessive? and because i'm single, i dont have to worry about coverage for a spouse and kids. my idea was to just waive them, take the extra money now, quit after 2 years, then work for a place like Kaiser where i get the best coverage for myself and my family (i am single now but may be married in 5 years, who knows?). good or bad idea?

how many of you would rather waive your PTO, Temporary Disability Pay, and health and welfare benefits (medical, dental, vision, and life) for an approximate $5 (maybe $6) increase in your base pay? i have the option of doing so. i am single, have 20/15 vision, don't really need dental nor vision benefits, and don't really care for life insurance. i also don't plan on staying at this hospital for more than 2, maybe 3 years tops. would you waive these benefits if you were me? thank you for your time, feedback, and response.

northshore08, thank you for your feedback, as well as to the other two posters who suggested the day shift. after looking at your variable schedule more closely, it looks very doable, if not desirable, for me if that was my own schedule. my concern with a variable shift would be working something like this: week 1: mon 7p-7a, tue 12p-12a, wed 7a-7p week 2: mon 7p-7a, tue 7p-7a, wed 7p-7a week 3: mon 7a-7p, tue 7a-7p, wed 7a-7p week 4: mon 7p-7a, wed 7a-7p, fri 7p-7a a schedule like this would totally screw up my sleep patterns and body in no time. that is what i'm afraid of and my manager hasn't yet answered my questions regarding that. so my impression is that i'm pretty much at their mercy. i'm just hoping i can get a schedule like yours and have more flexibility even though it's a variable shift. further, here are my reasons for ultimately choosing one hospital over the other: hospital #1: 1. $50/hr for a 4th shift (overtime via in-house registry) 2. day shift 3. nice manager 4. low nurse turnover, high patient turnover 5. as a new nurse, the ED sounds scary and may be too much for a newbie like me and i'm not sure i know what i'm getting myself into if i go to the ED first (this fear is due to my intimidating interview with the ED manager at hospital #2, although she started out in the ED too and was grilled and intimidated but yet, no matter what her manager told her when she first started, she kept with it because this was what she wanted (looks to me like she gave me and her other new grads the same treatment that was given to her as a newbie), unlike my interview with the ED director with hospital #1, the night shift ED job that i previously rejected, who said that she didnt' believe new grads should start out there, even though the hospital does hire new grads to her ED, and when i asked her why the hospital does that, she answered "i don't know", but this is another story.) hospital #2: 1. 18-week Versant Residency training (includes preceptor, mentor, debriefing and support groups, web-based training, etc.) 2. slightly closer to home so i won't have to drive through a portion of the freeway that is usually packed during morning rush hour 3. the ED is my first choice unit and i have little to no interest in inpatient medical telemetry (my future goal is to work in outpatient ambulatory care, preferably outside a hospital environment, such as a clinic, physician's office, outpatient surgery center, or even a prison or jail) 4. because of #3, i'd rather not waste my first year or two in inpatient medical telemetry and, instead, get started right away in ED (i know it won't be a total waste since i'll be learning things that can apply to the ED, but it won't be the same as actually working in the ED) 5. even though i gave a verbal agreement to stay 2 years, nothing is legally binding and i can leave after a year, after training, or whenever i feel marketable to apply to other area EDs which do you (the reader) feel is the better rationale for selecting either hospital? both programs start in july, so i will make a final decision soon and should give them enough time (3 weeks) to find a replacement. i dont feel i'm burning any bridges like that one poster said because this is equivalent to resigning a position and giving 2 weeks notice. this is a business decision, nothing personal, so should not be taken personally. you do what's best for yourself and can't worry about screwing others (recruiter, manager) over (sure, the recruiter will have to start over, but that's part of their job). right??? this is my life we're talking about and i need to consider it carefully. also, i will go and see if i can talk to the ED nurses directly.

in-house registry is like working overtime, or working a second part-time or per diem job at another hospital. so instead of picking up extra shifts at another hospital, you can work that at your current hospital, so it's in-house, and registry is like any other registry where you sign up if you want to work an extra shift a week or a pay period. i plan to do that and that $50/hr is very good incentive for me to work at hospital #1. both hospitals are 12 hour shifts. DOU's patient acuity is high and comprise of unstable cardiac patients, although they do get renal and other types of patients (except post heart surgery, which goes to CVDOU across the hall). the DOU patients mainly come from ICU or ED. as for hospital #2's variable shift in ED, i dont know the details as it can change anytime depending on their needs. also, i like to mention that i had rejected a night shift offer with hospital #1's ED before i even interviewed for the DOU position. the manager is very nice and didn't really ask me much during the interview (she knew i had rejected an offer with ED, and the ED director who interviewed me may have taken my rejection personally because she said she was "disappointed" in my rejection, so i'd prefer not to see her around the hospital if i were to decide on hospital #1. hospital #1's ED is a 12-bed level 2 but they claim to be expanding and there's an overflow unit upstairs, and their charting is not yet computerized). hospital 2's ED manager, however, grilled me during my interview and was direct and intimidating telling me how i will have to be on my feet for 12 hours and it's all stressful and the nurses are burnt out. of course, as a newbie, i expected to be intimidated, so i'm not sure i bought everything she said. she wanted to make sure that ED was what i really wanted before she gave me an offer. of course, during interviews an applicant (as was my case) will always tell the interviewer everything they want to hear. you will lie if you have to just to get an offer, because that is your goal during an interview: to get an offer. anyway, that's the full rundown. so far, it seems everyone would suggest i take the day shift with hospital #1. anyone in favor of a variable shift in ED? i have no problem working up till midnight, but my concern is after 3am and sleeping during days and switching this up back and forth. the only reason i rejected my first offer with hospital #1's ED is because it was nights. i figure with variable, i can get some days in, but someone told me that be worse than a straight night position? for those of you who work a variable shift, how was it for you?

both #10 and 11 are supposed to be for the opposite hospitals above. sorry for the confusion.

I am a new RN, received and accepted two job offers in two different units at two hospitals, and really having a hard time deciding. I would greatly appreciate any of your feedback on what you would do if you were in my shoes and what you think I should do. Here's the rundown on these two offers: Hospital #1: 1. DOU (Definitive Observation Unit, medical telemetry) 2. day shift 3. unionized with CNA ($700 mandatory annual membership fee) 4. 12-week training (class and preceptorship) 5. qualify for in-house registry after 6 months at $50/hr 6. 4:1 ratio 7. 10 mile commute to a ghetto area with a mixed population, including korean, black, hispanic, and illegal immigrants (non-english speaking) 8. second best unit in entire hospital, with a silver star rating in patient satisfaction 9. low nurse turnover, high patient turnover 10. at-will employment although my manager expects a 2-year verbal committment 11. large teaching hospital (350 beds) Hospital #2: 1. Emergency Dept (ED), 28 bed, level 2 or 3 (not sure), but not a trauma center but still see everything and gets over 100 patients/day 2. variable shift to include days and nights 3. Christian institution, non-unionized 4. 18-week Versant Residency training (class, preceptor, mentor, support group, etc.) 5. qualify for in-house registry after training at $46/hr 6. 4:1 ratio 7. 7 mile commute to a ghetto area too with over 90% hispanics (many of which may be non-english speaking too) 8. 4-star rating for their ED for patient satisfaction (out of a possible 5 star), top 25% 9. high new grad RN turnover for reasons unclear (manager says it's due to an issue with having to pay for benefits) 10. at-will employment with no verbal agreement, but an expectation from the recruiter to work there forever 11. large teaching hospital (400 beds) My dilemma: 1. ED has always been and still is my first choice, though I'm not sure I know what I'm getting myself into. Of all my clinical experiences in school, including critical care (ICU), the ED was what interested me the most (though I was only in the ED for one day, but enjoyed it and learned more there in one day than I did anywhere else, and that was where I actually got to do things like draw blood and start IVs, unlike my other clinical rotations where I did mostly paperwork for school. ICU was particularly boring.) 2. I have little interest in telemetry or critical care 3. prefer to work days instead of a variable shift that will screw up my body, health, and sleep patterns 4. As a new nurse, quality and length of training is invaluable to me 5. prefer to drive 7 miles instead of 10 miles through traffic 6. that $700 membership fee with CNA sucks (whether CNA itself sucks is debatable), but this mandatory fee was told to me only after I accepted their offer 7. both hospitals have a good reputation and pay rate is comparable 8. both units have computerized charting and looks nice My main issues are training, strong preference for days, and preference for ED. So, what should I do? I am 50/50, have been thinking for days, and cannot decide. Please advise. Thank you for your time and feedback!