Greetings, I am an RN/Paramedic and want to get back into a direct patient care role and continue my education. I started in the ER at a local level 1 trauma center as a paramedic before I became a nurse. In that role I could do 95% of the things that RN could do but was paid less. While at this hospital I completed my RN. I was working at 7a-7p shift as a medic, I was going to have to change to 5p-5a as an RN. This was going to present a conflict with my wife and I. I was able to transfer to the ER of a hospital in the same town run by the same corporation. I worked 7a-7p, 10a-10p or 1p-11p, so, not too bad. However, I did not like this hospital. It was basically a shell of a hospital (no OR, OB/PEDS, CT scanner would be broken for days, lab instruments broke frequently) and patient care was not organized at all (a nurse would pick up a chart carry out the orders, iv, meds, etc. and not write anything on the chart). I had a personality conflict with one of the charge nurses and his "pet" nurse. They would not listen to reason and I was wrong no matter what the situation was. Neither had worked in a trauma center to the best of my knowledge but you couldn't have guessed it by the way they acted (greater than thou attitude.) While I was working at the hospital I started at an ASC first as a tech (while I was a medic) and later as an RN, all PRN. While in the ER my shift slot was pulled away and give to the "golden child" of the ER that got his RN license about a month before I did. This was a due to an that was on FMLA. She was going to give 2 weeks notice after FMLA and leave. She decided to come back. Therefore, they gave her the 7a-7p that "golden child" was in and gave him my shift. I would have to go to 5p-5a (presenting same problem as at the trauma center.) As luck would have it the ASC called the same day they dropped the shift change bomb on me and offered me a full time PACU slot. I took it and liked it for awhile. It was very difficult to get 40 hours there and OT was out of the question. I had to scratch and claw to get 40 hours. It was for profit and owned by a group of physicians. You had to walk on eggshells there because of them. I am a very outgoing person (never met a stranger) and I was once scolded by the PACU charge nurse for "talking to the doctors too much." Also, I was the only male in the PACU and I felt under the microscope if you will. I was let go there from there because I was told "I didn't have enough experience." Funny thing is they knew my experience when they hired me. I bust my butt everywhere and am always the one to take on extra responsibility. Perhaps, you could consider me a "yes" man. Sorry I'm so long winded...After the ASC fiasco,I landed a job in a commercial plasma center as a Physician Substitute. I had been an RN since March 2008 and this was in July 2008. I would do screening physicals on potential donors and take care of them if they got ill during donating. So, patient care/contact but in a different scenario. I was quickly promoted to an assistant manager. I was loving this job until we changed center management. Our director left and the other assistant manager was promoted upward. She is consistently tardy, sick, etc. Takes lunches/breaks with her GIRLFRIEND who works there. However, she is untouchable and never gets in trouble. Also, our donor base has decreased due to a multitude of factors (that I won't get into), our production is down and we laid off 2 people this month. The company plans to remodel our building but I'm not convinced our company will survive. I think the company might survive but our center wont. I feel the writing is starting to appear on the wall. Therefore, I started looking at jobs back in patient care due to the company stability. I also want to get my BSN (have a prior BS in psych.) I can do that going 1 night a week for 1.5 yrs. I want a schedule that is more flexible to go to school. I feel if I stay at the current job the director will prevent me from going to school (we alternate opening/closing weeks so 1 night a week she would always have to close and she works hard to get out of anything she can.) I interview for a nurse quality manager job with another hospital corp (i.e. not the one I previously worked for.) I didn't get that job, but, I guess I can sorta see why (perhaps, not enough pt. care experience) So, I decided to try to go back to the ER where I first started as a medic. I knew the people, the hospital, it was "home" so to speak. I talked to a couple of the nurses I had worked with before and they thought I would not have a problem getting back on. I talked to the ER manager (who was the there when I left, always got along excellent with her) about my intentions and she told me to put in an application. I had discussed the whole thing with my wife and she was fine my wanting to get another job (she encouraged it) and was fine with my the prospects of going to night shift shift. Well, I had an interview yesterday with the ER manager and one of the ER education members (who was a nursing student when I was there.) I thought everything went great. I was told there was 5 total interview for 3, possibly 4 slots. Well, I was notified by email today that I didn't get the position. I can't understand why. I have 2.5 yrs. in as RN, 9 years as a medic and 2 years managerial experience. I have all the ancillary course (ACLS, etc.) except for TNCC which is not a prerequisite. A TNCC is being held next month at that hospital. Strangely, an ER RN position posted today after I was told I wasn't accepted. This was for a 7p-7a job. I had applied for a 7a-7p OR a 7p-7a slot and told the ER manager that either would be fine (I did say 7a was preferred but not a deal breaker.) Should I apply for this new slot?? Should I contact the ER manager and find out why I was not chosen. I am afraid she will say it was because I have been out of direct pt. care for so long. If this is the case then how can I get back in?? After I left my interview I noticed that the nurse for the small ER that was the charge nurses' "pet" was working there now. Did she or another former employee slice my throat?? They have new grads with no experience now in the ER. I know the system and don't think it take long to get back up to speed. Also, in December they will be losing 6 nurses (5 on day shift) because they will finish up their FNP program. I do not want Med/Surg, ICU is a possibility but prefer the ER. I want to go back to where I was but don't see how now. I want to continue my education and get an MSN or MSN/MBA. I need the flexibility of a hospital job but I upset and not sure what to do next. I still work on the ambulance 1-2 days a month. I apologize for the length but I have a long story to tell. I should have stayed at the trauma ER to begin with, worked 5p-5a and would have gotten to move to days eventually. I tried to do what I thought was best for my wife and I and didn't. Please give any and all advice/criticisms/comments/etc. ASAP!!