DavidDudley

ICU is tough. I recently cross trained there from the ER. I quickly found out that it was way too overwhelming for me and I got out of there real quick. And I have almost 4 years of nursing experience, half of which has been in the ER. So don't feel bad.

Your still going to have this particular problem in the ER as well. No getting around it. At least 50% of the people that come in through my door are not satisfied no matter what we do for them.

Home health probably offers one of the most flexible schedule you can find in nursing. Not strapped down to a facility for so many hours in a day, can see 2-3 patients real quick in their homes and spend the rest of the day at home.

Yeah I agree with the other posters, stay there for a whole year at least. However, I do know that the Hawaii job market is horrible. It really depends on your personal circumstances. Do you have anything thats preventing you from relocating or do you have the flexibility to utilize the whole USA as your playground for job hunting? Getting a hospital job in Hawaii with SNF experience is extremely slim, but if your applying across the USA with at least 1 year of SNF experience then your chances are significantly higher.

I would definitely go for the ICU position. It is very important that you keep your foot in the door with your med/surg position because if for whatever reason you don't like that ICU position, at least you have something to fall back on that you know you like. I know from experience because I had recently cross trained from the ER to ICU at my hospital and before I realized it, I absolutely hated ICU and wanted out real quick. So always keep that safety net until you find out for sure that this particular ICU position, at that hospital, with that staff, works well for you. Good luck.

Perhaps maybe you misunderstood me. The SNF position was my first RN job. I don't currently work in a SNF. I currently work in the ER.

Every job is going to advertise at least one year experience minimum. The key is to just simply ignore that. Everyone that I know has landed jobs and their not all new grad hospital jobs. LTC and SNF facilities seem to be the most willing to hire new grads because such facilities are the least desirable to work in due to their harsh high stress job requirements. When I got my first job in a SNF as a new grad, they literally hired me on the spot without even interviewing me. And I live in Southern California.

In my case, the shift from non-acute care to acute care did not result in better pay. I actually took a drastic pay cut, like a 2 grand a month pay cut. However, I enjoy my current work environment so much compared to my previous one that it is a price that I pay gladly.

Everyone so far has given great responses to the OP question. For me personally, as someone who did NOT start off in acute care, I wanted to go to acute care to fully utilize and maximize my physical and mental capabilities as a nurse. Essentially I wanted top action and a feeling that I have had a strong impact on the world and not to merely just make a paycheck doing routine mundane work. My nursing career started off by working on a subacute floor in a SNF, home health, and corrections... All non - hospital jobs and all those jobs made me feel the same way, bored and under utilized. I didn't have a love and passion for nursing until I finally started my career in the ER.

To OP: So much focus on getting into a new grad program. Your currently working as an LVN but aside from applying for hospital new grad programs have you also applied for non-hospital RN positions? I personally never been in a new grad program before. My first job was in a SNF on their sub-acute floor, then went to corrections, then to the ER. No new grad program. When I was a new grad having problems finding a job i was told to work as an LVN until I could eventually secure an RN Spot.. To me that's a mistake. Any RN experience will contribute to you reaching your goals, but not so much LVN experience.

The main factor for me is the quality of my coworkers and management. Unfortunately, you won't know until you actually start working the job

If your heart is set to work in the ER then find a way to make it to the interview while maintaining the case manager job. If you have to lie and say that you have a family emergency or whatever you can come up with then do it. I worked home health early in my nursing career and absolutely hated it. I didn't start love being a nurse until I got to the ER.

OR - way too boring and nurse does almost nothing

Yes almost everyone in the ER gets a chest X-ray but there are times when the doc is not immediately available to see a patient and your immediate physical assessment is necessary to determine whether the patient can wait or needs to be seen by the doc as soon as possible. I've identified spontaneous pneumo's with my stethoscope which I would not have otherwise spotted had I not had a stethoscope. Yes the X-ray would have shown the pneumo but the diagnosis and treatment would have been significantly delayed. I've used NG tubes per the doc based on my stethoscope alone and no xray verification. Let's not forget that resources are generally limited and radiology may not always be able to come immediately for your X-ray orders. In cases like that, patient's lives may hang on your ability to physically assess and prioritize in the moment.

I have worked both home health and corrections and I personally hate them both. Which one you should do ultimately depends on your personality and what you like. I'll briefly breakdown some pros and cons with both options. Home health pros - very flexible schedule, you work alone (for the most part), you spend a lot of time in your car driving, you get to focus on strictly one patient at a time as opposed to being stretched thin with multiple patients in a hospital or SNF setting cons - endless massive charting(you will take your work home), being called out of the comfort of your home to go see a patient when your most relaxed and comfortable, always being audited for anything and everything Corrections pros - great retirement and benefits, autonomy, physically easy job cons - not much team nursing, your pretty much it. Needy and deceptive inmates, backstabbing and gossiping nurses, management that makes your life hell, lack of appreciation from management, absurd prison politics As far as money goes, there's alot of money that can be made in both areas, but how much money you make in home health comes down to how many patients your willing to see.