Reassessment Nurse vs. Med-Surg

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Hello all, I am new to the site and this is the first thread I have posted. In fact I am new to nursing, which leads to my topic. I am asking for input about two separate nursing disciplines, which I have been offered a position. I appreciate your reading this and giving your input since it is a long comment.

After graduating as an RN in the AAS program (Associates Degree) and passing my NCLEX, I am working in a nursing home setting as a charge nurse. I hate it! Be that as it may. I have been offered two new positions:

The first is as a Reassessment Nurse for a reputable health insurance company. Let be clear, this is NOT a home healthcare nurse position. What it entails is performing UAS Assessments for New York State, at the patient's home, and can be described as assessing whether or not a home care patient's needs are being met, for instance; whether the caretaker is able to efficiently care for the patient; if there is food in the house; is there heat, air conditioning, adequate leisure, sleeping arrangements; if the environment is infested with bugs or rodents; the stage of disease, illness or pressure ulcer; are the meds being distributed properly and timely; the performance of the home healthcare nurse...and assessment in that nature. It also includes 6 month follow-ups (follow up from hospital discharge) and assessing whether a patient should be placed in a nursing home (LT) as well as collaborating with all other disciplines to propagate a stable plan of care. A boat load of computer work.

There is no detail that includes IV therapy, catheters, wound care, enemas etc., in fact, there is no need for a stethoscope. Here's the pros and cons from my perspective:

Pros: Wear regular clothes, 9-5 Monday thru Friday weekends off; starting salary 81,000/year ($40.00/hr) plus overtime (time and 1/2; $60.00/hr) after 11 cases per week; full benefits with moderate cotribution, 401k (company matches up to 6%), PTO (paid time off) 29 days per year; 3 to 5% pay increase per year available; bonuses for exemplary performance.

Cons: Travel time and expense; I live on Long Island (Suffolk County, Long Island is the only place in the world you live ON and not in) and cases are primarily in the 5 boroughs, office is in Manhattan, near WTC 19th floor (Tribeca);The company will pay for all travel occurring after the first case and until the last including tolls and MTA card, so getting to and from my home care cases or to the office is on me (approximately $3,500 per year); hard to continue BSN program (unable to get "clinical classes" in, can possibly use my PTO), 9-5 M-F and only leaves weekends for extra work to repair limousines and transmission overhauls (extra 30k/year) or, for instance, take on a job at a doctor's office; NO hospital experience what-so-ever.

The other position is as a med-surg nurse on a telemetry floor at a prominent university hospital, the same at which I attend school. I don't think I need to explain the position detail, you know what it entails. Pros and cons:

Pros: Hospital position, 3 and 4 day work weeks (80hrs per 2 weeks); easy to finish school; no travel time, I live literally 2 miles away; overtime available at time and a half (extra day per week); night position 7pm-7am, time to work another job (not much time to sleep, though).

Cons: Less pay, base pay $77,000/year ($37.00/hr); must work every other weekend; vacations are given as per seniority (which means my vacation will be in November or February); 6-8 sick days per year, 3 week vacations but not consecutive (so the same as above); health insurance comes from the ACA Exchange, so it costs a lot with a high deductible; and anybody who is a med-surge nurse knows what a *******' pain in the ass it is! No need to elaborate.

So that is the deal. I am fortunate to have two positions available after having NO positions available for some time. Many of these may be seen as pros and not cons or vise-versa. There is one more caveat, I am no spring chicken. After working for 25 years in the automotive business as a technician, humping cylinder heads and automatic transmissions, I have successfully reached the age of 48. I am in very good physical shape but I don't know if I have 20 years of med-surge in me; the reassessment nurse position has potential for management positions, so I thought I might just add that.

Any input will be appreciated and I am anxious to hear about your own experiences. Until then...Fuhgeddaboudit

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I don't know if this is the best section to post this considering we're mostly students/graduate nurses.

However these sound like amazing positions, i would personally go with telemetry considering you didnt do any real inpatient care in your first job. The other position sounds really good also but its something i would rather do after i retire or near retirement.

Good luck! :) you can't wrong with these amazing salaries.

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Thank you for your input. Actually at the nursing home I do a lot of inpatient care, like 13 hours a shift! It's a 40:1 patient to nurse ratio, and even though I am mostly on the desk (charge) I still do all the IVs, flushes and assessments that LPN aren't authorized to do.

It's funny that you mentioned retirement, I'm 48 years old, I've already retired from Ford, I'm on my next career.

Where do you think I should post this thread, please advise?

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Thank you for your input. Actually at the nursing home I do a lot of inpatient care, like 13 hours a shift! It's a 40:1 patient to nurse ratio, and even though I am mostly on the desk (charge) I still do all the IVs, flushes and assessments that LPN aren't authorized to do.

It's funny that you mentioned retirement, I'm 48 years old, I've already retired from Ford, I'm on my next career.

Where do you think I should post this thread, please advise?

You're welcome! and good luck :)

You will get alot more insightful responses in the general nursing discussion

https://allnurses.com/general-nursing-discussion/

Or here

https://allnurses.com/nursing-career-advice/

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Specializes in Hospice.

Best wishes. I loved med surg nursing. The other job seems a smidge boring ..... But sometimes boring is good[emoji12]

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

I think you should consider your long term goals. Which position will place you on a path that's headed toward your long term goals.

One job seems more administrative. Which could be good if you intend to stay away from the bedside / direct pt care and perhaps go into management.

The other gives you more bedside experience. This, I think is important if your intention is to work at the bedside in a specialty unit at some point.

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Yeah, that's it in a nutshell. The thing is I am looking to get into management, but I was thinking more in the clinical setting. The funny thing is, skills are my best attribute. I get lines started quickly, first try, never fumble with tubes, knock out catheters, chest tubes, PEG feedings, as a former auto tech my hand-eye coordination is key. But when I did my Psych rotation in school I loved the idea of not doing all that.

Well I have to decide soon, thanks for your input.

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Specializes in Med Surg.

This is also not my first career. Thing is, I think you get a lot out of that first year in med surg, whether you're 25, 45 or 55. So I would probably choose that one.

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It sounds like you'd prefer the reassessment position.

Someone else already gave the advice I'd of given, so I'll just leave it at that. :)

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