Seeking advice on which job to take

[Ms Blue Sky]

Dear nursing angels

I'm an MSc learning disability nurse and been doing my final year placement in a brain injury unit

I've been lucky enough to have been offered two jobs for when I graduate and both are appealing in different ways

1) Dementia floor in a nursing home - sole charge of floor but with support of managers who are always around and promised support from other nurses - dementia nursing is very appealing to me but it sounds daunting. It is up the road from me, the money is OK but not wonderful. I feel quite unconfident in clinical skills and this would not require that many as it is the dementia floor. I love helping others feel good and helping to provide a warm family homely atmosphere appeals 

2) Rehab nurse in a brain injury unit with a Preceptorship, the money is good, the training will be extensive. Further to travel and would need to move about ten miles or a bit more from where I am now but close enough to family and friends. Again the work of transforming other people's lives is appealing to me and I enjoy assessment. This sounds more exciting possibly than the nursing home and there would fortunately be no tubes or tracheostomy care which was good 

Advice from most is the brain injury unit! However I have also had an enormously stressful past two years and feel I could do with something more stress free and challenging, which may be the dementia home nearby, as a friend also pointed out it would be easier to do for a bit perhaps

Would anyone know from experience as well, which job would demand you to supervise and take charge of health care assistants the most and this is one aspect I find the sound of a bit daunting - I think in the rehab facility, the rehab team would be more of an autonomous unit and there would be more overseeing in the nursing home

The staff seemed nice in both but the second one had more of a lively feel 

Would appreciate so much any words of wisdom anybody has - thank you and best wishes 

Ms Blue Sky x

 

[Blatant Shannon]

You have quite a choice to make. As a nurse, I always look at the team dynamics and informal leaders within the walls of any facility I am looking to work at. There's also the amount of learning you can gain from your team. I recommend choosing a place not based solely on location, but on how you feel going into work.

Close your eyes and imagine a couple of months down the road and you're going to work one day. Do you think you would feel good about the job? If you say yes, then you made the right choice. Remember, no job is worth your loss of happiness and growth. I recommend choosing which ever consists of both happiness and growth. 

[Ms Blue Sky]

Thank you so much for replying to me, you made my day ?

I'll check in a little later after trying what you suggest as I need to go out now, it is a tough decision, speak soon XO

[Ms Blue Sky]

I think, reading your reply, I'd feel much better going into my first nursing job as a Preceptee with a Mentor

The thought of not having support is scary for me and I should imagine that the other nurses will be busy on their own floors in the care home

I was also told at the care home interview that some of their carers are challenging and asked how I would deal with this, I don't feel strong enough to handle challenging carers right now I don't think!

On the other hand when I think about walking into work one day I feel more confident with the care home, as it's near my house in an area I know 

I am so bad at making decisions haahah

But I do feel like I'd need some hand holding in my first nursing role and feel I wouldn't get that at the care home 

I think both would offer growth but I'd feel much happier with the Preceptorship 

There is no official Preceptorship in the care home and also, in the one with the Preceptorship, I would progress up a grade on completion XOXO 

I've also already been working in brain injury and have experience with PEG feeding, care of stoma sites, common problems experienced such as urine retention / challenging behaviours, helping to ease depression etc 

Thank you again! ?

[Hannahbanana, BSN, MSN]

Don’t think you won’t see “trachs and tubes” in a brain injury unit! People who get hurt bad enough to damage their brains may have had other injuries. 
But trust me on this, they won’t be remotely so scary after a week or two. Your mentor will help you. Taking the precepted position is (you should pardon the expression) a no-brainer, LOL. If you want to go to a different setting later you’ll have acquired a lot of great knowledge to take with you. Good luck!

[Ms Blue Sky]

LOL yes a no-brainer indeed hehe

I have used trachs and tubes luckily, I'm using them now but in this particular unit, my Mentor told me it would mainly be PEG feeds and catheterisation, I guess because it's transitional, getting people fit enough for the community so they are not too severe in their needs 

You are right about the knowledge, they told me read up all about brain injury, there's a lot to learn which I think I will find fascinating

There's no choice really with the Preceptorship being offered - our university tutors advised, so does the NMC, that newly qualified nurses should always seek a Preceptorship ideally when they graduate

Thank you Hannahbanana, love the name! ? X and thanks for the validation

 

[Ms Blue Sky]

ps. 51 years experience! Wow X

Yes, I could always move to another setting as well ? I keep forgetting that, there are a lot of options 

Also, for the interview as well, the care home interview was brief and easy with questions about wound dressing, dysphasia and managing care staff 

But for the Preceptorship you had to do ten in depth scenario questions and a drugs calculations test, so I feel I'd learn more there because they seemed to want to you to be of a high standard which makes me think their training programme must be a good one and they are serious about providing good care 

[Golden_RN, MSN]

Is the brain injury unit considered 'acute rehab'?  If so, I think this will give you the best foundation to either go to a different acute unit OR go into dementia care/LTC later on.  I also support the brain injury unit since they are stating that training will be extensive.  If it is primarily RNs on the unit, there will be much less supervision of aides compared to the dementia care unit.

SNFs often give very little training, and being in charge can be very stressful.  You'll be a new grad, but supervising lots of staff, be responsible for the care provided, learning lots of regulations and probably be pulled to the floor when short staffed.  I happen to love LTC nursing, and if you want a career in dementia care, then go for it.  But experience in a higher acuity unit (like the brain injury unit) is never a bad thing.  There will ALWAYS be jobs in LTC later on.

[Ms Blue Sky]

Hello Golden!

Thank you so much for your kindness and your encouragement and this is the option I'm going for now

It is considered "acute rehab" and they offer ten days of induction plus all the Preceptorship whereas the home offers virtually nothing - when I scanned through the small print I also saw that the home offers 16.8 days of paid holiday per year whereas the brain injury unit offers six weeks, which was another plus for the brain injury unit!

I do think it's far too early for me to take a job in which I'd be running the show, I haven't really supervised much before and there will be about 20 residents to take care of and ensure that they are being cared for ?

Some day I'd love to go into dementia care and you're right, there will always be care home jobs around

I'd get to use my skills more at the moment in the brain injury unit as well, such as PEG feeding / my knowledge of brain injury

Thanks again, so grateful as this has helped me, to know that the supervision of carers is usually far more intensive within nursing homes as well

Love X MBS