Should I switch from SNF to Clinic?

[newrnltc]

Hello all nurses,

I have been an RN working in LTC/skilled rehab... Sept will be 1 year.

At my current place my relationship with colleagues is pretty good/supportive but the hours are long, documentation for medicare horrendous. And depending on where I'm floated, the patient ratios can get pretty high. I like bedside nursing but alot of times I'm not able to give the level care I'd like nor have energy on my off days to continue my education. My permanent supervisor is not very supportive, gives me a crazy schedule due to "not enough staff" but is very reluctant to sign for OT/comp time.

Recently I got an offer to work with a very nice physician in her dermatology practice. I will be the first RN on her staff. She wants me to be in charge of her medical assistants, pursue prior authorizations for procedures and drugs for patients, and of course take part in patient care. She will pay for me to attend dermatology conferences and laser classes if I am interested.

At the SNF I work 5 days a week, alternate weekends (which is not always honored), 8 hour shifts. I have a pension and 401 that I contribute to myself, no match but I will be set in it after 5-7 years (it's with the city), free health insurance and I am on nights. I make about $70,000/yr.

The offer for the clinic is $60,000 with sign on bonus of $5000, 2% increase per annum if job performance is good, Year End bonus, 2 weeks of paid vacation; 1 week of CME time, Health Insurance, Retirement plan after 2 years of employment.

I imagine the clinic will be alot less stressful, hours more regular. Working for the city I believe is more stable in the long term but SNF is not where I want to stay. When I was a student I really enjoyed hospital med surg but I know it's different as a staff nurse vs student. I will get to participate in minor surgeries at the clinic.

For those of you that have left SNF do you regret it? For those of you that are still in there, if this offer was proposed to you would you take it? I would really love to hear everyone's opinion on this.

Sorry for the long post and thanks for listening! All the best!

[SHGR, MSN, RN, CNS]

The clinic sounds like a plum job. This doc is willing to invest in your education? Let you develop the position? Give you authority and autonomy? Give you regular hours??

Prior auths are easy once you get the hang of it. Get the PDF's online and just plug in the data- since we have EHR, I just cut paste cut paste etc print and fax. So much faster than MDS forms.

No contest! Congratulations on the job offer.