Taking that first nursing job.....

[locolorenzo22, BSN, RN]

This is a vent/question thread so bear with me......

I'm graduating in may...and went to follow up interviews last friday.....and I was impressed! 2 out of the 3 managers were interested in the new grad environment, they pushed "shared decision making", good ratios, fully staffed floors with a "resource nurse" on each shift...of course, I know that I don't see the full picture. But the staff seemed happy, they were receptive to questions, the rooms have bedside computers and technology seems to be a big selling point....a "floor council" is used, and every member of it is assigned to certain staff nurses...to ensure that changes are communicated to staff......also, the facility has equipment, the break area actually has room, tables, chairs....a renovation is planned for this summer to make the nurses station functional. This is on a medical floor with telemetry...and they do NOT take surgeries...a fact that was stressed repeatedly during the interviews and tours.....one manager turned me out when she mentioned that the staff can be "catty" and how would I , as a male, deal with that environment.....ummmm, that's not painting the best picture to me.....

At my own hospital(where I work as a tech), I see the following: often communication occurs in a setting of "oh I posted the new protocol, didn't you read it?", there is OPEN animosity betweeen shifts....and often patient care suffers as a result. We have been working short tech wise for about 9 months and NOTHING has been done. we have light duty staff come in, and NO accounting for acuity of patients. Depending on which house supervisor is working, we can get swamped with admits. Nurses are often left to their own devices, and shift prefence is seen often. Recently, a patient was admitted at 0400....did not receive any meds until 1900.......due to day nurse not having signed off on orders from MD during morning. Had the situation been reversed, that PM nurse would have been in deep trouble....not so for days....when we are late(even by 1 min) we are given heck....however, often day nurses run behind, and even sign in when saying didn't swipe badge....(one nurse had 57 write ins in a 2 month period!!!)

fluids are often left empty, IVs beeping for an hour or more...wrong info given in reports (like a foley out for 10 hours and NO voiding happening yet....client did not void for 13 hours total....and reported as such to me when I was getting her VS). I know we don't live in a world where everyone is perfect....but it seems like there is such a dynamic on the floor, that I would be worried about the workload and safety of patients.

I'm also getting pressured from my NM and day team leader that I should "make a decision" soon....first off, I haven't even interviewed for the hospital yet! I also have not been offered any job in the hospital.....and I feel like I'm only going to be offered that floor position.....

I have nothing tying me to the area....except family 1/2 hour away. Friends in the area, but nothing that much....always saying that I could come back and visit off and on, since it is only 1 hr away....and it'd mean moving to a college town (for major big 10 uni).....I guess I'm just going though a syndrome of knowing that the grass isn't always greener. I LOVE the staff I work with...and know they ALL have my back if something happens. I'm trusted to know when problems are occuring, and have no problem if we have to be forceful with a patient(don't want to go to the commode? Well, I'm going to forcefully suggest that for a few minutes....then we'll do what we need to do....i.e. pan. etc....) I'm holding off on making the decision until I interview at my hospital.....and the money is less, but money isn't everything......

Thanks for reading...and any suggestions on what to look for/at deeper...please feel free to tell me.....

[MIA-RN]

It sounds like the hospital where you interviewed is seeking Magnet designation---much of what you talk about fits in with the Magnet ideals (shared governance etc). I would shadow there and then try to talk behind the scenes to some of the nurses. It wouldn't surprise me that the picture that is painted at the interview might be a little different than the reality. However, if its really true, and really that nice a place, then by all means go if you are so inclined. You are right that money isn't everything and if you can afford the difference, and the place is what you want, then go for it.

Your current place of employment sounds kind of unsafe, as you have noted yourself. I might not opt to stay there, were it my license.