Two INCREDIBLE offers!? New grad needing career advice! (ER vs PICU)

Nurses General Nursing


Hi everyone! Very conflicted new grad needing major advice here!

I have been a tech in an ER for nearly two years now and absolutely LOVE the community hospital where I work. I have learned an incredible amount in the short while that I've spent here and am so thankful for all of the opportunities I have gotten because I was an ER tech.

I have however accepted a job offer from my dream hospital (a different hospital, level I trauma, very large hospital) in the Pediatric ICU! I have always wanted to work at this hospital on this exact unit, in fact it's why I went to nursing school in the first place. I can't believe I actually landed this job and am so happy that I can pursue this passion of mine. I got great vibes during my interview and have shadowed numerous times, as well as volunteered at this hospital in the past.

My dilemma is my last day in the ER approaches (next week) I'm having second thoughts. I've made a pros and cons list and want to get some input from everyone.


Familiar setting

Have established great rapport with doctors

Truly respect my manager. She's the best person I've ever worked for.

LOVE my coworkers to death. The most phenomenal nurses/techs/docs I've ever seen during my 3 years in health care/2 years in nursing school

Think that I could excel quickly given that I'm already a tech who can draw labs, start IV's, hang fluids, preform EKG's, help triage, do some assessments, and interpret lab values

Great benefits, this hospital gives me tons of PTO, and I'd have seniority in schedule sign ups.


Definitely a little burnt out from all the drug seekers/frequent fliers/ungrateful finger pain patients

Not really that passionate about being an ER nurse

Can get up to 10 PT's at a time (This hospital has team nursing...2 nurses and one tech care for up to 10 patients)

EXTREMELY exhausting. I think ER nursing is the hardest nursing that there is. (Just an opinion of mine)


Not a trauma center...critical patients/high acuity isn't seen that often


Passionate about critically ill peds patients

Know for a fact I'll never lose my compassion for sick kiddos

Lighter patient load (1 PT to 1 Nurse or 2 PTs to 1 Nurse)

Year long orientation period (fellowship program)

Fresh, new start which I think I really need

Level I trauma center with very high acuity


Rotating shifts (I'm a night shift person)

Have heard that the nurses here are cliquey

Unfamiliar setting, no seniority, no rapport or trust with coworkers yet

People say nurses at this hospital are robots because of the hospital system?

What are your thoughts? Should I begin as a new grad in the ER where I am already familiar/comfortable or take the leap and go for the job I have always wanted!? (Which I may very well end up hating...who knows!)

PS a plus is that my manager in the ER did say she would be more than willing to hire me back as a nurse if I ever wanted to come theres that!

Specializes in PICU.

I say go with the PICU:

Especially because of this


Definitely a little burnt out from all the drug seekers/frequent fliers/ungrateful finger pain patients

Not really that passionate about being an ER nurse"

You stated that you were passionate about PICU. Have you shadowed there? Cliquey nurses are every where and sometimes even it is a perception of cliqueness.

Year long fellowship sounds really nice and well supported.

Specializes in Nurse Leader specializing in Labor & Delivery.

Seeing how your ER manager has pretty much guaranteed you a job if you decide to go back, I think you would regret passing up the PICU opportunity. Look at it this way - you do a year or two there, decide you really want to go back to ED, and go back. Or, you decide you LOVE it, and you stay.

Take the PICU job. The community ED jobs will always be available, but PICU spots are rare.

Think of it this way- in my area are 3 large hospitals that have PICUs. None of the other smaller/ community hospitals have them. Each PICU has 15-20 beds. Out of all the hospital bed space in this metro area, there are only 55 PICU beds, and only a handful of nurses to work there.

If you have the opportunity to get what you want right out of school, be adventurous and take the job.

Don't be too quick to buy into the idea about cliquey nurses; that is a very subjective, second hand judgement. Give people a chance.

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