Two job offers. Help me make a decision!

[Kerploink]

Background: Finished BSN in January, worked 2 months in NICU, 1 month in Acute Care. Doing more med/surge is not an option - I'd rather change profession entirely.

Ok! On with the show.

Job A: Acute Dialysis in the most prestigious hospital in the country. 1:2 patient ratio. Will also be taught AB0 apheresis, immunoabsorbtion and plasma separation. Will always be in in the room with minimum one more RN (only RNs working there. No doctors, no nothing (they can be called quickly, obviously)). 7½ hour shifts with 30 minute break.

Job B: Chronics in a nice hospital. 1:2½ patient ratio. A few acutes now and then, but it seems like it'll be 95% chronics. Always minimum one more RN in the room. Only RNs working there. 7 hour shifts with ½ hour break and 1 hour scheduled education and/or chatting each shift. There's no turnover.

Both have a minimum of 2 months training.

So which do I choose? I want job A because it seems to offer an amazing package of skills I can learn and I'll get experience with all kinds of critical situations MUCH more quickly than with the other job. I'm also thinking this job will look better on paper if I later want to go into a different specialty such as anaesthesiology (just an example). I want job B because it seems much more laid back and a sweet deal over all. I'm also a bit scared that I'll be overwhelmed by job A and I really want to stay in one position for a year now. On the other hand, I'm scared that job B won't look good enough on paper if I want to switch to something else in a year or so and that my skills in general won't develop outside of handling a machine.

Thoughts? And as many of them as possible, please!

[Tish88]

If you are looking into anesthesia in the future, most schools require a minimum of 1 year of recent ICU experience before applying. That is for CRNA school.

How many patients are being dialyzed in the chronic unit at a time? How did you get a ratio of 1:2 1/2 patients? My chronic unit is 1 RN to 20 patients and also uses 4-5 pct's.

If you are going to do acute hemodialysis and pheresis treatments, you will need more than 2 months worth of training, especially since you have no real nursing background.

I personally don't think dialysis is a place for new grads. You need to have a nursing background and be able to function independently in an emergency situation.

When I started over 20+ years ago doing acutes ( hemo and pheresis), you needed to have at least 1 year of ICU skills before you would even be considered for acute hemo/pheresis treatments.

[Kerploink]

CRNAs don't go to school as such, here. We are in apprenticeship for 2 years with full pay and some weeks of school here and there during that period. Apparently, acute dialysis nurses stand a very good chance of getting into such a program.

I'm not in the US. Chronics are treated in a hospitals here, there are only RNs and the ratio is 1 RN:2½ patients. There is no privatization in regards to dialysis.

As for the acute job, again, this isn't the US, so conditions are totally different. I'll be trained for 2-3 months, start with stable patients and then after 6-12 months start training with pheresis, unstable patients and all that in gradual steps. Nothing will happen before both I and my employers are happy to go on to the next step.

Both settings are staffed only with RNs in this country and I will never be without at least one experienced dialysis nurse in the same room.

It will be one of these two jobs. Have to give my answer in 10 hours and still can't make up my mind!

I guess my real question is this:

Is the experience I would get in an acute setting (as described above) of such professional value further on in my career that it is preferable to a more laid-back job in a chronic setting (as described above), or will the chronic setting be more than enough for a year or two.

[Kerploink]

I made my choice so replies are no longer necessary.