What would you do? Sorry so long!

[KellyCCRN]

Ok here is my dilema...... I been working in a hospital ran acute RDU for right at a year now, I actually kind of fell into the position because I needed more hours. A little background.....I have worked in the same hospital my entire nursing career. I started off as a new grad working nights on a med/tele floor then quickly went on to working float in ICU (a combined CCU/MICU/SICU), EC, and the surgical floor as needed. After nearly three years on nights I finally went to a dayshift PRN position on the Med/tele floor but still floated some to surg/CCU/EC which worked much better for my family. Well last year the census drastically dropped after february and even some FTE's were getting called off shifts. I floated to the Vascular access lab and PACU everywhere I could trying to get in hours but was still struggling for shifts. I was used to getting in 86hrs a payperiod as a PRN employee and was getting nowhere near that. To make a long story short a friend/former coworker is the Director of CCU/Dialysis/Vascular lab offered me a position in acute dialysis which I took. I had never really wanted to work in dialysis but figured it would be a great learning opportunity and it definitely has been. I learned the ropes quite quickly and have earned alot of respect from the nephrologists I work with. I work in a small unit with 5 bays, we have 5 nurses on staff (one who is on maternity leave right now) and 1 PCT. I charge M-F, work one saturday a month (unless more is needed, which often is), take call one full weekend a month and usually 2-3 nights during the week. I usually average 90 hrs worked in a payperiod. Now here is where my dilema comes in I just recently found out that our RDU is going to be contracted out to the company who owns all of the chronic units in the area (6 total), they also contract the other hospital RDU in town and all of the area nephrologists act as medical directors of the units. We are not sure when the changover is going to take place....have heard possibly as soon as July. The nephrologists are really pushing me to to stay and sign over to the company that is taking over. The company in question has a great reputation as a nonprofit with good pay and benefits and generally very high employee satisfaction that truly puts the patient's best interest first. I know several people who work for them who are very happy. My director has said that he will support my decision regardless what I choose but that he would really hate to loose me as a employee and would open a PRN dayshift position in ICU for me if I choose to stay with the hospital (which is next to impossible to get) and I would still have the option to float if the census drops in ICU. I have also been approached about training in Nursing Admin as a PRN house supervisor. At this point I just have no idea what to do. I enjoy dialysis for the most part and really enjoy working with the nephrologist, but the call and unpredictable schedule is draining. I like the routine of HD but also really miss crititical care. If you actually made it this far:yeah:what would you do?

Thanks,

Kelly

[traumaRUs, MSN, APRN]

Whew! Its nice to have options. Depending on the economy in your area, I would stay with the hospital. To be honest, you can probably still work prn at the dialysis unit if you want.

[Tish88]

I would stay with the hospital and get hired on per diem with the dialysis company. When you are not getting enough hours there at the hospital, you could do some per diem acute treatments.