Will I be perceived as disloyal?

[rural-rn-15, ADN, BSN, RN]

I'm a new grad (May 15, licensed August of '15, thank you slow state BON) who's almost done with a new-grad rural-health-RN residency at my beloved critical-access hospital. My grandmother worked there, I was born there, my other grandmother LIVES there (in the SNF). I am deeply invested in my hospital and my town and I have no plans for leaving. (Plus the commute can't be beat. Seven miles, ten minutes.)

BUT. There are things I will never see if I go through my entire career and only work in my own district. Our hospital does not have L&D services. (In fact, our COUNTY has no L&D services). I've never seen a lady partsl birth. Our ER is busy and interesting, but critical cases divert to a nearby city or "hot-load" into the helicopter on our helipad and never come inside. I've never even performed chest compressions. (I can say that since I'm not at work, right?)

So I was thinking about finding out about applying for a per diem L&D/float position for new grads (18 months out or less) at a modest-sized hospital in a nearby city. I remember from reading the P&Ps when hired that this has to go through HR in some way. I do not want to 1) jeopardize my job or 2) make it look like I am a flight risk, after my employers have just invested tens of thousands of dollars training me across five departments. I repeat, I DON'T want to leave. It's not even about the money; I'd do it for free if the other hospital would let me. I just want to broaden my experience a bit, one eight-hour shift per week at a time.

Should I even bother trying at this point? Or should I wait a few years? The advantage of trying for the new-grad PD position is that applying as a new grad means I don't have to have a year of L&D experience to apply, and I can obtain various certifications after being hired instead of having to have them in advance.

[Penelope_Pitstop, BSN, RN]

Here is my concern about this...

just because THE POSITION is per diem...well, it does not mean orientation is part-time! Oftentimes orientation is full-time because that makes you "staff" quicker. So you'd need several weeks available for that. (L&D orientation for a new grad, in my opinion, should be at the very least 12 weeks - I got 12 weeks as an RN with ICU experience!)

Just some food for thought.

[rural-rn-15, ADN, BSN, RN]

Here is my concern about this...

just because THE POSITION is per diem...well, it does not mean orientation is part-time! Oftentimes orientation is full-time because that makes you "staff" quicker. So you'd need several weeks available for that. (L&D orientation for a new grad, in my opinion, should be at the very least 12 weeks - I got 12 weeks as an RN with ICU experience!)

Just some food for thought.

True. I had wondered how that would work. Thank you for the reply.

[Maevish, ASN, RN]

Don't worry about not doing chest compressions yet lol I was on the floor for nearly 6 months (I think more, but I'm not 100%) before I needed to do that. Haven't even done any in the last year or so as an ICU nurse, so don't fret about that. :)

xo

[jadelpn, LPN, EMT-B]

Loyalty is not a bad thing, but sometimes a thing of the past. All is fine, well and good until the hospital is gobbled up by big business (and small community hospitals that stay solvent is not common these days). Then things change for the worst as far as your nursing career, and your loyalty would mean nothing.

I am just saying this because you should be able to do some per diem in a hospital where you will get some different/varied nursing practice under your belt. You never know what the future holds for the facility.

I worked in the same small hospital that generations of my family did as well. The hospital I was born in. As an LPN, myself and many other LPN's worked every department in the place, and knew it like the backs of our hands. Can't even put into words how much I loved my job. We did not keep critical patients, either. But to be IV certified, wound care certified, hospice certified--to be able to dabble in this and that and be cross trained--it was awesome.

With all that being said, there were rumors here and there about financial hardships. That the facility was actively looking for assistance from a larger parent company. Not sure we thought it would actually happen. And then it did. The moment that big company took over, everything changed in what seemed like a moment. And not just for the group of LPNs. For everyone. BSN only, period. There were ADN nurses and LPN's that had been there for 30 years or more!! ADN (and at least 2 diploma RN's who had been at the facility for 40+ years) managers demoted. LPN's can take a hike, or take a non-nursing job. BSN's with little to no experience took over--and our very small town group of patients didn't know what to think. Only that the nurses that they knew for generations had all but disappeared. Or LPN's who "always got their IV in the first time" stood by helplessly while they got stuck over and over....or that "pain in the butt guy in room 634" was really just an old time character who just needed gentle but firm direction. Or that you could set your clock by Mrs. Smith and her every 6 month drive to Vegas with her sister, and subsequent lack of Lasix taking... (and I can remember the calls to the MD on call "Mrs. Smith is back from Vegas" "Give her my best, hope she hit the jackpot, and 60mg IV Lasix...let me know if she's not putting out at least a liter in the next 4 hours, ok? And put that commode right beside her bed and NO she can't run to the ladies instead..." Ah, the good old days...)

My point to this example is that YOU, OP, can be as loyal as you would like to be. Don't think for one moment your facility feels the same way, or will continue to feel the same way should it go the same way. You need to do what you can for the future of your career. And if that means PRN for an alternate set of experiences, then go for it. You always can use another option.

Best wishes!

[HouTx, BSN, MSN, EdD]

The issues you've identified are common with many rural/critical access facilities. I urge you to put together a clear and concise 'project plan' to address them.... provide data about the lack of opportunities to practice those emergency response skills that need to maintained for the safe care of your patient population. Then, you can work on the development of creative training plans - maybe purchase a high-tech simulation manikin? Partnering with your tertiary receiving hospital? Collaborating with your local emergency services & nursing schools in a joint training initiative?

In many cases, there are a lot of funding opportunities for "underserved" populations that you could tap into, especially if your patient population has any distinctive characteristics that may interest a foundation.

[Ruby Vee, BSN]

As a relatively new grad (less than a year after licensure), I think you should concentrate on one job until you become competent -- a process that usually takes about two years. As you've trained across five departments, it may take longer. Once you're truly competent where you are, you'll be in a better position to soak up experiences in a new position, and you'll be more valuable to the new hospital. Just my two cents.

[RNOTODAY, BSN, RN]

Don't worry about being considered disloyal... managers know the score , they do not take this stuff personally at all... you do what you want and think you need for YOUR career, because you are the only one who's concerned about it, or worried about it.