Would you pick the hospital medsurg job or the subacute rehab job?

[kmend11]

Hello, newly licensed RN looking for advice. I recently received a job offer as a medsurg nurse at a small community hospital and a job offer at a subacute rehab unit at a skilled nursing facility. The medsurg hospital job is located 1 hr to 1hr 10mins drive from my house, the subacute rehab job is 20-25mins from my house. I would make slightly more per year at the hospital medsurg job b/c of night shift diferential, appx. 5,000-6,000 more per yr. There's no shift differential at the subacute rehab place, However i also don't really want to drive 1 hr+ to work depending on how traffic is and i see i'll be using up a lot of gas and snow season will be a tough commute. In regards to experience, i'll get about the same experience. The subacute rehab place get's a lot of complex and variety of cases, similar to what you would see on a medsurg floor in the hospital and they told me in the interview it's basically a medsurg floor that I would be on. The hours are 36 hours per week, 7P-7A, 3 shifts per week for the hospital job, 1 weekend per month and every other holiday. The subacute place is 40 hours, 5 days per week, 3P-11P. I like that I don't have to work overnight shift since I'm more of a day and evening person. Patient ratio is 6-8 for the hospital, and 10-14 for the subacute rehab. What do you guys think?. Pros, I do like working only an 8 hr shift but you also get more days off with the hospital. Such a tough decision

[Curious1alwys, BSN, RN]

Night shift without diff? NO WAY, lol

Hospital. It will go further to count as real experience for you as it is "acute care". Don't ever take a night shift without diff, ugh. Plus, I think 8 hr shifts will suck. That's 5 days a week.

[kmend11]

Thank you! I ended up choosing the sub-acute rehab place. I'll be working 3-11, no nights (11-7). I think acute care experience will definitely be much better but the hospital is just to far from my house and I won't make much more money. And I don't really want to work nights to be honest, i feel that would mess up my routine/health. 8 hours shifts do suck but the job is much closer to my house. When I'm able to get a hospital job closer to my house or something else that's better paying, I'll take that down the road.

[TheCommuter, BSN, RN]

Med/surg is hard work. Subacute rehab is hard work...

If I were presented with the two options, I'd select the med/surg position due to the better pay and hours. I've worked 8-hour shifts in subacute rehab and, to me, it felt like hell on earth.

[NurseGirl525, ASN, RN]

3 days opposed to five? I'd prefer to get my 36 in 3 days.

I Saw you took the subacute. You have to do what is right for you and nobody else.

[kmend11]

I'd only make a buck more at the hospital job + the night shift differential, i calculated to about 5k more per year but the hospital is also 2.5x the distance from my house as opposed to the subacute place, 1-1hr 10mins vs 20-25mins. There are nearer hospitals to my house but it's more competitive to obtain a job + to be honest im not really sure i even want to work in a hospital. I was even considering home health or public health down the road or even just going into management down the road at the subacute place. They told me if i get 2 years under my belt, they have openings for management positions. In the hospital i don't feel id get this kind of opportunity.

[Libby1987]

I see that you've already chosen the rehab, you didn't give anytime to receive any feedback.

So in hindsight, your choice at this point should be based primarily on which will most likely be a successful 1st year as a new grad.

Nights an hour away, nothing to take lightly.

Neither is nearly double the patients of almost comparable acuity.

Try not to think in terms of pay right now (if that's remotely feasible) and more of an extension of school. It's all about setting yourself up for where you want to be for the rest/majority of your career. Both of these will give you a strong start, now which one can you most likely be successful?

[kmend11]

Both jobs will be difficult, i like not having to work over nights and not having to drive 1hr+ to work which is why i ultimately chose the subacute rehab place. Your right, pay isn't impt as a new grad, this is just something temporary until i move on to something better work wise and better paying. I can technically apply for hospital jobs near me while im doing this job but i'm not sure yet if i'd like to go into the hospital as there are other areas nurses can work in and still make good money.

I see that you've already chosen the rehab, you didn't give anytime to receive any feedback.

So in hindsight, your choice at this point should be based primarily on which will most likely be a successful 1st year as a new grad.

Nights an hour away, nothing to take lightly.

Neither is nearly double the patients of almost comparable acuity.

Try not to think in terms of pay right now (if that's remotely feasible) and more of an extension of school. It's all about setting yourself up for where you want to be for the rest/majority of your career. Both of these will give you a strong start, now which one can you most likely be successful?

[Not_A_Hat_Person, RN]

I'd choose Med-Surg, because hospital experience opens more doors than non-hospital experience.

[LizRN572, BSN, MSN]

This is 7 years later here I am replying to this but I think it would help future new grads. I've been a nurse now for 6 years. I made the same mistake as the poster and worked at a subacute center for various/life reasons. I also didn't feel fully ready as a new nurse to work in a hospital when I first graduated. I opted to take less stressful/less bullying jobs first so I could get the hang of the nurse flow if you will, and some skills, so that way no one had a reason to bully me at any hospital! (Since that's where bullying happens the most, especially to new grads ?). That scared me and I didn't want to walk right into that. Considering all of that, now looking back, I wish I did put myself in to the Hospital as a new grad. Reason being, a FEW may be more snobby/bullies but as a whole, people work with you better and are understanding of your newness. Also, the time will fly, and all the sudden you'll find yourself with a years experience of ACUTE care. Even though I've been a nurse for 6 years, it's harder for me to get accepted/get chosen last for any acute position. 

One year of Acute care unfortunately beats 6 years of Subacute care (☹️) and I didn't know that at the time of being a baby nurse. I just did whatever I thought was best and safest for me at the time.

 

I think that if bullying wasn't an issue, and if there were more opportunities for residency programs for non-newby nurses, we'd have more experienced nurses in hospitals, and perhaps more nurses not quitting as a whole. And we need every nurse we can get.

 

If I were this poster, I would move homes just to take the hospital job, because after her one year she'll realize how much harder it will be to get any acute job no longer a New Grad nurse. Take that Hospital job right out of school, you'll make it. You'll survive, and you'll be able to use your bully experiences to help others later down the road. It won't kill you, but not being able to be as hire-able later in your career will.

Take the Hospital job new grads!! Xo 

[mmc51264, BSN, MSN, RN]

I did sub acute ortho rehab. 15+ pts, learned time management  REALLY fast. Now on and ortho/trauma unit. Wouldn't go back. Almost took a PRN job at another place in an acute rehab. Old classmate had left there and said "run" I love working in the hosp. Much more options and better money