1 year decision: contract job vs perm, need advice

Ginger's Mom, MSN, RN · Oct 30, 2011

You are not qualified for temp nursing, you have had 2 jobs and have not found your comfort zone, do you think after one week you will be comfortable .....even if you are getting great pay? Do you think you have the skill to adapt after one week?

Perhaps hospital nursing isn't for you. Or you need to stay in a position longer than 6 months. Jumping around does not look good on a resume. Do you think your resume will look better with 1.5 years experience and three positions?

ruralgirl08 · Oct 30, 2011

I think you should take the tele position. Take it from someone who was in a similar boat as a new grad. I had two temp. positions in my first year, and even though I was exposed to new skills, I never developed that comfort zone and confidence in my first year, and also almost left nursing. Once I took a permanent position, and grew some roots, I was able to develop more as a nurse. You need a solid foundation to grow, and from there you can figure out where you want to be.

ukstudent · Oct 30, 2011

You do not have enough experience to do contract nursing. The agency will tell you anything to get you on their books. When hospitals look at agency nurses they normally want at least one year of experience (that is one full year after orientation) and most want a minimum of two years.

That experience has to be in the type of contract nursing you will be doing. So if you have only done med-surg nursing you will NOT get experience in other areas while being a contract nurse.

However, any hospital willing to take you as an agency nurse will as little on your own nursing as you say you have, will most likely be desperate for warm bodies. That normally equates with it being close to hell on earth. You will then possibly quit prior to the contract ending (having to pay back money to the agency) or the other bad possibility is that the hospital fires you prior to the end of the contract (because it will be very difficult for you to keep up) and you will have to pay back money to the agency.

So, take the tele job if you get an offer and stay a minimum of two years even if you don't feel comfortable.

kcmylorn · Oct 30, 2011

I agree with Ginger's mom. Agency nursing is a hit the ground running position. I did agency travel for 3 years. I had over 25 yrs experience when I did it. The orientation is not 1 week it more like 3 shifts. 2 of those shifts are not on the floor- it's learning the computer system and the paperwork of the facitlity. It is an abreviated orientation that the facity designs specifically for the agency nurses. I takes years of experience to be comfortable/secure in your skills. You have to be prepaered to go in there with the attitude that if no one will help you, that's ok, because you can function independently, because with agency there is alot of resentment from the regular staff, agency is perseceived as a glam or higher paying job. As an agency you will be given the worst assignment on the unit for the most part, the world's worst problem patient, the poopiest patient, the hot mess patient, the scattered assignment- patients located on the 4 cornors of the earth(unit) where you need a bus fare to get you to each room.

I did telemetry for 8 years: 2002-2010. Telemetry is a rough sport. It takes at least 1 year to find your comfort zone especially being a inexperienced nurse. That comfort zone only comes with sticking it out( repeat that ten times) and experiencing different situations in that given speciality. Comfort zone is being unphased by anything trown your way, the ability to draw from you personal experience base and knowing you have seen mostly every patient senario that comes your way and when one that you have not encountered comes your way you feel confident to meet that challenge ahead, drawing form you experience, critically think that situation through and carry through wilth a safe implementation and if that approach didn't work, try something else- the ability to be creative safely- (example: dressing change anchoring, If the standard way doesnt work, what other way, but in the rules of safe practice, can you anchor a dressing with out the patient loosing a limb from lack of circulation.) As an agency nurse you also have to have a sound footing as to what is safe pratice and when the short cuts you are seeing from the regular staff are not sound clinical judgement- you have to know the correct way to do it. As an agency- you are on your own, relying on yourself. You see alot of fumbling in this new found hospital nursing work force- the old experience nurse is few and far between anymore, they chased us out. My generation of nurses had older experienced nurses around to ask when we were baby nurses. The reality is, the administration doesn't care until some patient is seriously injured or dies. The administration wants a cheap workforce, in at 7 and out at 7 and nothing more.

I, as an older nurse stepped waaaay out of my very comfortable zone- adult age group only acute care hospital bedside 30 yr nursing because of this job market for older experienced nurses( they don't want us because of the payscale and we will not stand by like lambs to the slaughter with their corporate BS - different forum rant) to a family health outpatient clinic. I now have some peds patients-little people OMG!! It took me at least 6 months to find my comfort zone in this position. I felt like crying every day, I felt like the dumbest nurse on the block, I didn't know the simplest things. I was 'totally' lost. My world was for 30 yrs- bells, whistles, IV meds, pumps, stats, codes, RRT's, ACLS interventions and a lot of "I am holier than thou" bad attitudes. The reason I persevered this new change in environment: 1. I needed the job/pay. I did, on a number of occasions, almost quit, came veeery close to it. 2. The staff is awsome and that, alone, made me WANT to learn my new role. They smile, they talk to you decently,I get a lunch and pee breaks. My upper manangement tells me I am needed and appreciated( let me capitalize that: APPRECIATED) My NM comes to me and point out I haven't taken any vacation. They told me something I never heard in 30 yrs at any hospital- My Nurse Manager told me I have a good work ethic and wished others had the same. This made me start reading articles, doing research on family practice medicine and found a online instructional video on the primary care. Now after 13 months- the newer older staff(other agency nurses who have been NM's themselves, in their past life) and young inexperienced staff come to me as the " clinical resource nurse" for advisement on dressing changes, med administration, to intervene in a tough patient situation- med surg skills( which I have 18yrs of) and "professional respect and acknowledgement" I am agency at this position.

Agency nursing takes for granted you already have this knowlege base skill. I know agency opportunities had dried up in my area when I did travel- 2006. Then it got even worse when I tried to go back in 2008, and had remained that way- because then I signed up for agency per deim, based on the old addage- plenty of work for perdeim agency- not so. I got shift in LTC- OMG. I was perdeim at a hospital but those shifts were few and far between- sometimes no shift for 2-3 months so I started taking temp positions on my own- sifting through websites- to ride this new found **** poor nursing job market out, but at a great financial and emotional cost to me. And that's with lots of experience( med-surg, oncology, tele, cardiac surgery stepdown, cardiac interventional, endoscopy, sameday surgery). That comfort zone one only finds after staying in one spot for a long while- for me it was 13 months and still counting. There is a learning curve to every position. You have to be willing to ride it out and getto the other side- comfort zone.

DutchRN09 · Oct 30, 2011

"My theory is if I eventually went contract in my metro area, the hospital would likely pay me significantly higher than what my pay grade should be because otherwise, even 3 contracts a year with 12 weeks off would be as much or more money than your average full time worker"

If you are in the US, once you take a floor job your pay will be the same starting level as far everyone else, since you qualify for benefits and they cost money. You do not have enough experience to travel IMO

Sniped4Life · Oct 30, 2011

Thanks for all the thorough replies. I will definitely take the consensus advice.

However, IF I do not get offered the permanent job, what to do? My area has worse employment than the nation does on average. I see this moment in my life as a kind of now or never situation only because there are no guarantees in the job market right now - the old rock and a hard place situation.

UKstudent: duly noted about the possibility (probability?) of the situation you describe. I already have taken that into account, and yes that is a major concern. The one thing that somewhat prepares me is that I did have to take 6-8 patients while not having a "full-time" charge nurse even on the floor at times. I tend to adapt to survival pretty well, but I know some things are beyond surviving.

It's either this or go occupy wall street...lol have to smile sometime!

merlee · Oct 30, 2011

ALWAYS take a permanent job over agency with less than 2 years' experience. Any agency-type job requires you to be able fit in very quickly, with minimal orientation.

Get grounded, get experience.

Best wishes!

Home Health Columnist / Guide · Oct 30, 2011

Your first sentence is the answer:

I am a struggling RN with one year experience.

Struggling RN's don't belong in travel nursing. First 6 months to 1 yr are most difficult for new grads..and even for experinced RN's who change positions. You have changed 2 positions in past year, I suspect just need to push through that 6 month wall to find your footing. Contact positiion can be taken away immediately if can't functtion quickly in position.

Telemetry may not be the best position as need to learn cardiac rhythms, patients condition changes in seconds needing RN to quickly react along with a rapid turnover of patients. In choosing this next posiition. you need to isoul search and dentify what made you leave tha other positions, any skills you think your lacking to break this cycle.

bagladyrn, RN · Oct 31, 2011

Please listen to others here and do not try a contract job at this point in your career! I've been traveling for 15 years but did not start it until I had been a nurse for 15 years.

Even with experience it was tough getting started. Staff may resent you and give you little to no help. Remember that wherever you go as a traveler you are expendable. If someone doesn't like the way you look at them you can be terminated - and have very little recourse. Some corporate hospitals are even known for terminating travelers several weeks before the end of their contracts in order to avoid paying completion bonuses. Contracts available have been at an all time low the last few years, though they are starting to look up.

I'd strongly advise going for a full time staff position, getting a couple of years of solid experience then considering traveling.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Oct 31, 2011

Through experience I've learned that anybody who writes a contract makes sure the terms are in their own best interest any way they can. Approach contracts with caution. That said, the lest onerous contracts I've seen were in travel nursing. But still, when you're the highest paid staff member, you get offered the least and worst hours, and are the first one cancelled. I had a few DECADES of ER experience, and so the clinical challenges were enjoyable, but I would urge any new nurse to get a solid background of a bunch of years before risking getting in over your head with contracts.

Have also seen hospitals offer sign on bonuses in various forms. Researching them taught me there was a good reason they had to bribe nurses to work there, and those who did couldn't wait for their contracts to run out so they could bail.

Not meaining for this to sound negative, but to enlighten you of what's behind some ways employers mistreat staff. Wishing you good luck in your career.

bulletproofbarb · Oct 31, 2011

I had worked for 5 years before i even considered casual/travel nursing...I do it now as my only nurse job but I have been working for over 20 years.

I would not even consider it if you have only one years experience and you admit you are struggling.