Career Advice

Bikeworks

Well-Known Member
I realize that this is almost as up there as asking for medical advice on the internet, but I really am conflicted and am trying to get as many unbiased views on this as possible, so here it goes:

So, as some (most?) of you know, I am a RN in the ER, and was previously a CO. I love what I do, even though I have been increasingly frustrated lately due to the lack of staff and the vaccine mandates. I am responsible for saving lives on a daily basis, sometimes being the sole reason why someone has a positive outcome. I am also responsible for precepting new RNs on how to be good ER RNs, which I also enjoy immensely.

Now, I've been given an opportunity. I am under consideration to be the Trauma Director for the entire hospital, a Level 1 Trauma center (albeit a small community hospital). To have started in the hospital only 10 years ago as a nursing assistant and now be in this position is in itself a major accomplishment, I realize that. I am also not necessarily "qualified" on paper for this (letters after my name, AKA schooling credentials), so it's doubly flattering (impressive?) that I am being considered. Going a step further, I'd be holding meetings with some of the same people who refused to hire me when I first became an RN due to my lack of an advance degree. Not being petty (maybe a little, fine), but it's an enormous sign of validation for me and my commitment to my profession. It's additionally exciting as I would be stepping into this role as we get ready to open a brand new, state of the art, Emergency Department and OR suite. There is also the potential that we may be taken over during that time by a large hospital system. That could be a plus or a minus for this position as I could see even more opportunities, or I could potentially be replaced.

The position comes with a bump in pay (somewhere in the neighborhood of $30k more), a staff of about 10 people, and weekends and holidays off. Sounds like a no-brainer, right? Well, obviously by me making this post, it isn't for me. I've grown accustomed to having days off during the week, and not having weekends or holidays does stink, but I manage. However, that does take away more opportunities to ride (only people like you will understand that importance), as well as to get projects at home done. The job is very data/report/administratively driven, and would pretty much completely take me out of the clinical part of nursing (I'd still respond to traumas when available). It is also a salaried position, so no OT, no union protection, and 1 week less of vacation.

So at its core, I'm looking at an increase in pay, a potentially better career path, and a more traditional lifestyle, with less (different?) stress, versus the status quo of solid pay, union protection, more vacation and time off, and doing the clinical stuff I love.
 

THATmanMANNY

Well-Known Member
If you don’t mind sharing. What is your marital status and kids?

I think it’s easier to go back to being a nurse, right? Get this under your belt and if it doesn’t work out go back to doing what you love or keep moving on up! Congrats! It’s okay to have emotions about proving people wrong!

Our favorite oncology nurse just told us she is going to a pharma office job but will be working per diem when needed. Huge loss for the unit but people gotta do what they gotta do.
 

dvaidya

Well-Known Member
Things that stick out for me from your post:
respect you have earned with folks making the decision, potential less stress, higher pay, your love for clinical stuff, union protection, less vacation and OT.

Questions that I would ask myself if in similar situation:
  1. Respect and backing from folks considering you for the position even with your background. They have confidence in your ability to successfully, make the change and thrive in the new role. If after making the change you believe it's not for you can always go back to full time nursing but it might require looking for a job at different hospital.
  2. known v/s unknown stress, from my personal experience moving from individual contributor to management position. The stress mostly came from dealing with the political crap that came with management role. So the question would be are you going to be comfortable with the political situation and your relationship/respect with folks that you will be working with. Personally, it might be straight wash on the stress level or slightly less in the new position.
  3. Is the pay difference between what you make in OT v/s pay raise still in the positive ( >15% raise over your OT pay). I am also assuming that the new position is likely to be more of 9 to 5, with occasional long hrs.
  4. Less vacation, this is something that you could negotiate when the position is offered to you.
  5. Clinical portion of the existing job. Your comment - "I'd still respond to traumas when available", is it possible for you to say I want to spend couple of hrs a week doing the clinical part. I would make that part of the job acceptance and use the tactic that you need to keep your skills up to date, in case you are called on in an emergency.
  6. Union protection/support - No idea on this to be honest, since I do not have any experience with what union support means
 

Bikeworks

Well-Known Member
If you don’t mind sharing. What is your marital status and kids?

I think it’s easier to go back to being a nurse, right? Get this under your belt and if it doesn’t work out go back to doing what you love or keep moving on up! Congrats! It’s okay to have emotions about proving people wrong!

Our favorite oncology nurse just told us she is going to a pharma office job but will be working per diem when needed. Huge loss for the unit but people gotta do what they gotta do.
Thanks for the response, Manny, and I hope things continue to go in a positive direction with you and your kiddo.

Yes, I can always fall back to being a staff RN, although I may lose some seniority. That said, I will look to expand my clinical flexibility should I be offered and accept the new position. I am married, raising two adult autistic children.
Things that stick out for me from your post:
respect you have earned with folks making the decision, potential less stress, higher pay, your love for clinical stuff, union protection, less vacation and OT.

Questions that I would ask myself if in similar situation:
  1. Respect and backing from folks considering you for the position even with your background. They have confidence in your ability to successfully, make the change and thrive in the new role. If after making the change you believe it's not for you can always go back to full time nursing but it might require looking for a job at different hospital.
  2. known v/s unknown stress, from my personal experience moving from individual contributor to management position. The stress mostly came from dealing with the political crap that came with management role. So the question would be are you going to be comfortable with the political situation and your relationship/respect with folks that you will be working with. Personally, it might be straight wash on the stress level or slightly less in the new position.
  3. Is the pay difference between what you make in OT v/s pay raise still in the positive ( >15% raise over your OT pay). I am also assuming that the new position is likely to be more of 9 to 5, with occasional long hrs.
  4. Less vacation, this is something that you could negotiate when the position is offered to you.
  5. Clinical portion of the existing job. Your comment - "I'd still respond to traumas when available", is it possible for you to say I want to spend couple of hrs a week doing the clinical part. I would make that part of the job acceptance and use the tactic that you need to keep your skills up to date, in case you are called on in an emergency.
  6. Union protection/support - No idea on this to be honest, since I do not have any experience with what union support means
D, thank you so much for this thoughtful post!!!! It made me do an even deeper dive, especially on points 1 & 5. Point #2 and my personality are likely one of the selling points that were made during the decision which brought about my name getting tossed into the hat. I'm no shrinking violet; I'm also very respectful to chain of command, so it's a good balance when having to interact with higher-ups with whom you are tasked with ensuring are compliant with policy and procedures.

I think I have a good idea of what steps I should take next. I hope to have a clearer sense of where this will go sometime early next week. Thanks again!!!
 

pooriggy

Well-Known Member
Team MTBNJ Halter's
Sometimes we don't know we're in a rut until we do something different and later realize we were no longer challenged in a previous job.

I'm not saying you are in a rut, but the new position seems like a challenge.

At this stage of your life, do you want a challenge?

The pros as I see it.
A chance to build a trauma unit the way you think it should be built. Have a bigger impact on quality of care.

The Cons.
Dealing with admin more, politics, and the emotions and headaches that go with it.

Part of me believes that you follow up on an opportunity that presents itself. You don't want to wonder what may have been 10 yrs from now.

In any case, love what you do.

Cheers
 

JerseyPete

Well-Known Member
Are you considering your age and where you want to be 10 years from now (financially, career, etc)? 20 years, and so on? What will give you the greatest mobility and finances in the future if you want to relocate?
And of course, new bike?
 

w_b

Well-Known Member
You can always go back to work as an ER RN if it isn’t your cup of tea. $30k and weekends off takes care of a lot of overtime. If you’re competent you don’t need a labor union to protect your job, you get a better one.

Go for it. and new bike.
 

stb222

Love Drunk
Jerk Squad
30lk is a lot, but obviously money isn’t everything but like others have said, you can always go back and if you don’t try, you never know.

Managing staff can be challenging and can also suck at times (or all the time).
 

Bikeworks

Well-Known Member
Sometimes we don't know we're in a rut until we do something different and later realize we were no longer challenged in a previous job.

I'm not saying you are in a rut, but the new position seems like a challenge.

At this stage of your life, do you want a challenge?

The pros as I see it.
A chance to build a trauma unit the way you think it should be built. Have a bigger impact on quality of care.

The Cons.
Dealing with admin more, politics, and the emotions and headaches that go with it.

Part of me believes that you follow up on an opportunity that presents itself. You don't want to wonder what may have been 10 yrs from now.

In any case, love what you do.

Cheers
I don't think I'm in a rut, but I am definitely a bit more jaded by my job, mainly because of shitty staffing. I still adore what I do, which is the first time I can say that as an adult. I'm 53, certainly don't feel it, but I recognize I can't continue this physically demanding job forever, and this opportunity is not physical at all (small con).

I'm likely going to take the next meeting, see what I can negotiate as far as terms, then make my decision. Despite just having bought a new bike, buying a new bike is always a good thing. Of course, finding time to ride them in a 5 day work week will be a colossal challenge for me. We shall see...

Thank you to everyone who responded. I knew this was the kind of feedback I could expect to receive. You guys rock!
 

Patrick

Overthinking the draft from the basement already
Staff member
Just to add - when someone is plucked "off the line" to "direct the line" - it means they believe you can raise the level of everyone,
demand more of new hires - and know how to get them there. Talking the language, leading the reviews (ex-post of what went great and not so much)
and spotting issues (got some family where this led to alcoholism and ptsd type stuff) - you could address the staffing issues which you referenced.

Consider this - it is a giant risk on their part. If they take a top person from the line, and expectations are not met in the new position, they made two mistakes.
You have their trust.

Best of luck.
 

Bikeworks

Well-Known Member
So, I removed myself from consideration. They were very gracious about my withdrawing, stated my clinical reputation was very highly regarded (which was nice to hear).

The clincher for me in making my decision was my patient I had the day before; autistic adult accompanied by mom, had him as a patient before. Mom stated that she was so glad I was his RN and that she was hoping I was there that day. Went home and told my wife, and we agreed that was the whole reason I became a RN; because we always hope there was someone like me in the ER for when we had to bring one of our kids in, someone who 'got it.'

Thanks again for all of your advice, it was appreciated and helpful.
 
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