If you’re new to the world of nursing and looking for your first job, congratulations! You will however, want to know a few important things…

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Staffing

When considering a new job, one huge factor should include staffing. Most directors or hiring managers may not be very forthcoming with this info as it tends to be an area that’s lacking in basically every unit out there, but it can be better or worse.

Ask the other employees working there how it is, they’ll give you a more honest answer.

Patient:Nurse ratio

If you are interviewing for ICU positions, you should know that for extremely critical patients you may be at a 1:1 ratio, but normally have a 2:1 on most days. That being said, most ICUs will occasionally “triple,” when staffing is tight, so if it’s 3:1 don’t be shocked.

Step-down and other intermediate floors are typically 3:1 to 4:1. If the ratio is going to be more than 5:1… walk!

On a med-surg floor, you’ll be lucky to get a 5:1 ratio, and will probably see 6:1 most of the time, or even 7:1 ratios. Now, a normal ratio of 7:1 is horribly high for hospitalized patients, and the higher the ratio climbs, the more dangerous your job becomes, so if they say something like 7:1 or higher… run!

Salary

When offered a job be sure to have previously researched average hourly wages in your area. Most places will give you little pay bumps for previous experience as a CNA or equivalent, so be sure to ask if they don’t bring it up. Don’t let them low-ball you!

There is usually a small amount of negotiation that you can do with hospitals, but they won’t tell you that. Most people jump at whatever the voice on the phone says because it’s your first job, but even a few extra bucks can add up over time.

Shifts

Make sure you know what work week (hour wise) you’re signing up for. Full time can be between 32-40 hours. Some are 8 hour shifts, some are 12, and I’ve heard of 4 hour shifts as well. Make sure that the number they lay out is actually what you want.

Overtime

Make sure to find out if your job has mandatory overtime, or if you can sign up for overtime in the event that you’d want to for extra money.

Some hospitals try to hide mandatory overtime by calling it “on call” hours. This means you will have to sign up for a set number of on-call hours every schedule period in case the staffing is inadequate and they can call you in to work.

Scheduling

Some jobs let you create your own schedule, while others will assign you one. If you want more flexibility, go with a job that lets you create your own.

Realize that most full time jobs are 36 hour work weeks which is 3, 12 hour shifts. Some people like working 3 in a row, and others hate it, so you can see how having control over your schedule is important.

Shift Flipping

Some jobs for new grads, and in general, require you to flip between day and night shifts. This is something I would stay away from personally, but it’s just another thing you want to be aware of.

Residency

Residency programs should be fairly long, and help you learn and grow as a new grad nurse. Think of it as a mini-school for RNs. Besides probably going over the stuff you learned in school (never hurts to get a refresher), you’ll also be familiarized with your hospital’s departments, protocols, policies, etc.

Internship

A new grad internship is pretty neat if you can get into one. Basically you get to test-drive multiple units before deciding which one you think would be the best fit for you. It typically lasts a few months of rotating between various floors, and at the end, you get to choose your favorite.

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