In my first job, but still looking.

Nurses New Nurse

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I am in a part of the country where there are a TON of new grad BSNs looking for work. After many months, I was hired as an inexperienced new grad at an LTAC hospital. I am VERY grateful for the training and the opportunity. I work hard and am doing my best to be an asset and it is going well. I am about to finish orienting/probation but I am very much part of the team and have been working with very little supervision for awhile now.

They do not normally hire new grads but have a huge problem with staffing and rely heavily upon registry. The work environment is perfectly fine and typical for LTAC, I hear. The staffing problem is because there is a huge shortage of experienced RNs.

Typically I get 5 patients and cover another 5. It is very busy but do-able. Also, my patients are generally very similar (g-tube/vent/A&O 0-3/wound care). My daily skill set is very focused in those areas. Same meds. Same procedures. It is very routine.

None of my colleagues on the floor have BSNs. I worry that I am going to get stuck in the LTAC environment and my skills will not increase past a point. When I was in school I had hoped for a more diverse and challenging patient population. Also, this is a seniority-based environment so my pay will increase over time, but not directly as a result of my accomplishments. Benefits are less than I would get at a major hospital. There are no retirement benefits (which bothers me a lot).

I feel VERY guilty about this, but my plan is to jump ship to one of the local major hospitals as soon as they will have me.

Am I being disloyal and ungrateful? Is there a minimum amount of time I should stay to repay the time and effort to train me? Should I tell my manager when I start looking again?

If you can, I would stay at least six months if not a year. I would not tell your manager anything until you have your offer letter in hand for another job.

I dont think you are being disloyal. You must do what is best for you and your career goals.

Won't my next job want a reference from my current employer before I get an offer? How does that work when someone is changing jobs?

I am in a part of the country where there are a TON of new grad BSNs looking for work. After many months, I was hired as an inexperienced new grad at an LTAC hospital. I am VERY grateful for the training and the opportunity. I work hard and am doing my best to be an asset and it is going well. I am about to finish orienting/probation but I am very much part of the team and have been working with very little supervision for awhile now.

They do not normally hire new grads but have a huge problem with staffing and rely heavily upon registry. The work environment is perfectly fine and typical for LTAC, I hear. The staffing problem is because there is a huge shortage of experienced RNs.

Typically I get 5 patients and cover another 5. It is very busy but do-able. Also, my patients are generally very similar (g-tube/vent/A&O 0-3/wound care). My daily skill set is very focused in those areas. Same meds. Same procedures. It is very routine.

None of my colleagues on the floor have BSNs. I worry that I am going to get stuck in the LTAC environment and my skills will not increase past a point. When I was in school I had hoped for a more diverse and challenging patient population. Also, this is a seniority-based environment so my pay will increase over time, but not directly as a result of my accomplishments. Benefits are less than I would get at a major hospital. There are no retirement benefits (which bothers me a lot).

I feel VERY guilty about this, but my plan is to jump ship to one of the local major hospitals as soon as they will have me.

Am I being disloyal and ungrateful? Is there a minimum amount of time I should stay to repay the time and effort to train me? Should I tell my manager when I start looking again?

FYI - the primary, though not only, driver of nursing pay is years of experience/years in a particular job, not so-called "accomplishments." Your skills will only develop to a point in any job.

I wouldn't feel guilty - they'd cut you loose in a heartbeat if it served their needs. I do think you may be unrealistic assuming you'll learn/do more in an acute care hospital - especially on a floor (vs. ICU or procedural area). Many of your LTACH patients are probably sicker and require more "skills" than a typical floor patient.

I do think you may be unrealistic assuming you'll learn/do more in an acute care hospital - especially on a floor (vs. ICU or procedural area). Many of your LTACH patients are probably sicker and require more "skills" than a typical floor patient.

Good point, thank-you. I will probably think about a specialty down the road, like cardiac or oncology.

I chuckle when I read this more than 2 years later. I had no clue.

1) Nurses change jobs all the time. I left after a year and it was pretty much expected.

2) Salary is always based on experience/union contract.

3) LTAC was boot camp. I did more procedures and such in a week than I typically do in a year in my traditional short-stay acute care hospital.

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