New Grad - Offered Nursing Home Position but want to work in hospital, advice? - page 3

by circularstaircase

Hello, I will be graduating from RN school in 2 weeks. For the past month I have sent out applications EVERYWHERE (well primarily hospitals in the area anyway) and so far have gotten the "thanks, but no thanks. Come back when... Read More


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    I am a nursing student who will be graduating at about this time next year, and I am anticipating having to make the same decisions soon. Last week I spoke with a 2009 graduate of my nursing school (Santa Rosa Junior College, about an hour's drive north of San Francisco). He had some advice to share that I would like to share just because it is so different from what I am hearing in this thread. I am curious if it is because of my location or if he is just wrong.

    He said that if you get a job in LTC, you are stuck there because hospitals will assume that you are not trained to function in a higher acuity environment. You need hospital experience to work in a hospital and you had better get that experience as soon and you can, even if it means commuting 2 hours for your first job.
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    You have to take in advice from all sources, then make your own decisions.

    I worked as an LPN at a LTC facility while in RN school. I went to work in a small ICU after I graduated as an RN. My manager picked out my resume because she used to work at the same LTC facility that I did. She felt that LTC experience is very beneficial for ICU nurses. Time management is important in both environments. And the majority of our patients are elderly people from nursing homes, or from home, but in the same age group. While you are treating the reason they are in ICU (resp distress, cardiac issues, etc...), you still have to deal with more routine issues such as crushing their meds, incontinence, fall risks, dementia, sundowners, family, etc... Who better to handle these issues than those with LTC experience. Most of the ICU nurses I work started out in LTC.

    I have heard that nonsense about hospitals not hiring you with LTC experience. You have to understand hospitals don't hire you. Managers hire you, or at least tell HR who to hire. Every single manager has their own ideas about who they want to hire. You cannot make generalized statements like your friend is making. How could he know what any particular manager is looking for. Put yourself in the manager's position. You have a hard working hustler who took a LTC position out of school, worked at it for a while to learn the craft of nursing, then wanted to move into a hospital environment to try something new. On the other hand you have new grad who has been unemployed since graduating, because they say they don't want to settle for a LTC job. Who are you going to hire.

    One last thing. When interviewing, keep in mind that the manager across from you has very likely worked LTC at some point in their life, and you may want to be cautious about what you say about LTC. You might unknowingly offend them, and lose you chance at job. Wherever you work at, make the most out of it, and learn as much as you can. That good attitude will take you wherever you want to go.
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    Thanks, for your comments Mikeicurn. What you say makes a lot of sense!
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    So I found out a little more information about the facility....here are some pros/cons.

    Pros:
    One of the best rated nursing homes in the area
    20:1 patient ratio (while that seems like a lot, from what I've been reading on here, thats pretty good for a nursing home)
    Electronic charting
    Clean facility; the patients seem to like it there

    Cons:
    Since it is a small facility it would just be me and one other nurse (LPN) who would be working on the 3-11 shift; I guess what I'm concerned about is that I would be the only licensed RN present during these hours. If an emergency occurs, am I correct in assuming that the RN present in the building is then responsible? While I do have two years working experience as an LPN, I worked at a doctors office so it's obviously totally different. I've never done LTC.

    What do you guys think? Should I still just take it even though I will be the only RN at the facility during those hours? I guess I'm just a little concerned about the fact I have no one to go to if I need help :/ They said they are always available by phone, but still....
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    @ macgirl: how/where did you get a hospital job in 2 weeks? i've been applying and unable to find new grad positions. hospitals hire with experience only it seems. what was your area of choice? thanks
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    oh man i would take it in a heartbeat.


    i can't get into a hospital, much less a ltc center that doesn't have a hire/fire reputation for its nurses. i mean, i could take the job that most nurses last 4 months before they get fired. but i don't want to have a job where i got fired from on my resume or pop up on the background search.


    as long as it doesn't have a bad rep. i would be so down. and I'm almost 1 yr out of school.
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    Quote from tyrion stark
    oh man i would take it in a heartbeat.

    i can't get into a hospital, much less a ltc center that doesn't have a hire/fire reputation for its nurses. i mean, i could take the job that most nurses last 4 months before they get fired. but i don't want to have a job where i got fired from on my resume or pop up on the background search.

    as long as it doesn't have a bad rep. i would be so down. and I'm almost 1 yr out of school.
    Don't mind me. Tyrion last name is Lannister right?. I watch Game of Thrones. Okay back to the regularly scheduled forum...
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    Quote from circularstaircase
    Pros:
    Electronic charting
    Clean facility; the patients seem to like it there

    Cons:
    Since it is a small facility it would just be me and one other nurse (LPN) who would be working on the 3-11 shift; I guess what I'm concerned about is that I would be the only licensed RN present during these hours. If an emergency occurs, am I correct in assuming that the RN present in the building is then responsible? While I do have two years working experience as an LPN, I worked at a doctors office so it's obviously totally different. I've never done LTC.

    What do you guys think? Should I still just take it even though I will be the only RN at the facility during those hours? I guess I'm just a little concerned about the fact I have no one to go to if I need help :/ They said they are always available by phone, but still....
    *** The electronic charting may well be a con not a pro. It depends on what program they use. There are many, I would say most, programs out there that are terrable and very slow & time consuming. With many programs I have used I would very happily go back to paper.
    Yes as the on site RN you would be responsible. That's the say it is. It's why they have an RN there.
    If a hospital job is not available as you have indicated before I would take this job in a heart beat.
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    hi everyone! @circularstaircase i just want to know. did u take the job? i'm sort of in the same situation. i have an offer to work at a nursing home but i really REALLY want to work in a hospital. i have sent alot of applications to different dept of different hospitals but still got no response after a month. i worry that if i get the job offer and start working at the nursing home i might get a call from the hospitals i applied at. arghhh! i really can't decide on what to do right now! >.<
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    Hello msrn1012...sorry for the late reply! You probably already made up your mind on what you are doing, but I'll give my 2 cents anyway

    I actually wound up taking the nursing home position and *gasp*....got offered a hospital med-surg job 2 1/2 months later! I say go for it! I was only there for a short amount of time but I am still amazed at how much I learned. I really feel as though my brief stint there really helped me learn how to prioritize/how to handle emergencies/etc. I think my experience in LTC helped land me a job as well. If you have any other specific questions don't be afraid to ask! Good luck and let me know what you end up doing!
    CON1 likes this.


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