*warning-a little more on the life seeking/career advice end then I originally planned*

In a few weeks I would have been a employed BN RN for 1 year- though with 90% of that experience coming from a long term care placemen.

Its a 40 bed home for levels 3/4, with IVs done when needed(largely iv antibiotics), daily trach/dressing/G-tube care- as such its not a huge waste. I also have gained a good part of a year with being the charge nurse, with 75% of the time being the only RN on site. So some leadership skills, and general experience but i'm still lacking any real acute care with no real light at the end of the tunnel in that regards. I moved to this smaller town with a small hospital under the idea I would have a chance to gain experience/training but outside of my TNCC course its been kinda minimal.

I'm wondering if I should look up some online critical care courses if I wish to move and go into an acute care position in the future. To be completely honest I plan on moving in the future but have no idea where, with no real cities with a huge amount of family/friends around. Kinda freaked about the idea of ablind move, only to find myself in an acute care position where I find myself over my head. In the fall i'm hoping to gain training with ACLS/medivac ambulance but thats far from 100%.

So I kinda am fustracted- in the mean time I know I have taken a good 40% of my student loans off the books, and am hoping to be almost debt free by the time I am ready to move but...

A little more of a rant but i'm finding myself fustracted being in my mid 20's, single, in a small town where I just don't believe I am gaining a ton in regards to the future in the profession. Thanks for any advice.

WOW...sounds like you have a ton of experience gained in this year. Consider looking for a LTAC- long term acute care hospital if you want to be challenged more but don't think you can move into ICU environment.

WOW...sounds like you have a ton of experience gained in this year. Consider looking for a LTAC- long term acute care hospital if you want to be challenged more but don't think you can move into ICU environment.

Our Long Term Acute Care (LTAC/LTACH) has more info about this work setting.

Agree with advice to move into an LTACH - this would provide you with hands-on experience with high-tech equipment that is normally found in ICU such as central lines, ventilators, dialysis, etc.

Continuing education is always a good idea, but I doubt whether any online courses would impress employers unless there is a national certification involved. ACLS certification would definitely be a bonus, as this is usually a requirement for ICU or step-down areas. First-responder/ambulance training would not add value as this has very little relevance to in-patient settings.

It's great that you're open to relocation & I'm glad that you seem to have a clear understanding of the stress associated with this strategy re: lack of support system & acclimating to a new environment. Since you don't already have a clear preference, I would suggest starting out by just thinking about the geography/climate that would be most appealing to you. What leisure activities do you enjoy? If you're a fisherman or surfer - look at coastal areas; if you want to ski or hike, maybe you'd be happy in the mountains. Do you enjoy hot weather or would lack of a real "winter" bother you? Make a list of your favorites, and find some areas you'd like to explore. Then take a look at employment opportunities in those areas.

Best of luck to you! Keep us posted here on AN

So what is your idea of acute care? Do you think acute care experience is only learned in a hospital setting? Reading your post I got the feeling that you don't feel you've gained any credible experience working in LTC (wrong, you have) Also this may be why you haven't gotten a job in the hospital, you're not presenting yourself in the best light. Make a list of everything you've learned in the past year including leadership skills (never put on a resume or say in an interview you have some leadership skills) and you'll be amazed at the experience you do have and can use to get the job you want in any hospital. It's all in how you present yourself and if you present yourself like you did in this post you won't get the job but if you highlight what you have learned and can articulate this to a potential employer you'll be ahead of the game. Try buying nursing career books that give solid advice on getting that nursing job you want, Donna Cardillo wrote an excellent book called The Ultimate Career Guide for Nurses. You'll find examples of resumes, cover letters, interview tips and more.

Stop thinking that just because you work in a LTC facility you're not acquiring skills that can be transferred to a hospital setting because you are. All nurses gain experience in different types of settings and these experiences can be transitioned to other part of the nursing profession, keep this in mind when setting out for your next job interview - you have transferrable skills.

Good luck!