No hospital job after working LTC? True?

netglow, ASN, RN · Jun 21, 2011

Just depends. These days it is about who you know. If you are LTC you may have a chance, depending on who you know.

I have had people tell me point blank (recruiters) that they will not take experienced LTC nurses, that, they do not retrain nurses. It's either you are brand spankin new, or have less than a year experience somewhere else... meaning you get out of LTC and into Acute before they consider you "ruined". Pretty brutal. They also "say" that if your experience is only home health as a first job, you will not be considered for acute care. Their reasoning is that the nurse managers tell them HH nurses never make it through acute care orientation, and it's not worth the gamble. If you have been in LTC or Home health for a year you are not eligible for any kind of regular longer acute care orientation anymore on the whole. Working anywhere for a year means you are supposed to be on your own pretty much whereever you work. Lots of assuming going on that seems to pretty much end things for lots of people.

If you gain connections in the mean time, of course, you're in. It won't then matter who you are or where you came from. Your connection is what got you in, and that trumps it all.

CrissiQ · Jun 21, 2011

I work in a LTC setting. I had a 2 interviews with local hospitals and am currently waiting on them to call me back to tell me if I have a position as of yet. Both the nurse managers were very nice and receptive of my LTC history. They both felt that the skills of prioritizing, delegation and time management were well taught in a LTC setting. That everybody has to start somewhere and it was perfectly acceptable.

joanna73, BSN, RN · Jun 21, 2011

It also really depends. Just because someone has a year of experience....well, they may be great or only marginally adequate, or somewhere in between. I worked with a nurse in my LTC who had 8 years of cardiac experience. She was scary, and lacked even basic nursing sense. I have no idea how she survived cardiac nursing. So you never know.

catfish1 · Jun 21, 2011

I've been a nurse for 20 years. First an LPN then RN. All my experience has come from LTC/SNF rehab. About a month ago I applied to a local hospital and was hired to work on the orthopedics floor. I was very excited because I always felt like I cheated myself for not starting out in a hospital. You know how everyone says you should have at least one year hospital experience to be considered having solid experience. This ortho floor was more of a overflow of any type of surgical patient you could imagine.You had at least 6 patient per nurse, had to do your own vitals, if they were post-op it was Q4hr v.s., and you could have 3 discharges and 3 admissions in a 12 hr. shift. Most patients were young adults who were getting morhine every hour. My preceptor was a new nurse one year grad. I'm 48 and healthy so keeping up was not an issue. The charting was on computer and you were luckey to find one that worked plus the Dynamap machines were scarce or not working at all. It was a zoo. Doctor calls, call lights, oh yea and the yougsters who needed morphine every hour. It was like trying to learn to drive a race car on the Daytona 500. Everyone was so busy trying to keep up with their own patients. I started taking 3 patients after one week then it went to 6 one week before going off orientation. My preceptor told the unit manager she felt a disconnect between us? So I was paired up with another nurse but by that time I was so frustated and busy I could hardly do an assessment on my patients. Here I am lost with so many new things to learn like hanging blood, patients with constavacs after having bilateral knee replacements, N.G. tubes, patient need to go to the B.R, take off orders, PACU calling to give you report, ohh, I have another admission? Hold on my I.V is alarming, their calling me overhead your needed in room 409 patient needs pain meds. You know what took me over the edge? Several nurses were so rude and condicending at shift report. Rolling their eyes when I missed something or questioning me about things that they already knew. Finally one night at shift change this same nurse who was an absolute b.... had my group of patients and needed report. I started giving my report and the questions ripped. That was it for me after I got home I called and said I would not be comming back. I was so disappointed. I wanted to work at this hospital for so long and was so excited about it. I just could not put up with all these young nurses who felt superior and could not try and make another nurse feel welcome. What this long post is getting at is it's much harder to go to a hospital setting from LTC/SNF. It's totally different all the way around. Most women are mean and will chew you up and spit you out. You have to be able to fuction on your own very early on and learn alot in a short amount of time with little direction and most orientations are less than ideal. They'll promise one thing and do another. Now I'm not sure what I am going to do next. I think my chances would have been better if I was started on a slower paced unit with more support. Oh, and there are alot of bitter nurses in the hospital who wish they could leave thats probably what was wrong with the ones that gave me such a hard time.

Rntr · Jun 21, 2011

I am so sorry to read this report.. it is really bad out there. This is one of the reason's I have never gone back to the hospital "floor" to work..attitudes are horrible. Instead of helping you make it, they help you out the door...

One thing I have learned over the years is the individual hospital has alot to do with what goes on. Was this by any chance a for profit hospital? I know they all can be bad but my experience has been that the "for profit" monsters are horrible. I work the OR and I know what it's like there and what a difference between for profit and private..

catfish1 · Jun 21, 2011

Yes, this was a county hospital. I know I'm not alone with my feelings in regards to the horrible attitudes and hatefulness from other nurses. We do have a private HCA hospital close to me but after this experience I'm not sure if I want to chance it. I still want that hospital experience though. You learn alot in LTC/SNF but it's not quite the same. I do know that it made it alot harder going from LTC to the hospital. Should I take another chance or move on to something else? Thanks for sharing your experience.

Rntr · Jun 21, 2011

Depends on you.... what do you want to do from here? Is it hospital based or maybe stay out of the hospital into something else. There are other area's like home health and such...

I think if it were me and I wanted to work in the hospital I would go for the 11 to 7 shift on m/s or see if you can't get into one of the units..good luck

ijuanabhappy, ASN, RN · Jun 22, 2011

Catfish,

I'm sorry to hear about your hospital experience. I graduated from school last year (RN), with no prior hands-on medical experience. I started out on a telemetry unit right after graduation and my preceptor was so mean and not helpful in the least. I was already nervous and she made it a million times worse for me. There were two younger new grads in the group with me and she was pleasant to them and always seemed to be more helpful. If I asked a question she made me feel stupid and would say things like, "didn't you do this in school?" I am not sure what it was about me. Maybe my older age, I don't know. I come across as friendly and nice, maybe a bit shy and unsure of myself, but so did the other girls. I switched positions within the hospital system to a clinic position because I knew that I was not going to learn anything from her and my nerves were shot. It was depressing because I really wanted the experience.

Do you find that nurses in LTC are nicer and more helpful? What about LTC did you not like or why are you wanting a change? Just curious. Do you feel if you had started off as a new grad at the hospital that you would have fared better? I'm asking all of these questions because I have been offered an LTC position but not sure if I should take it or not. I feel like my first year as a nurse has been a complete disaster and I am worried about another bad move or failure. I would like to get the floor experience but now I'm worried that maybe I am just not cut out for the hospital and it would be the same book, different chapter.

Were you working nights at the hospital? I heard this may be a better shift to start as a newcomer. Did you find LTC to be easier and less stressful than the hospital? If you really want the hospital experience, maybe find a slower/different floor and work nights. Good luck!

catfish1 · Jun 22, 2011

I was an LPN before becomming an RN so all that was really available to me was LTC. It has it's own stressors like having 25 to 30 patients that you give meds to and do all your treatments if no trearment nurse. Plus you do get admissions and discharges as well. On the other hand the hospital gives you 6-8 patients and you are responsible for all their care and you really need to be able to act independently. I have gotten alot of experience from LTC especially over the last several years because hospitals are d/c patients sooner and require more acute care. I've had experience with IV's, wound care, ortho, psych. I think hospital experience will give better opportunity with assessment skills and more advanced technical machinery. You will never learn to hang blood or get much if any experience starting IV's. Trying to go to the hospital now after being in LTC setting makes it more challenging system wise. They are complete opposites. Most hospitals are computer charting where LTC is still written. I just feel like I'm working myself backward if that makes any sense, like I've cheated myself as an RN. As an example, today I went for an interview for Hospice and was told I needed at least 1 year hospital experience. So you see even with all my accumulated years of experience as a nurse wasn't enough and it all came down to no hospital exp. This is just my own take on this and what I have been through. I dont do night shift but at times wish I could. You dont have all the other disiplines to deal with and can go at a little slower pace but night shift can be just as crazy as days I've heard. Just one more thing, I can relate to your type of personality b/c I am more quiet and unsure of myself and this can come back to bite you as a nurse.There are alot of hardcore nurses who can make someone like you or me feel pretty intimidated. You need to get a thick skin. I've cried alot of days after leaving work.

SCcountrygirlRN · Jun 24, 2011

I originally wanted to work at a hospital but when I graduated none of the hospitals were hiring new graduates in my area so i went to work at a LTC facility and continued looking for a hospital job. I worked LTC for about 6 months when I got my first hospital job. For me it was easier to get a hospital job working in LTC. They say "its easier to find a job when you have a job" nursing experience is nursing experience it doesn't matter where you work!