Need advice about starting my career at a Nursing home

When there's little opportunities in acute care setting such as tertiary hospitals, it is not uncommon for RN's to seek employment in other settings such as nursing homes. I've seen this phenomenon happen during the mid-90's when I saw quite a bit of RN's (some with BSN's) who were working at skilled nursing facilities like I was doing at the time. It seems like the current economic crisis is making it harder for new RN to find openings in acute care hospitals. Unfortunately, we have to face the fact that we have to find work and be less picky when there's little options.

There are different kinds of nursing homes and those that offer skilled nursing care may be able to offer exposure to RN's who start IV's and give IV meds, provide specialized wound care dressings, administer continuous ambulatory peritoneal dialysis, and other procedures you wouldn't expect to see in a nursing home. So it may not be as bad as you think. When the current economic climate changes and more job openings surface in acute care hospitals, you should be able to transition to working in the hospitals if that is still what you desire to do when that time comes.

I worked in a nursing facility for three years before eventually working at a telemetry unit of a hospital in the late 90's. The transition wasn't too bad for me but I did get the occasional remark from other nurses about having to be watched because I have not worked in a hospital. I let those just roll off my shoulders and try to catch up with new things to learn. I've since worked in ER and ICU and have transitioned smoothly throughout these changes in my career. I look back at my nursing home experience with fondness but I have to admit that it did push me back a few years from advancing to my current role as an Acute Care NP much later than I would have wanted.

Well, the experience didn't push me back from being an NP per se, rather, it pushed me back from pursuing my goal of becoming an Acute Care NP which was what I've always wanted to do. If I had started in acute care early during my career, I would have felt ready to start graduate school much sooner than I did. Be aware that there are options for nurses who work in skilled nursing facilities in terms of pursuing a master's degree. Aside from the more obvious Gerontological NP track, Gero-psychiatry or Adult NP can also be an option for nurses who work with older adults. A fellow RN I worked with in the nursing home is now an FNP and she works with a physician who sees patients in the same nursing home we worked in.