If you've only work in this field for a year, I think you haven't pigeonholed yourself. The truth is, it's probably going to be harder for someone like myself who has been working in Critical Care since 2004 to switch to a field such as Long-Term Care (not that I would want to do that). I actually started out working in Physical Medicine and Rehabilitation straight out of NP school and stayed in it for a bit over a year. It did become boring for me and I pursued more Acute Care oriented fields by just applying everywhere I see a job posting and there were interviews that didn't pan out. What helps is if you can make connections. I don't think it's the fact that you work in SNF that's turning off potential employers, I think it's not knowing who you are among a pile of resumes. To be honest, I was able to break out into Critical Care in 2004 because I knew an NP in the group I was applying to (a batch mate from my ACNP program). In a competitive environment, it helps to have someone put in a good word about what you are like as a potential NP. I wouldn't need that now and I got my current position because I am experienced in this field as an NP.