LTC vs. Dr's office for a new ADN grad (x-posted)

[dreavt, BSN, RN]

Hi all,

I'm a longtime lurker, but this is my first post. Hoping to take advantage of your collective wisdom while I make some tough decisions.

I'm 37, just graduated with my ADN, this is a second degree for me (BA in liberal arts from 100 yrs ago), and I plan to go on to get a BSN, or maybe just straight for an MSN, online in the near future. I live in northern New England. The two largest hospitals in commuting distance have recently suspended (temporarily? we hope?) their new grad residency/internship programs. I actually have been working as a secretary at a smaller community hospital while in school, and as example of how crazy things are around here, their new grad program had 40+ applicants for 4 positions (already filled) -- which I didn't even apply for because it requires a 3 year commitment which I was not willing to make. I gather from reading here and elsewhere that this is an issue in many parts of the country right now -- hospitals in general are just *not* hiring very many new RNs.

One of the larger hospitals is the one that I have had my heart set on working for -- longterm I really want to work in an outpatient hematology/oncology setting, possibly giving chemo, ideally working with clinical trials and doing risk assessment, patient teaching, system navigation, etc. It seemed that working for 1-2 years on an inpatient hem/onc unit at a teaching hospital with an NCI-designated cancer center was the best way to get the experience necessary to get my OCN certification, as well as really get to know this population and improve my skills, and of course make connections.

I am continuing to work my connections at this hospital, follow up with the recruiter, etc., and am hoping that things will settle out/improve in a few months and I will be able to get in there. BUT in the meantime.... I should probably get a job as an RN. Which brings me to my question....

Short of acute care experience, what type of nursing experience would be most helpful to me in terms of a) improving my general skills; b) "impressing" (to the extent possible) hospital recruiters; and c) working toward my long term goals. I am relatively confident that I could at least get per diem work (which would mean keeping my current secretarial job, since I carry the insurance for my family) in long-term care or a doctor's office (more likely as a float for a group of outpatient practices).

Does anyone have an opinion on which would be better for me? Neither particularly feel like my "niche", but I am slightly more attracted to the offices -- at least that setting would mimic my longterm plan of working in a hem/onc clinic. OTOH, are LTC nurses seen as having more really "nursing" experience by hospitals, since at least it's inpatient, nurses are rather independent, etc.? Or is there some other option I'm not thinking of? I got a recruitment letter (what? someone actively LOOKING for a new grad nurse???) from an outpatient substance addiction treatment center.... which I would totally have no problem doing, but I have the impression it's basically taking vitals and handing out bupe, which doesn't seem like it would be terribly impressive on a resume.

Thank you so much for any feedback, thoughts, guidance, etc.!

Best,

Drea