Which non-hospital job is best for a new grad with hospital aspirations?

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    If a new graduate is unable to secure a hospital job right out of nursing school, which one of the following jobs would be easiest to transition from into an entry-level med-surg position after say, a year of experience in that field:

    Corrections (jail/prison nurse)

    Dialysis (one of the big 2 companies)

    Psych (state psychiatric hospital/behavioral health/psych ward of local hospital)

    Long term care/skilled nursing facility/nursing home

    The above options seem to be the "big 4" fields in my area that graduates who are unable to get a coveted hospital slot ultimately end up in.

    If you were going to rank them in order from easiest to transition into the acute care setting to most difficult in terms of the skill set you will acquire in each one, how would your rankings go?
    Joe V likes this.
  2. 5 Comments so far...

  3. 0
    I would try psych, maybe one day they will pull you and have you float to another area !
  4. 0
    I graduated in May 2011 and could not find a job at a hospital. I worked at a nursing home that had a transitional/medicare unit. I am fortunate to have finally gotten a medsurg/tele job. LTC is viewed as an easy no skills job unfortunately but this is not always the case. On a transitional/Medicare unit you will be taking care of patients who are there for physical therapy and will then go home. They tend to have more acute issues like CHF, PNA, DVT, and some IVs. If you stay at just a LTC unit you be only be passing PO meds and doing wound care. In the medicare unit I did IVs, wound care, insulins, heparins, incentive spirometers, remove staples and stitches, CPM therapy, took my own INR levels for the pharmacist to titrate coumadins and more. I had to chart head to toe assessments. I constantly admitted, transferred and discharged patients. Not all patients are "elderly". I have had patients as young as in their 50's but needed to be in a nursing home temporarily to get better and because they are not healthy enough to rely mainly on home care. When you get an interview at a hospital make sure you tell them all that you do. Nursing homes are very modern and can be aggressive in medical treatment these days. There are even nursing homes that have ventilator and trach patients.
    Dialysis nursing would be a great learning experience with the ability to specialize early in your career. Dialysis centers are very limited in the care you give however. They are very outpatient based. If any change in condition happens you send the patient to the hospital. If you have the ability to be a dialysis nurse that can work at a center and be oncall for a hospital that would be great. I have met dialysis nurses that will go to hospital to do dialysis in the patient room and then leave after. If you pick psych, I would recommend getting into a psych unit within a hospital, you will be an internal employee and be able to get another job in that hospital later. Maybe you will have to opportunity to float to a medsurg unit.
    I personally would not recommend a state hospital facility. There are for psych prisoners and will have a level of nursing care less skilled than that of a nursing home. There is usually a couple units that have a higher acuity but will still be below a nursing home. But the money and benefits will always be great at a state hospital or prison. I'm not sure about the acuity of prisons. I have heard they are still less than what I did in a nursing home. The money is great I know.
  5. 0
    Another great option would be to consider applying at an outpatient surgical center. It is non-emergent, non major surgeries but can encounter stuff like TKAs and rotator repairs. If they code you send them to the ER. However, you get to do surgery education, surgery forms, patient education, IV therapy and have to deal with intubation, anesthesia, respiratory depression, hemorrhaging etc. There are usually three positions you can take" pre-op, OR and post op. Most places will not even consider an inexperienced nurse for the OR but the others are doable. Post-op would be great because it has the possibility of resembling a mini PACU unit. You will also get to network with a lot of surgeons who may also have "pull" at a hospital.

    You will get to network best at a inpatient psych unit, and surgery center. Many LTC and prison/state hospitals will not have much people that are acute focused or even acute experience.
  6. 0
    I wasn't in quite the same quandary you are. I finished when every grad had just to apply to get a job in a hospital. The children were 3 and 5.

    My entire class with the exception of a few who went straight to anaesthesia school, all went the hospital route. I was still working for a general practice doctor that I loved dearly. Then my husband lost his job a year or so later, and I suddenly got scared. I went to work at Head Start..BIG mistake. Went from there to Vocational rehab and then to an Oncology Hospital unit. Husband got a new and better job with the state and stayed 30+ years there.

    Well I was working the hospital, by then both children were in school. Then my 10 year old was hanging from her knees in a tree and the limb broke. Concussion. and Thoracic vertebrae compression fractures. See me run, see me stay home and do a fair job of home schooling. My nurse recruiter called me one day and said she knew I hated Oncology and she understood? Would I please come back in the float pool?


    So for me:
    Doctor Office, School nurse, Voc Rehab, Hospital ,stayed home, float pool, and landed one day in ORTHO !!!!!!!!!!

    All those twists and turns and I ended in what I had always dreamed of. I stayed 22 years-not float pool, but a job where no one died, -code cart would have dust bunnies under it-I could talk to healing patients, I could help people get better. We had a small cadre of doctors-about 35 Ortho with a teaching service (a LOT of new stuff to be learned by simply listening to them as they made rounds.)
  7. 0
    Psych is good because you will encounter psych patients in ANY specialty, so you will pick up valuable skills that will travel. If you can land in geropsych or psych medical, your will also pick up a lot of medical skills. Best would be to land in a psych unit in a medical hospital so you have the opportunity to float.

    A lot of people also enter acute care from LTC. As one of the posters above mentioned, LTC is often a lot more than the passing PO meds and babysitting that some are convinced that it is. Depending on the type of LT unit you're on, there's potential to learn a lot there as well. Aim for transitional/Medicare unit, LTAC (long-term acute care) or sub-acute care.


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