SNF job is a barrier to getting into the acute setting

Nurses Job Hunt

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Specializes in psychiatric nursing.

I am a RN that did an entry level master's degree program. I have been licensed since June 2012. Graduated with the MSN in April 2013.

I live in Sacramento, CA, probably the worst job market for new grads in the county. So, after being rejected for hospital jobs, I accepted a job at a SNF/rehab facility in August 2012. After working there a year now and continually applying for better jobs, still no hospital job offers have come my way.

I have only had two hospital interviews. Both interviews were with a hospital that had hired many of my classmates recently. I was the only one in my nursing class that actually worked as a RN job during our master's degree program. None of my classmates had medical backgrounds. After being with my classmates almost every day for 2.5 years, I know for certain that none of them had better experience than I did.

So I'm asking myself, why are they getting the jobs and I am not? My GPA was 3.93. I have been told by many recruiters that my resume is very good. I have good references. I have at least SNF experience. I wear nice suits to my interviews and speak articulately. Yet no hospital job offers.

In both of my interviews with this large hospital chain, when I spoke about my SNF experience and all the nursing skills I did learn from it, my interviewers seemed to "poo-poo" that experience. They made sure to remind me, "it's not considered acute care experience...". Yes, I know that, but shouldn't that experience be worth something? Well, apparently it's not worth much in the mind of interviewers.

I can't even get a home health or hospice job. Actually I'd much rather prefer an hospice job anyway. I went on a hospice interview, and the story was pretty much the same.

Because I have paid RN work experience, I'm not eligible for new grad jobs. But the other jobs posted ask for acute care experience, which I don't have. So it's a catch 22. I feel totally stuck working at the SNF.

I am thankful to have any job right now, but SNF jobs are fraught with problems from ridiculous patient ratios (1:30 or 1:40 where I am at). So I am passing meds for 30-40 patients, treatments, taking and inputting orders, calling docs and family, handling the emergencies like falls that happens almost every shift, and the mountains of charting on computer systems what are frequently slow or down altogether. And we get in trouble if there's overtime. It's truly a 'no win' situation.

Anyway, I just wanted to vent and say that depending on where and who you interview with, SNF work may or may not be well received.

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Specializes in public health.

Are you looking for jobs as a rn or np?

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Specializes in psychiatric nursing.

I am looking for a job as a RN, since I'm not a NP yet. I just started the NP post master's program. My MSN was a generalist degree with a specialty in case management, so it did not allow me to sit for the NP certificate.

98% of my classmates found hospital case management jobs. Two of them found RN jobs on the hospital floor as a staff nurse. I have been rejected for both types of jobs.

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Specializes in Pediatrics, Emergency, Trauma.

At the facility I work at, it's not a barrier...most likely it is because it's a mixed facility. We have a whole short term unit; as well as a mixed unit; and they prefer to treat in house; so we hang fluids, IV abx, have wound vacs, trachs, etc.

I suggest if you cast your net wide for a long term acute care hospital facility (LTCAH) for another position or moon light per diem if possible for a more "acute" experience.

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A couple of things:

1) You've only got a year of experience which is still minimal. I didn't get any action until I'd it the two year mark. You may simply be a bit early still.

2) When I graduated, I was hosted for a visit by one of the ICU managers at UCD. He told me that he likes newer nurses out of the SNFs because they are used to dealing with minimal resources and many patients. Just his opinion but try not to get discouraged. You're still pretty green.

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Specializes in public health.

Is your NP program online or do you have to go to school. I ask this because I have seen case management position posted online for new grads. If you can move.....

I am looking for a job as a RN, since I'm not a NP yet. I just started the NP post master's program. My MSN was a generalist degree with a specialty in case management, so it did not allow me to sit for the NP certificate.

98% of my classmates found hospital case management jobs. Two of them found RN jobs on the hospital floor as a staff nurse. I have been rejected for both types of jobs.

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Specializes in psychiatric nursing.

My facility also has mixed units, and so I have gotten at least some experience with IVs, trachs, ostomies, etc. There is only one LTAC in my area (Kindred) and I have also applied there and received a rejection. Kindred is very firm in only hiring nurses with at least 6 months acute hospital experience, at least in my area in California.

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Specializes in psychiatric nursing.

Yes, my NP program is online through the University of Colorado. I thought of moving, but my husband says absolutely he won't move. He likes his job and doesn't want to leave it. And since I don't really want to get divorced, I don't push the 'moving' issue any longer.

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Specializes in Critical Care, Education.

I am a bit confused.... OP says she worked as an RN while she was in her "entry level Masters program". How can you work as an RN if you haven't yet completed an entry level program? But I digress . . .

Honestly, GPA & even NCLEX success is pretty meaningless when it comes to entry level jobs. There is absolutely no correlation between those factors and clinical competency. Things are getting a bit better now that NCLEX is evolving into more 'real world' critical thinking (select all that apply) questions but it has a looooong way to go.

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Four women who are in my new graduate program have two years of experience in a skilled nursing facility: Two are on med/surg, two are on telemetry. A SNF job is not a barrier at all. My preceptor transferred units - she started out at a SNF for two years, when to med/surg (new grad) for 9 months, and is now a NICU nurse.

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Specializes in psychiatric nursing.

The way my master's program worked was that the first 4 semesters were dedicated to RN licensure. After that time, we could take the NCLEX, and if you pass, work as a RN. However, my program then continued on for 3 more semesters for the actual master's degree work in the case management specialty. So by the time I actually graduated from the program with the master's, I was already working as a RN for 9 months.

To get into the entry level master's program you already had to have a bachelor's degree, in any discipline. I had my bachelor's degree in Business Administration.

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Hi PeacockMaiden,

I'm in sort of in the same boat as you.

Graduated in Dec 2011, licensed in Jan 2012 with RN, BSN, PHN -- couldn't get into any kind of New Grad Program. I am in Southern California, and probably the other worst area for new grads, second, if not equally as bad as Sacramento.

While in my med-surg rotation in BSN (in Nor-Cal) -- I was encouraged to put in my application at this hospital because the staff really liked my work ethic, people skills, IV start skills, etc --- and the med-surg new grad position would be guaranteed for me after my licensing. I didn't take it because I needed to come back home to Southern California. Like you, I graduated c a good solid GPA; my professors/clinical instructors back in BSN wrote all kinds of recommendations for me; praised that I had exhibited excellent nursing/clinical knowledge skills, and that I would be a good nurse someday, blah blah blah.

For a whole month after licensing --- 10-16 hrs a day, 7 days a week, I was putting in my application everywhere. I became so desperate that I endorsed my license to other states in hopes I would get an "acute care setting" nursing job. Nothing. Unlike you, I never got any hospital interviews.

I'm also probably one of the very few nurses in my BSN program who has not held a hospital job to-date. And yes, I share the same sentiment, I also had classmates in BSN who had failed in clinicals who have hospital jobs today because either they knew someone, or that they are related to someone working in the same hospital (the latter being more of the case).

Finally -- I decided, out of my desperation, I'd take any job I could get. So I did -- Home Health. I did that for four months, and then SNF with a variety of units ranging from sub-acute/subskilled/residential/SNF/and SNF level 2. So, I share the feeling of being drowned from too much paperwork, 0 OT hrs paid, staff and patient overload (from 1:16 to 1:42). It is insane, to say the least.

Then I thought I entertain my hospital dreams after 6 months --- nothing --- but I got a call from the County for a PHN job. I did the PHN job for 6 mos.

Then got admitted to MSN-FNP program where I finally decided I needed to focus on school, and entertained my hospital dreams again even if it will just be per diem/part time. I've also done research on this one, and it makes me really nervous because --- hospitals require acute care nursing experience of xyz amount of yrs for a NP to actually get a job (especially here in SoCal, and probably NorCal as well). I don't have that.

My former DON at my old SNF job called and offered me a DSD/Director of Staff Development position full-time at another SNF, which sounds like a great job, and perhaps, prestigious position to have -- teaching nursing staff etal... but I think to myself --- how will that experience actually be of benefit to me when I will be practicing FNP in the future...So... I don't know if I should take that position knowing it may not be the best fit for what I'm academically pursuing for. :cry:

I'm thinking positive, but at the same time... I also don't really know how to attack the situation.

I also thought about volunteering; I've contacted a few people, but volunteering for someone who needs to pay the bills may not work either. I know there are options out there, we just have to keep looking.

How about hospital-sponsored job fairs? Another posting I also read is to apply for a per-diem position just to get your foot in the door (which I've also tried, and still waiting for a call) --- it's worth a shot!!!

Keep on keeping on!!!

Best of luck!!!!!

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