ADVICE NEEDED: New Grad going into Post-Acute Rehabilitation Facility

[J.O.RN, ADN, RN]

Hi everyone!

I recently graduated from an ADN program in May, took the NCLEX end of July, and officially became a registered nurse! I am so excited to start my career as a nurse. I started looking for jobs immediately after I received my license number, and it has been such an overwhelming experience.

I am starting school in October so I can get my BSN, because I know many hospitals prefer or even require a bachelor's. My plan was to get a job before starting school and gain experience. 

I do not have a lot of experience in healthcare, and was only a CNA for 8 months during nursing school. I worked at an office in my college for a total of 3 years and that's my only job experience. I quickly realized that nobody wants a new grad nurse with no experience in healthcare. Nothing in my resume makes me stand out ? 

The whole month of August, I applied to multiple hospitals. I am interested in ICU, ER, Telemetry and even Med-Surg. I know that as a new grad, ICU/ER or any specialized department is very difficult to obtain. I still hoped for the best and applied for those positions. I haven't heard anything back, and many of my applications have not been accepted. It's very discouraging. 

I applied to a RN position at a Rehabilitation center close to my home. After three days of submitting my application, I got a call and scheduled an interview. I was very excited. The interview went very well, and met the DON. I was offered the position and I will begin my orientation this week. At first I was hesitant to take the position because I have always wanted to work in a hospital. But this is not the time to be picky, experience is experience. I want to learn everything I can during this "New grad" period. I won't lie though, I am extremely nervous. I have heard so many stories about new grads working in rehab, and getting 15-20 patients at a time. I hope I will be able to handle it ? 

Ever since I started nursing school, I always read different discussion boards on this page whenever I needed advice about something. I saw it as experienced nurses giving ME advice. I see all of you as my "Nurse Moms" ? 

Now I truly need advice. ANYTHING is helpful. I want to know how to properly prepare myself as a New grad, things I need to know about working in a rehab facility, how to not pass out on my first day and anything else you guys recommend! I'm open to any advice.

Thank you everyone!

[bethp2, ADN, BSN]

Hi J.O.,

Congratulations on passing NCLEX and getting your first job as an RN! I am also a new RN and started at a post-acute rehab facility about 6 weeks ago. The work is hard but you will learn a lot and I think it is a great place to start. Most of your time will be spent passing out medications and charting. However, you will also deal with IVs, catheters, colostomies, wounds, PEG tubes, etc. and more depending on the patient population. Formal orientation will likely be short (maybe a week?) but after that, continue to ask questions and use the other nurses as a resource. My facility is very teamwork-oriented and I feel like they understand I am a new grad and have not put too much load on me in the beginning. I hope your facility will be the same ? Being on your feet all day is physically tiring, so just remember the basics to take care of yourself: good nursing shoes, compression socks, and drink water throughout the shift. Except for maybe a protein bar, I don't usually eat during my 8-hour shift, but I make sure I eat well and eat healthy outside of work. 

Everyone says the first year as a new nurse is really hard, no matter where you work. But they also say it gets better with time. Remind yourself of that when you have a hard day, and keep going forward!  

[mmc51264, BSN, MSN, RN]

I started in an ortho rehab facility that was part of an LTC. It was great for me. Taught me time management and critical thinking skills. When I was offered a job on an ortho unit after 10 months, I was still considered a new grad and was eligible for new grad residency and I had a lot more experience than the other new grads. 

I don't know if I could have stayed in the rehab position forever, but it was a great place to start. 

[J.O.RN, ADN, RN]

On 9/9/2020 at 12:12 PM, bethp2 said:

Hi J.O.,

Congratulations on passing NCLEX and getting your first job as an RN! I am also a new RN and started at a post-acute rehab facility about 6 weeks ago. The work is hard but you will learn a lot and I think it is a great place to start. Most of your time will be spent passing out medications and charting. However, you will also deal with IVs, catheters, colostomies, wounds, PEG tubes, etc. and more depending on the patient population. Formal orientation will likely be short (maybe a week?) but after that, continue to ask questions and use the other nurses as a resource. My facility is very teamwork-oriented and I feel like they understand I am a new grad and have not put too much load on me in the beginning. I hope your facility will be the same ? Being on your feet all day is physically tiring, so just remember the basics to take care of yourself: good nursing shoes, compression socks, and drink water throughout the shift. Except for maybe a protein bar, I don't usually eat during my 8-hour shift, but I make sure I eat well and eat healthy outside of work. 

Everyone says the first year as a new nurse is really hard, no matter where you work. But they also say it gets better with time. Remind yourself of that when you have a hard day, and keep going forward!  

Thank you so much for your response! I have done a total of two days of orientation and I AM EXHAUSTED. They told me that they are giving me 10 days of orientation, and I was very shocked. I might ask for an extension, but I'll see how it goes. It's going to be very difficult. I already feel like I've learned so much but at the same time I feel clueless. I am lucky to say that my preceptor is very sweet and does not make me feel dumb for asking questions. I really do need to invest on new shoes and compression socks, because I'm already sore from only two days on the floor ? 

Thank you again, and best of luck to you! ❤️

[J.O.RN, ADN, RN]

On 9/9/2020 at 7:50 PM, mmc51264 said:

I started in an ortho rehab facility that was part of an LTC. It was great for me. Taught me time management and critical thinking skills. When I was offered a job on an ortho unit after 10 months, I was still considered a new grad and was eligible for new grad residency and I had a lot more experience than the other new grads. 

I don't know if I could have stayed in the rehab position forever, but it was a great place to start. 

I have heard many people at my new job say, "if you can work here, you can work anywhere!" and although that's kind of scary to say to someone who's only been orientating for two days, I do see what they mean.

The patient load, the medications, and charting seems like so much work to do. It is doable though, and I know it will help me gain so much experience and knowledge. It will also prepare me well if/when I do end up working in a hospital.

I can't wait to see how much I learn in just a few months!

[motherofcats, ADN]

Congrats! And welcome to the jungle. You will truly get SO much experience, in prioritization, being flexible, delegating, all that! I am/was a new grad and my first job was post-acute/rehab/SNF (LOL). I was charge nurse for sometimes up to 40 patients and it was wild. Make friends with your CNAs, develop rapport with your doctors, get comfortable on the med cart (I did charge and meds sometimes), and roll with it (BUT STAY SAFE). Ask a million questions. You will be in a whole new space within 6 months. I will be honest I had some days I just cried because of staffing shortages but I survived. If its not safe though or the administrator/DON don't seem legit, get out. Too many horror stories. By the way I left for an acute care job about 8 months in. The experience counts!