Frustrated trying to get a hospital job!

Nurses General Nursing

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I live/work in the Pacific Northwest where getting into hospital nursing is competitive. I graduated with my ADN in March 2018, got licensed and then employed as a pediatric home health nurse soon after. I have spent the past year working in home health and doing my Bachelor's degree. I have now been licensed for 16 mo., have over 1 year RN experience/employment and completed my BSN at the beginning of June (2019). I have applied for around 20 hospital jobs, 2 specialty internships/residencies, but mostly med/surg positions, 1 psych and 2 urgent care clinical jobs. I'm so frustrated. I have done 5 interviews but no job offers yet. Nothing "bad" happened in the interviews...like oh no, I just blew it. I have had friends who are nursing professionals look at my resume - they said it looks great. I am now being offered a 1 year med/surg residency, which involves classroom training etc. The organization - a smaller hospital - wants a 2 year empoyment contract. A nurse recruiter told me I'm not qualified to work in the hospital setting, "acute care" without going thru a residency. I'm confused - when did it change in nursing that our schooling and clinicals aren't enough? What happened to job orientation and being with a nurse preceptor for x amount of shifts to learn and grow into the role? Where can a new nurses gain the desired acute care experience outside the hospital setting?

I would feel differently if this was a specialty unit or critical care, but we're talking med/surg, floor nursing. I just completed 4 years of nursing school, but that isnt enough....I must do a residency and sign a contract of employment committment for 2 yrs!

The hospital is a one hour commute (requires leaving my residence at 4:45 a.m) and pay starts $7/hr less than 2 other larger hospitals closer to me. I have a family to care for so adding 2 hrs of driving to my work day (3/12s) is a lot.

I am contemplating passing on the residency and getting a job in a SNF to gain more experience...maybe not getting into the larger hospitals closer to my home have to do with only having had one nursing job - in home health. Staying in home health is not an option; I'm incredibly bored and unchallenged, the pay sucks and often the work environment does also!

Any suggestions, thoughts or tips on what I've shared are welcome! Thanks for letting me vent.

Ponymom2

41 Posts

Well you can't have everything.... Apparently that's just the way it is in your area. Not that it's right, but it is what it is... Probably would be just as well to go SNF for a couple years. Contracts become common because nurses jump ship (usually because the place is understaffed,, which leads to most all of the other problems, but that's a whole other topic). Applying at 20 hospital jobs and having 5 interviews isn't really all that much.

I was never into the hospital thing, but only because of the long commute... I was ALL about working as close to home as I could. I live rural, in a beautiful area and I LOVE my 'little' place here, so commute time was a big factor to me, nothing is close to me.

I eventually left nursing entirely to go back into manufacturing. The pay was higher, the benefits much better, the aggravation (due to being understaffed) was non-existent, and the commute a good bit shorter, with only two roads to drive on (I live in a very heavy snow area).

I'd go the SNF route. I think the longer daily commute with the lesser amount of pay will really weigh on you. You may get mandated at times and then you have that long drive home after that. I'm not familiar with your area, but factor in weather extremes, too.

beekee

839 Posts

Beggars can’t be choosers they say. Personally, I would have a hard time with a commute like that, but I may do it just for the experience. The longer you are not in acute care, the harder it is to get in, in my experience. Good luck!

allnurses Guide

Nurse SMS, MSN, RN

6,843 Posts

Specializes in Critical Care; Cardiac; Professional Development.

When did it change you ask? A long time ago! I am honestly wondering how you did not know this, and I don’t mean that to be snarky.

It sounds to me like you got exactly what you were looking for. A residency is only going to do good things for your patients and you, including helping with the reality shock that is awaiting you in the world of acute care. You definitely do not even know what you don’t know based on your post, which means the residency will serve you well.

Take the job, recognize you got lucky (most hospitals only hire new grads into their residencies) and use it to make yourself an even better nurse.

Your opportunity to get into acute care will only become more difficult with time. There isn’t much crossover between SNF and acute care. If that doesn’t bother you then go the SNF route but if acute care is where you ultimately want to be the residency is a fantastic opportunity and working for a SNF may very well close that door forever.

LovingLife123

1,592 Posts

It’s always been this way. At least in the time I’ve been a nurse. You should be happy to get a residency position. It will help you.

No, clinical are not enough. That’s not experience. Plus, you’ve been a year removed from those clinicals now. SNF is not going to give you the experience you need to get into acute care.

I commute 45 minutes each way to work. I have a family to take care of as well. But my husband takes it over on days I work. But I like that time to decompress from my day before getting home.

If your goal is acute care, take this job. I’m surprised you are being offered a residency program. Those are usually reserved for new grads only.

SoCalRN1976

15 Posts

Specializes in RN.

I will let you know. I have been an RN 27 years. Before my nursing degree, our country in the 1980's and early 90's was in an nursing shortage... bad. There was a huge influx of international nurses from all over the world who was brought here, to work under a work visa. It was that bad! it was called being SPONDSORED. I graduated in 92. Jobs were not that plentiful. I applied everywhere. I got a job at a teaching hospital. I was the ONLY American working at times. My nurses were from Ireland, England, the Philipines. It was like a little UN convention at times. None the less that was back then.

Shortages have never been that way since. There has been an influx of nursing students and colleges are saturated with nursing students often waiting years to get in! NOT what I had to deal with. Jobs are not that easy and hospitals often want staff who can hit the floor running.. meaning no intensive 8-12 week mentorship.

Hospitals have alot to invest in a new grad type of RN position. If you don't land an acute job out of school and you settle into home health, or a SNF you will be labeled and unfortunately seen as non acute experience. I have had this happen to me when applying for outside jobs an they see 13years of a prior specialty on my resume. Its unfortunate but it is how it is.

Your area where you live has alot to do with nursing need, hospital need. Having clinical training at school is not often enough. My one piece of advice.. don't give up I would be resistant to sign a 2 year contract with unmanageable distance. You will burn out and it's not worth the health issues that come with that. Keep you day job. keep applying, but try TEACHING hospitals. They seem to be a bit less eager to higher an old nurse like myself that will cost them nearly 100K in annual salary. Also smaller hospitals.. are less eager to pay an old nurse like me that salary. Also make sure you are looking at new grad positions. Hospitals sometimes offer "new grad" openings. I'd flood those as well. You already have more experience then they do, but not acute! You could be seen as a viable candidate still.

Flood the smaller community hospitals and teaching hospitals. They don't have the big financial baking of the larger hospital franchise....

Specializes in Mental health, substance abuse, geriatrics, PCU.

I think you should consider taking the job in order to get the experience. A commute sucks but honestly if you just accept it for what it is and get used to it you'll find a rhythm and routine. I know the pay they are offering isn't great, but the experience could prove to be very valuable especially since they're giving you a full residency.

On the other hand, if the commute and contract are just too much I would advise getting into a good SNF. It's not acute care but it will expand your skill set that will cross over with acute care. I would encourage you to do some research and see if there are any chronic vent facilities in your area as you can learn and do a lot in those types of facilities.

I would also encourage you to try to enjoy wherever you decide to work. Remember acute care isn't the end all be all and there are many lucrative, satisfying, and challenging jobs outside of the hospital.

Good Luck!

Editorial Team / Moderator

Lunah, MSN, RN

14 Articles; 13,766 Posts

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Don't turn your nose up at med/surg, OP... it is actually its own specialty with a board certification (CMSRN). As others have said, beggars can't be choosers. You applied, you interviewed, you were offered a position — this is not bad news!

JKL33

6,777 Posts

Keep looking for acute care positions. Although there were no major snafus during interviews, review them all in your mind for how they could be improved. Did you seem to make connections...why/why not, did they seem receptive to the way you handled questions, did you take the time to know a bit about each employer/position, etc.

A proper orientation is not inadequate to train/orient a nurse these days or ever. Proper orientations have included the required certifications as well as specialty-specific classes for a long time; things like that didn't come about with residencies. The problem seems to be that an adequate orientation is rarely how things play out for various reasons (poor staffing and/or unit culture, nurses overburdened in other ways), and then the new nurse is very unhappy and moves on. Enter "residencies" with their compulsory contracts. The problem is, the same issues that affect orientations also affect residencies; at some point you're out on the floor trying to learn how to manage an assignment (or, later, handle one on your own) and there is either a supportive culture where you can safely care for people or there isn't - - but that issue isn't determined by the existence of a residency vs. an orientation.

The way to look at these non-negotiable contracts is that you agree to pay for additional training either by making a time commitment to an entity whose operation you won't truly know ahead of time, or by being prepared to pay money to leave before your commitment is up.

I do agree that a med-surg position is challenging work and provides an excellent nursing foundation; you will learn a ton and you might love it and want to stay. And you might find that you're not getting any acute care job in your area without a contract.

Only you can decide how the commute, the pay, the contract, etc. figure into your sense of what is acceptable.

Thank you for this feedback...I have found it the most helpful! I understand that I have a lot to learn on the floor and see the value of having a preceptor. As a student nurse I learned there were 2 "routes" to getting into the hospital, 1. Nurse residency programs 2. 1 year of nursing experience, getting a BSN, then starting in med/surg. I applied for a few residency programs as a new grad, but they are very competitive to get into and I was never contacted. So I went the 2nd route, working in home health and completing my BSN. Let us not discount homehealth as nursing experience....we still must use the nursing process, use critical thinking, make important judgements, use skills to provide a wide variety of care, and work with other care providers such as physicans and therapists. The experience I am lacking is managing care for multiple patients at a time, delegation and prioritization...and I am sure there is much more! As a new nurses I am willing to learn and grow with the help of experienced nurses as a valuable resource! Thank you again for sharing your insight.

13 hours ago, Pixie.RN said:

Don't turn your nose up at med/surg, OP... it is actually its own specialty with a board certification (CMSRN). As others have said, beggars can't be choosers. You applied, you interviewed, you were offered a position — this is not bad news!

Definitely not turning up my nose at med/surg...I picked med/surg as my 1st option for the residency. I respect and value the knowledge, skills and hard work of floor nursing. I am "turning up my nose" at a 2 hour commute, 2 year contract, as well as much less pay than what is offered at 2 local hospitals closer to me.

On 8/17/2019 at 4:00 AM, not.done.yet said:

When did it change you ask? A long time ago! I am honestly wondering how you did not know this, and I don’t mean that to be snarky.

It sounds to me like you got exactly what you were looking for. A residency is only going to do good things for your patients and you, including helping with the reality shock that is awaiting you in the world of acute care. You definitely do not even know what you don’t know based on your post, which means the residency will serve you well.

Take the job, recognize you got lucky (most hospitals only hire new grads into their residencies) and use it to make yourself an even better nurse.

Your opportunity to get into acute care will only become more difficult with time. There isn’t much crossover between SNF and acute care. If that doesn’t bother you then go the SNF route but if acute care is where you ultimately want to be the residency is a fantastic opportunity and working for a SNF may very well close that door forever.

Thank you for sharing your insight and thoughts. I understand that I have a lot to learn and I do see the value of having a preceptor. What I am having a hard time with is the 2 hour commute, 2 year contract for a lot less pay (than what my local hospitals offer). As a student nurse I learned there were 2 "routes" to getting into the hospital 1. Nurse residency programs 2. One year of nursing experience, completing a BSN, then starting in med/surg. I applied for a few residency programs as a new grad, but they are very competitive to get into and I was never contacted. So I went the 2nd route, working in home health and completing my BSN. Let us not discount homehealth as nursing experience....we still must use the nursing process, use critical thinking, make important judgements, use skills to provide a wide variety of care, and work with other care providers such as physicans and therapists. The experience I am lacking is managing care for multiple patients at a time, delegation and prioritization...and I am sure there is much more! As a new nurses I am willing and able to learn and grow with the help of experienced nurses as a valuable resource!

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