Help!! Can new grad BSNs start in Long Term Care and move to the Hospital Setting?


So I am starting this thread hoping to find some success stories of nurses who are a little further along in their career who were able to start in Long Term Care and move into the hospital setting.

As a new graduate I have applied to many hospitals...and even to get an interview is so difficult. As ANYONE who has browsed the job market lately can tell you, their are not alot of job postings listed...and those that are require 1 year of experience. I have to get a I am resigned to the fact that I will have to start in a nursing home.

I know this may sound elitist..but their are those of us new grads who went to nursing school specifically to get into the hospital setting--and tailored their education to that end. In my case, I got the BSN right away. I did a hospital externship and ect--just so i would be prepared for work in that setting. This is why I invested $60,000 and almost five years in college.

People who work in long term care are special people..they are providing quality of life to those who are frail and weak and could not take care of themselves..this is God's work and I believe that. However...i feel for myself that this is a waste of education to get a job that you only need an LPN licence to do..I have no interest in administration or managment...just acute care of adults. I am sorry to say this as I know it will offend some..but I just feel like I should be able to get the career that I paid and worked for...but have heard so much about becoming unhireable in the hospital unless u start there right away from college.

Can anyone offer any advise as to what I could do to become more marketable in the hospital or stories of hope? I am interested in what any recruitors have to say about this as well.

Thanks so much!!!



2 Posts

congrats on passing nclex! i recently graduated in may 09. i passed nclex on july 15 and started an rn position with northshore university healthcare system july 27. they have a new grad program and i started with 25+ new grads (of adn and bsn rns). northshore is really good about hiring new grads. i recommend contacting the hr department of the hospital you want to work at (build a relationship) and the specific manager for the unit you want to work on. email or mail your resume and portfolio then follow up with an email or phone call. when you do interview, bring additional resumes, references, and portfolio. i had a folder ready for each person containing those documents. bring extra copies because you never know how many people you will meet and interview with the day of.

i did have a leg up when applying for the position i'm working right now. i worked as a cna at the hospital for 2 years before applying. also have exceptional references from individuals of status and reputation.


50 Posts

I am curious about your question too. I am also a new grad and there is NOTHING in the hospitals for us new RNs. I have even applied to sub-acute facilities/LTC (nursing homes/short term rehab etc.) and they don't seem to be hiring either, however it is probably our best bet to get a job at the moment.

I too do not want to go into LTC for the same reasons you stated. If I wanted to work in LTC or a doc's office, I would have become an LPN instead of a RN. I want to work in a hospital so that is why I chose the more expensive and more time consuming path to become a RN. Most LTC facilities want RNs to supervise the LPNs and CNAs, and as a new grad, I don't really feel like I have the right to be supervising LPNs who have been working for many years and could teach me a thing or two!

On the other hand, my former nursing instructors told us that it would be better to work in LTC rather than no where at all. If you have to go to LTC, try for ones that offer short term rehab for post op patients still too sick to go home. We would have dressing changes, IV meds, wound vacs etc. which would help us to gain confidence with our psychomotor skills, and this would be at least "close" to an acute care patient. That experience would count for something and it may help you to get into a hospital once the job market opens up again. That is what I am thinking of doing.

I know it is not ideal, and believe me when I say I am not too happy about having to go this route either, especially since I really do not want to start a job only to leave it a few months down the road when I can get a hospital gig. I would feel pretty crappy about doing that to the facility that hired me and gave me a shot.

I do know of people who started in LTC and then went into the hospital, and they were fine with the transition and actually valued their stint in LTC - one being one of my former teachers who also graduated during a period when nurses couldn't find jobs. But then the shortage caught up with them again and they were happy to hire nurses who came from LTC facilities.

I would love to hear what someone who actually went through this recently has to say about going from LTC to hospital practice. Thanks for posting the question, Sarah


85 Posts

Hi. I think ?Brian? the moderator for went through the same thing. He did LTC first then transitioned to the hospital setting.


14 Posts

Hello there... I am in the same boat you are as a new grad BSN. After being terminated from my first RN job in a hospital after a week over politics, I can tell you that I am thankful for the job I have doing LPN work in a nursing home. I was born for the acute care setting, but I've had to backtrack a bit. After my orientation I will move from LPN to RN status when the position comes open. I just got the job today, and it's not where I want to spend the rest of my life, but after 6 months-1 year I will be able to transfer somewhere else and keep moving up the ladder. Like you, I was in college 5.5 years and spent over $80,000 on school and study abroad. I feel your pain, and it's an 11 on the 1-10 scale.

If a nursing home around you is not what you'd like to do, try a Long Term Acute Care facility instead. They have those and they are more like a hospital than a nursing home. They build your skills with sicker patients than a nursing home can handle but they will be present for a longer period of time than those patients in a hospital. I am looking for them in my area but I'm sure it will be a difficult task in rural Arkansas.

I wish you the best of luck. Just know that you are not the only one out there with this dilemma! :sstrs:


14 Posts

Hello all...

I wanted to follow-up on the reply I had posted earlier. As a new grad BSN now working in a nursing home under the job description of an LPN... I can say after only two days: I LOVE IT!

I have never been one for nursing homes. Frankly, and no offense: they creep me out. But let me tell you, in two days I have gained so much that I thought I'd never use in this setting. The staff (all LPN's) respect me, teach me, and value me just as I value and need them. And I love my patients- all 83 of them!

I do not lack for skills. I pass many meds and some days that's all I'll do, but I've also performed assessments, charted in care plans, procesed admissions and discharges, spoken to families, written orders, delegated to CNAs, and even had my first staff meeting with the administrator. In two days I've worked with IV's, PEG tubes, tube feedings and wound care. In fact, I will be the wound care and treatment nurse for the next week! As told by my D.O.N, I will be working with trachs, blood, even vents at some point. Let us not forget the multitude of psych issues that I deal with on a daily basis. I learn about insurance, Medicare and Medicaid, and about the many forms of abuse that patients suffer...things certainly NOT taught in the acute care setting because there's not enough time. In the next few months after I build my skills, I will be in charge of the entire 100 bed unit on the weekends when the pace is slow.

The nursing home is becoming more acute all the time. There are moments when I lament the fact that I'm not working in the hospital and I'd love to go back, but I am valued and needed at this facility. If I don't get hired on in a hospital at some point in the future, they'd be crazy!! New grad BSNs, there is HOPE and there are JOBS! There ARE those who will value you and your education and in turn, you will value yourself. Please do not overlook LTC as a short or long-term career. I've made an unexpected change and it has definitely been for the better, even if for a little while.

God bless :redpinkhe


11 Posts

Congratulations! I am a new grad BSN RN. Where and what facility/company are you working for?


69 Posts

I just wanted to say that I am in the same boat. I havent found one yet but still looking.

any more new grads started off at the LTC? For those of you did, could you share your experience with us?

thank you :)


14 Posts

Has 8 years experience.

I just started my first job at LTC facility because hospitals around me are not hiring. I decided to broaden my horizon so I applied to nursing homes, doctors offices, etc. So far it's quite a challenge for me. I am a charge nurse on nights. I am in charge of 60 pts and 3-4 CNA's. I'm still in orientation and I'm learning a lot about these places since I never had a taste of them in nursing school. I'm flying solo after 10 days orientation...scary! I'm grateful for the experienced CNA's that work for me however I feel it's strange for a new grad to be a charge nurse right off the bat. I'm being optimistic about this and going to try my best until I leave for the Air Force.


3 Posts

hello. i wanted to ask if i were to take a part time rehab position as a new grad in a hospital setting, will I still be hard for me to transfer toa med-surg floor or any unit after a year experience? Wil is till be considered as a new grad even though i am in a hospital setting?

Experience in a long term care setting is a good stepping stone to acute care. Considering that the aging baby boomers are the majority of hospital admissions in med-surg, the ER and the cardiac units, I have found that the slower pace of LTC gives you time to assimilate new information and skills. There are many quirks in the aging body that seem to go against standard trains of thought. LTC gives a good foundation at a pace that builds confidence.


5 Posts

Has 2 years experience.

I graduated with an RN BSN and went right into a LTC facility that had a medical unit. It had the rehabpatients and the more critical patients. It was wonderful experience. I am so glad I did it. I now have the confidence and the skills to move to a hospital. Don't think any less of LTC. It is hard work and you will learn A LOT!!!!!

This topic is now closed to further replies.