LTC vs Dr's office vs ?? for a new ADN grad

[dreavt, BSN, RN]

Hi all,

I'm a longtime lurker, but this is my first post. Hoping to take advantage of your collective wisdom while I make some tough decisions.

I'm 37, just graduated with my ADN, this is a second degree for me (BA in liberal arts from 100 yrs ago), and I plan to go on to get a BSN, or maybe just straight for an MSN, online in the near future. I live in northern New England. The two largest hospitals in commuting distance have recently suspended (temporarily? we hope?) their new grad residency/internship programs. I actually have been working as a secretary at a smaller community hospital while in school, and as example of how crazy things are around here, their new grad program had 40+ applicants for 4 positions (already filled) -- which I didn't even apply for because it requires a 3 year commitment which I was not willing to make. I gather from reading here and elsewhere that this is an issue in many parts of the country right now -- hospitals in general are just *not* hiring very many new RNs.

One of the larger hospitals is the one that I have had my heart set on working for -- longterm I really want to work in an outpatient hematology/oncology setting, possibly giving chemo, ideally working with clinical trials and doing risk assessment, patient teaching, system navigation, etc. It seemed that working for 1-2 years on an inpatient hem/onc unit at a teaching hospital with an NCI-designated cancer center was the best way to get the experience necessary to get my OCN certification, as well as really get to know this population and improve my skills, and of course make connections.

I am continuing to work my connections at this hospital, follow up with the recruiter, etc., and am hoping that things will settle out/improve in a few months and I will be able to get in there. BUT in the meantime.... I should probably get a job as an RN. Which brings me to my question....

Short of acute care experience, what type of nursing experience would be most helpful to me in terms of a) improving my general skills; b) "impressing" (to the extent possible) hospital recruiters; and c) working toward my long term goals. I am relatively confident that I could at least get per diem work (which would mean keeping my current secretarial job, since I carry the insurance for my family) in long-term care or a doctor's office (more likely as a float for a group of outpatient practices).

Does anyone have an opinion on which would be better for me? Neither particularly feel like my "niche", but I am slightly more attracted to the offices -- at least that setting would mimic my longterm plan of working in a hem/onc clinic. OTOH, are LTC nurses seen as having more really "nursing" experience by hospitals, since at least it's inpatient, nurses are rather independent, etc.? Or is there some other option I'm not thinking of? I got a recruitment letter (what? someone actively LOOKING for a new grad nurse???) from an outpatient substance addiction treatment center.... which I would totally have no problem doing, but I have the impression it's basically taking vitals and handing out bupe, which doesn't seem like it would be terribly impressive on a resume.

Thank you so much for any feedback, thoughts, guidance, etc.!

Best,

Drea

[caliotter3]

With the job market the way it is you may have to settle for the offer you get, if you get one. Keep an open mind, unless you are willing to relocate for just the right job.

[stressed5242]

If you want a job in a hospital in the future, LTC would be better (although, the job is not the greatest ). I am a fairly new grad, I have been working in Ltc for 2 months. In those two months (of hell, ha ha ) i've learned, how to insert a catheter, colostomy care, IV administration, (they sent me to get IV certified) wound vac's, wet to dry dressings, Immunizations, urostomy care, all sorts of medication administration, How to read & UNDERSTAND labs, hospital admission/discharge paperwork & mounds of other paper work. I could go on & on, I definitley think ltc experience will prepare you so much more than a MD office if you intend to work in an acute care hospital someday. good luck :)

[dreavt, BSN, RN]

Thanks a lot for your replies! I am definitely not taking anything for granted at this point, and I realize I may have to take what I can get. For now, I am trying to stay a little positive and hope that I *may* at least be able to choose between two jobs I don't particularly want, and I'd like to choose advantageously. Good point, Stressed, about the kinds of skills you're likely to develop in LTC that you wouldn't in an office setting.

Thanks again,

Drea

[MB37]

Do you have LTAC in your area (long term acute care)? These can be even better experience, as you get a little sicker pt than at your typical LTC, and even get to learn vents, etc. Massachussetts sounds like a tough market according to these boards, so you may not have a ton of choices. Apply at acute care hospitals and see what happens, but apply at other types of facilities as well. I've never had a coworker in my ICU mention previous work in a clinic/MD office, although several have worked LTC/LTAC/psych/substance abuse (for whatever that's worth). You'll probably get experience considered more valuable by hospitals at an LTC.