LTC vs Psych

[Satori77, ADN]

I am a new grad who has been offered two positions. One is in a skilled nursing facility and rehab. The other is behavioral health. I know a lot of people say to start med-surg, and I do eventually want to work in the hospital, but unfortunately I have not been offered a position in the hospital.

Both are second shift. The SNF is 2pm to 10 pm, five 8 hour shifts per week, every other weekend. The psych facility is 3 12s, from noon until midnight. Pay is similar. And even though psych is only 36 hours, I can pick up hours to make it 40 when/if I want to. Benefits are also comparable.

My main concern is what would be better for eventually getting a hospital position. Is there one that would be preferred to hospital managers? Does it matter? My dream was always to go into the NICU, but I'm also very interested in oncology, surgical, and ortho.

[Sour Lemon]

Considering some of your possible long term goals, I think SNF would be a better start for you out of those two choices ...but if NICU is your top choice, I think you should look for something pediatric or women's services related, even if it means you have to move across the country.

[Neats, BSN]

SNF would give you more skills that transfer I agree with the other if you want NICU you should get a job elsewhere. If you take the SNF I would volunteer in NICU as a cuddlier or something that places you closer to your goals. If you work in SNF for a year I would apply to the residency program still next go around.

[Satori77, ADN]

I had the feeling that SNF would have more skills that I would utilize, no matter where I wanted to work in the hospital. I have applied for all the women and infant services and even L&D in my area that will accept RN's (one hospital system will only accept BSNs, which I am working on). I know that I might never work in a NICU, and I am not able to move. I have a family here. My husband and his job, my kids go to schools they love, and my elderly dad is here. Moving isn't an option, even if that means I will never work NICU.

[learning247]

SNF- I was in psych for 3 years before finally an opportunity opened up on a med surg floor. AND I'M SO FAR BEHIND (my skills, my knowledge, my prioritization skills have all fallen to the wayside in the time I've been on psych)

[Satori77, ADN]

And that's exactly what my fear is. I really enjoy psych, but I don't see myself doing it long term. I actually like dealing with psych issues with my medical patients, and not doing just psych. Obviously I'm going to keep applying for med/surg positions. I just don't know how long that will take.

[kbrn2002, ADN, RN]

I'll give the opposite response of the others that say the skills/experience you will get in a SNF will make it easier to transition to a hospital later. If the behavioral health position is affiliated with or even better part of the hospital your odds of transitioning to the hospital will be better since you are already in their system and will be given preference over external candidates when positions open. If the behavioral health job is a standalone clinic however, it won't give you any advantage.

Another consideration is regional bias. It's probably not true everywhere, but at least where I live LTC/SNF experience is not considered "acute care experience" and will not be considered when applying for positions that state acute care experience required. But then a standalone behavioral health facility would also carry the same bias. If that is the case where you live go with the SNF, it will definitely give you more hands on skills with way more diversity than a singular specialty like behavioral health.

[Satori77, ADN]

Unfortunately the psych facility is not associated with a hospital, it's a stand-alone facility.

[monkey205]

Does the psych facility have medical unit? I worked in psych hospital on the medical unit and let me tell you, some days it was harder than working on the floors between the wound care, tube feedings, acute injuries, etc.

[Satori77, ADN]

No, there is no medical unit. They don't do any of that except minor wound care and care of colostomies. Anything else medical gets transferred to a hospital.