My career just started and all...not sure what to do

[Catch22Personified]

So I landed my first full time job at a LTC facility three months ago. It's pretty good if the census is up. If the census is high more nurses get put on the floor which means less patients for me. I work nights so we get stuck with med record reconciliation/rewrites and a higher patient load. My mom works at the local trauma center and she told me to apply there since a 7a-7p 72 hour part time position opened up at a med surg floor. My mom is apparently very serious about this as she seems to have talked to both HR and the head nurse on the unit.

To be honest, I don't feel ready to go to the hospital yet. I've done only one admission and that was the day after I got off orientation so it was well...rather poorly done. The the people on my shift at the LTC facility have been treating me well and always been willing to help me out. One of my preceptors there treats me like one of her own, and was the one that got me the job in the first place. The part time position pays considerably more and is unionized. RN's in my current facility are not under the protection of the union and tend to be thrown under the bus by administration which is my only real complaint other than crappy staffing if the census is down (38-40 patients at night vs 29-30 if it's up). I feel bad if I just get up and leave. I guess I have some warped concept of loyalty still.

I applied to the hospital as my mom said. My plan was to stay in the facility for a year then drop to per diem after I get my experience, but this is rather earlier than I expected. I'm not exactly sure what to do.

[CrunchRN, ADN, RN]

Grab the opportunity and never look back. Although you should resign very graciously.

[llg, PhD, RN]

Where do you see your career heading in the long run? Do you want to stay in LTC forever? If you want to stay in LTC forever (not that there is anything wrong with that...) then stay where you are. But if you want the option of working in an acute care setting and/or switching to any specialty other than LTC, then you need to take advantage of the hospital opportunity.

The longer you stay away from a hospital environment, the harder it will be to get a job in a hospital and the harder it will be to make the transition from LTC to acute care. It won't get easier with time, it will get harder. So, if you are at all interested in possibly working for a hospital some day ... you need to take the chance while it is available. Don't assume you will ever get another chance. You might get another chance ... by you might not.

[Catch22Personified]

My preceptor told me to treat my current job as a stepping stone but right now, I feel like I don't know much at all. And if I did accept this job I would be going into the acute care setting with like....zero knowledge I feel. I hope the hospital wont eat me alive. But I need the acute care experience to eventually go into grad school for some form of advanced practice.

Where do you see your career heading in the long run? Do you want to stay in LTC forever? If you want to stay in LTC forever (not that there is anything wrong with that...) then stay where you are. But if you want the option of working in an acute care setting and/or switching to any specialty other than LTC, then you need to take advantage of the hospital opportunity.

The longer you stay away from a hospital environment, the harder it will be to get a job in a hospital and the harder it will be to make the transition from LTC to acute care. It won't get easier with time, it will get harder. So, if you are at all interested in possibly working for a hospital some day ... you need to take the chance while it is available. Don't assume you will ever get another chance. You might get another chance ... by you might not.

You make it seem like LTC is a black hole/dead end. I know LTC is not the best but...is it that bad?

[llg, PhD, RN]

You make it seem like LTC is a black hole/dead end. I know LTC is not the best but...is it that bad?

Not really ... but almost. You are not learning the skills you will need in a hospital setting there. Staying there longer won't give you the skills you need for a hospital job. The longer you stay, the more the hospital skills you learned in school will deteriorate.

NO new grad is competent at first. Everyone (rightly) feels they have a lot to learn. The only way to learn those hospital skills is to work in a hospital. Delaying it will make it harder, not easier.

Now ... before all the LTC nurses jump all over me ... there is nothing wrong with a career in long term care. You can get a MSN specializing in geriatrics and do wonderful nursing work taking care of terrific patients who happen to be elderly. In fact, if you like that kind of work and have a talent for it, I think it is a specialty with great potential. As the baby boomers age, the country will be flooded with elderly people -- old people seeking health care -- and people seeking retirement communities, assisted living communities, and nursing homes. It is/will be a growth industry. Someone with experience in LTC will have the option of teaching nursing school, working as a manager, staff educator, or clinical specialist in a geriatric facility, etc. There are lots of possible career paths for people who specialize in that field. If that's what you prefer, there is nothing wrong with that -- and then there would be no need to ever work in an acute care hospital.