New Grad - Do hospitals consider LTC as "experience" needed to obtain hospital job?

[Nurse Beth, MSN]

Hi Nurse Beth,

I'm a new RN graduate this past May 2015, and just passed my NCLEX this past October 2015. Concurrently I've been an LVN for the past nine years. My question to you is, should I take a Skilled Nursing position to help me gain my experience for an inpatient acute care RN position. As everyone knows hospitals want experience, however do hospitals consider LTC as the "experience" needed to be considered for inpatient/hospital? Some tell me they do, some tell me they don't. Unsure if I should wait it out and continue working as an LVN in hopes that someone will recognize me and offer me an RN position within the same company? Or move on to LTC and hope after gaining my experience I will be hired inpatient?

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Dear LVN to RN,

Congratulations! As to whether long term care (LTC) nursing experience counts” when applying to acute care, it all depends. It depends on the LTC facility, the skill sets were utilized in the LTC, and if the acute care hiring manager recognizes that there are many overlapping skills. Of course that would be your job to highlight those skills in you resume.

You mention you might continue working as an LVN (hoping) that someone will recognize me and offer me an RN position”. If there is an RN position at your facility that you want, apply for it. It's time to make a move, RN friend. You cannot be passive in your search for an RN job. If you wait until someone notices you and/or you hope that you are offered a job, you will lose out to the person who actively pursues the position.

Back to the LTC question- the term LTC covers a wide range of services, and broad patient population.

Acute vs non-acute

It used to be that there was only acute care” and skilled nursing” (or long-term care”), with skilled nursing not accorded the same expertise as acute care nursing. The thinking was that skilled nursing did not prepare an RN for the intensity of acute care. Now there is more than one level of intensity in the non-acute realm.

New Business Model

The gap between acute and skilled has narrowed as there is a fairly new specialty called ”subacute care” which falls in between acute care and skilled care as far as nursing intensity. Some traditional skilled nursing facilities now have a subacute wing. Ironically, some facilities want their subacute nurses to have acute care experience. The skills are that similar.

Kindred hospitals, for example, describe themselves as transitional hospitals...licensed as acute care hospitals with an additional Medicare certification that supports a longer length of stay – usually weeks not days – as compared to the typical five day stay for patients in traditional hospitals.”

Subacute Care

Subacute provides a level of comprehensive, goal-oriented inpatient care designed for patients who have an acute illness, injury, or disease exacerbation. It can be provided after acute care, or sometimes as an alternative to costly acute care.

These patients require highly skilled, professional care. As a nurse, you could manage vents, wound care, infections, IVs and more for patients with multiple chronic medical conditions. The skills utilized are many of the exact same skill sets required in acute care.

There is both general sub acute care and long term acute care (LTAC). General subacute is less intensive than acute care, but more intensive than long term acute care (LTAC).

So in answer to your question, subacute can be seen as a step towards acute care if that is your goal.

Best of luck to you,

Nurse Beth

[CapeCodMermaid, RN]

All the hospitals around here consider a year's experience in a SNF as experience. We take care of patients with chest tubes, insert PICC lines in house and all sorts of other things that translate into being able to work on a med surg floor. SNF ratio on the sub acute unit 20:1---at the hospital 5:1

[LVN2RNpanda824]

Thank you so much for taking the time to respond and clarify the differences between LTC and the experiences gained at these facilities. I believe this post will help lots of LVN-RN students like myself. I'm in the first semester of my bridge RN-BSN program and decided to work as an LVN within my current company. I have a weekend job set up at a LTC facility as an RN until I finish my RN program in December. Meanwhile, I'm still applying to new grad positions in my area. Keeping my fingers crossed! Thanks again Nurse Beth!