New Grad starting out at SNF?

Nurses Job Hunt

Published

I'm a new grad with no jobs but was told that I would be better off starting a position at a hospital rather than at a SNF. If I started at a SNF, it would be difficult for me to get my foot in the door at a hospital job since I would have no experience and I wouldn't be considered as a new grad anymore. True?

I'm just so broke and desperately need a job. It's been so hard living like this... I don't know what to do. It's like should I just apply to jobs for now as caregivers? And even just part time jobs? OR should I wait for the RN positions?

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I have a friend who works in a SNF as a new grad. Her patients are 80% acute.
I totally believe this statement...

I worked on a skilled Medicare rehab unit at a SNF/nursing home for the better part of 2 years, but it was structured much like a free-standing rehabilitation hospital. I usually had 15 to 17 of these types of patients during day shift, and about 30 to 34 residents at night. My former workplace liked to separate the rehab Medicare wing from the LTC units, because they did not want the fully alert rehab patients to mix with the demented nursing home residents.

On this particular unit, we dealt with many central lines, IV antibiotics, CPM machines, feeding tubes, suture removal, surgical staple removal, complicated wound care, ostomy appliances, diabetic management, casts, braces, splints, cervical halos, Coumadin monitoring, and so forth. I once had a patient who was receiving TPN.

Most of my patients had recently underwent surgical procedures such as laminectomies, knee and hip arthroplasties (joint replacements), kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.

The non-surgical patients were typically admitted to our unit for recovery from CVAs, acute MIs, debility, various cancers, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, generalized weakness, HIV wasting, motor vehicle accidents, beatings, and other afflictions.

Since this was a nursing home, we did not have adequate staff to care for these higher acuity residents. On most days I had only 1 CNA to bathe, dress, feed, and toilet the 30 people. The attending physician made rounds 3 days per week on Tuesdays, Thursdays, and Saturdays. The residents were highly demanding and their family members were even worse.

I ended up quitting because the stress level resulted in physical symptoms for me such as diarrhea, tachycardia, anxiety, perspiration, headaches, palpitations, and more.

I worked at a SNF as a new grad. And it was pretty rough, it still is. I just took whatever I could because I know they don't hire new grads at hospitals anymore. My teacher told me that get experience for a year at a SNF and then move to something else. Another teacher of mine said you lose your skills at a SNF, which I can see what she means. But with the economy now I say.. take what you can get. I have about a year experience and I'm looking for a second or another job. And I'm having a hard time.

Thank you for your input. May I ask why you say working at a SNF is rough? I am just curious. I have an interview at one on Wednesday (I am thankful for anything at this point.). I worked at one as a CNA at a SNF one summer and then I was a CNA on Med-Surg and I did notice a drastic difference even between the roles of the CNA in those two environments.

I realize the above question was not directed at me, but I feel I can help to answer it.

SNF - meaning a true short term rehab unit or facility serving Medicare skilled pts - not to be confused with LTC or long term care, can be extremely challenging for a number of reasons.

Depending on the unit, the acuity is usually a small step down, sometimes the same, sometimes higher than a typical med-surg patient. The difference is the staffing levels. One SNF I worked at had me covering for a 22-bed unit, as the only nurse, on day shift. I was lucky to have 2 aides. Much like LTC, med pass takes up most of your shift. Not to mention that many of these pts. had recent surgery and require frequent pain meds. Or recent pneumonia and need breathing tx Q4h around the clock. Also, Medicare requires that a full assessment be done on skilled patients every 24 hours. That usually falls on day shift or 3-11. So, if you do the math, on my former unit that means 11 full assessments on top of everything else. Throw in some often complex wound care. And new orders written daily by the NP's that have to be entered/written in the MAR by the nurse, since unit secretaries are often unheard of in SNFs. That also means you'll be fielding all of the phone calls.

Almost manageable until you get 2 admissions at 2:00, somebody crashes, falls or pulls a foley/G-tube/IV out.

Specializes in SNF, Oncology.

I graduated in May 09 and couldn't get a job in a hospital anywhere. I had put in more than 100 resumes/applications it was very sad. I finally went to a SNF and gave them my resume/app and was hired 2 days later. Not my dream job but I was told that if you work on the skilled side of that type of facility that it counts as med surg experience. I don't know for sure. I do know that being a nurse in SNF is hard work. However, that being said, I was just hired in a Hospital and I feel so lost. My mgr is great though b/c she understands that I have no Hospital experiecne and has assigned me a preceptor for 6 weeks or so. It feels weird b/c I can't say that I'm a "new grad" anymore but I'm not experienced either. As someone else has said though, you may just have to take it. Because I worked in the SNF for 10 months then we moved out of state and it less than a month to get a hospital job. So the experience will not make it hard to get into a hosptial, i think it will make it easier. JMO.

Good luck:-)

Another teacher of mine said you lose your skills at a SNF

I had sent out 50+ applications by the time I was finally hired at a SNF. I had a few people tell me that same statement but quickly realized this: how can you loose skills at a SNF if you have none to loose? As a new grad, we do have some skills. But in the eyes of the hospitals, we don't - that's why they aren't hiring us in the first place. The only way to "loose skills" at a SNF is if you worked at a hospital before hand. I've been working at the SNF for 9 months now and am starting to look at hospital jobs again. Although a number of them still say "1-year acute RN experience" (acute = hospital), a lot of them say "1-year RN experience" (no 'acute' requirement = SNF experience!)

Additionally, what will cause you to loose your skills faster: Working at a SNF where you learn time management, interactions with MDs, patient & family customer service, management of nursing support staff, assessments, etc... OR staying unemployed?

i couldn't agree with this statement more. and telling our new grads they should avoid working in SNF needs to end, a hospital job may be ideal but a job in SNF is a great way to begin your career and get your foot in the door. i know several nurses who used their SNF experience as a foundation to landing a hospital job.

and yes any experience is better than no experience.

I had sent out 50+ applications by the time I was finally hired at a SNF. I had a few people tell me that same statement but quickly realized this: how can you loose skills at a SNF if you have none to loose? As a new grad, we do have some skills. But in the eyes of the hospitals, we don't - that's why they aren't hiring us in the first place. The only way to "loose skills" at a SNF is if you worked at a hospital before hand. I've been working at the SNF for 9 months now and am starting to look at hospital jobs again. Although a number of them still say "1-year acute RN experience" (acute = hospital), a lot of them say "1-year RN experience" (no 'acute' requirement = SNF experience!)

Additionally, what will cause you to loose your skills faster: Working at a SNF where you learn time management, interactions with MDs, patient & family customer service, management of nursing support staff, assessments, etc... OR staying unemployed?

+ Add a Comment