New graduate nurse with only MH experience - how to land an interview in med-surge?

Nurses General Nursing

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Hi all,

I passed my NCLEX and am now an RN. It has been a month since I've began job hunting and had few interviews which I turned down because it was in LTC and I want to ground my nursing skills in a medical or acute area. However, I am an external applicant so the hiring process typically takes awhile.

I am passionate about mental health and my whole year and a half experience has been in mental health (inpatient, outpatient, community) but almost all the recruiters I've talked to, clinical instructors and preceptors have recommended me to get my foot inside a medical, surgical or any unit to brush up on my skills and open up more doors in the future (I admit, I have not done IVs or any foley etc!)

Part of me feels extremely discouraged because I am the least qualified candidate to even get a position in a medical-surgical field or even subacute, orthopedics, or a rehab/transitional area. Been applying for over a month now.

Any advice fellow nurses?

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LTC experience would make you a more desirable med/surg applicant than someone with no experience, at all.

I'm confused about you being a new grad RN and having 1.5 years of experience in mental health ...what was your role there? Were you an LPN?

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You are sorely mistaken if you think LTC has nothing useful to teach you.

Take it from someone who went to a LTC for a few months as a new graduate, then was hired into a level one trauma ED, I would not trade those months of LTC for anything else.

LTC will hone your time management and prioritization skills like no other. You think you're going to have 47 patients with 20 blood sugar checks on a Med Surg unit?

You're going to get into it with some CNA that's going to test you, they smell weakness. It might rattle you at first, but you get a hold of yourself and damnit, you delegate just like they taught you in nursing school. You gain confidence as your coworkers gain a new respect for you.

You might not know how to paper chart like me out of nursing school. My entire nursing education had been with EHRs. Oh so convenient, no need to even call a provider, I'll just alpha page them, and they'll just enter the orders remotely. Transcribing? The hell is that? Welcome to LTC, where many of these facilities don't have the money or the motivation to switch to EHRs. Yeah, paper charting is tedious, yeah calling providers for something trivial sucks (and those ridiculous paper SBARs they made me do), but learning something they never really taught me in nursing school is valuable in my book.

You're probably wondering why we need to know how to paper chart, well, some times EHRs go down, sometimes for an entire shift. But I'm not that nurse that crawls into a corner to cry about it, because LTCs taught me that lesson a long time ago.

So I highly recommend you keep an open mind when it comes to LTC facilities. You don't have to make a career out of it, but I think it is the ideal area for a new graduate to pass through.

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You are sorely mistaken if you think LTC has nothing useful to teach you.

Take it from someone who went to a LTC for a few months as a new graduate, then was hired into a level one trauma ED, I would not trade those months of LTC for anything else.

LTC will hone your time management and prioritization skills like no other. You think you're going to have 47 patients with 20 blood sugar checks on a Med Surg unit?

You're going to get into it with some CNA that's going to test you, they smell weakness. It might rattle you at first, but you get a hold of yourself and damnit, you delegate just like they taught you in nursing school. You gain confidence as your coworkers gain a new respect for you.

You might not know how to paper chart like me out of nursing school. My entire nursing education had been with EHRs. Oh so convenient, no need to even call a provider, I'll just alpha page them, and they'll just enter the orders remotely. Transcribing? The hell is that? Welcome to LTC, where many of these facilities don't have the money or the motivation to switch to EHRs. Yeah, paper charting is tedious, yeah calling providers for something trivial sucks (and those ridiculous paper SBARs they made me do), but learning something they never really taught me in nursing school is valuable in my book.

You're probably wondering why we need to know how to paper chart, well, some times EHRs go down, sometimes for an entire shift. But I'm not that nurse that crawls into a corner to cry about it, because LTCs taught me that lesson a long time ago.

So I highly recommend you keep an open mind when it comes to LTC facilities. You don't have to make a career out of it, but I think it is the ideal area for a new graduate to pass through.

I just wanted to thank you for this response. I know I'm not the OP but I am a new grad starting a LTC position in a few weeks. I've been a bit down-in-the-dumps about it not being my ideal position right out of school but I've been trying to pump my self up. This post really eased some anxiety. I know that all facilities are different and my experience may not be identical to yours, but I know that this is the right move for me right now :)

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Thank you for your feedback. I am aware of the typical role/duties of an LTC nurse but was worried that the skills are not transferable to such units, such as a trauma ED.

I guess the push to go "all medical" from everyone is getting to me.

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Foley's and IV's are just tasks. If mental health is your passion, go for it. You can have a long and fulfilling career as a psych nurse without ever learning those so called "skills".

Best wishes.. go with your heart.

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Thank you. I do wish to explore other areas but I just have no interest in going to an ICU/ER/Burns/Transplant/Neuro etc type of unit. I love being able to interview and assess patients, educating and advocating for people. I feel MH allows me to do all these things without worrying about completing "skills".

I want to specialize in older adults with MH one day, or a relevant field that requires teaching specific to chronic disorders and living healthier and functional lifestyles.

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I've been a psych nurse for 32 years and never worked one single day in med/surg. But if you want that experience, maybe you can look for a med psych position. I know the state hospitals usually have those units for psych patients with both acute and chronic medical problems. With your psych experience you should be a shoo-in for one of those jobs. And the other upside is there aren't a lot of nurses looking to work in those areas so it's not as hard to find a job. Good luck! We need more passionate psych nurses, and especially geri-psych nurses. In fact, you can get a decent amount of medical experience just working on a geri-psych unit.

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