One year of Nursing Down in a SNF--- Now what?!

[Lemon_squeezy, BSN, RN]

So to start-

I'm a May 2009 BSN graduate from Delaware who was one of the blessed few with job connections. My mother happens to be a Nurse Manager at a SNF in PA, and was able to help me get started in a Charge Nurse position which I began in July 2009. While I am greatly appreciative of this, and quite comfortable here (I adore my staff and residents)- i'm ready for bigger and better things. I was the charge nurse (Basically 3-11 RN on the unit), up until recently. I loved the position, and it was a great way to build confidence in my patient interactions and leadership abilities, but it was also a position in which I didn't often get to utilize my nursing skills to a large extent.

Recently, they had asked me to start a new RN position they had created in our building's vent/subacute unit (It used to be LPN, and the nursing supervisor would come to do IVs and the like.) THe acuity shot up greatly the past few months, and a full time RN position was needed to join the LPN. While I enjoy this new opportunity (It's nice to finally use more skills, and it feels like a mini ICU considering the condition of some of these residents..)- I am still eager to get out of this area and the geriatric facility field.

I'm planning on relocating to Philadelphia when my apartment lease is up (November). The first problem I am experiencing is one like the New grads.. no jobs! When I graduated college, everyone required a year experience, now that I have that- I feel like every app I put in requires 2+ years. I've been highly interested in Oncology and Psychiatric Nursing for a few years now, and through clinical experience grew to love both more and more. When applying for an RN position that I thought would be perfect (Cancer Tx Center of America, I Believe..) - I was given the same response I got for the first time around.. 'not enough related experience'- despite the fact that most of my clinicals had in some way dealt with oncology, I worked with long term oncology patients, etc.. I'm not really sure how to handle this.

My second fear is that if I stay with the SNF too long, I won't be able to find a decent hospital position. I've heard about being labled the "Nursing home nurse"- does anyone have any input on that? SNFs are no piece of cake to work in, and have a ton of challenges I never faced in a hospital (through clinical, or being a PACU nursing assistant for 2 years)- but I know as well as any other that there is often a stigma there as it relates to nursing homes.

Despite this, i'm trying to remain positive. I'm planning to stick to this new position for a few months (At least until mid-summer... that way I can have an official "year under my belt"- and not to mention not have to pay back vaca time, haha)- but any advice, or perhaps if anyone knew anything in the Philly/Delaware area? I've contemplated getting the nurse manager's number for that original job and sending my resume personally, but i'm not sure how to highlight my sincere interest and skills in hopes to cover for lack of "related experience". Any tips on how to stand out (Especially now that another batch of new grads is emerging..)

Thanks in advance! :]

[ghillbert, MSN, NP]

I don't know that starting in a "charge nurse" position is a favor.. as a new grad, you don't know what you don't know. You have been working about 9 months so far, I would definitely stay in the subacute area for several months while applying for other jobs. Why leave if you have a decent paying job, when you can have that security AND apply for other jobs that you feel would be better-suited to you at the same time? I'm afraid the only thing that tends to count towards experience is hands-on, bedside RN experience. Once you have that, convincing someone by your cover letter and resume is the way to let them know what skills you have that are transferable to their environment.

Does your mom know any hospital nurses that could put a word in for you?

[Lemon_squeezy, BSN, RN]

I suppose It was a favor simply due to the fact that there are still girls who I graduated with that have no job. After exclaiming to her the fact I had put in about 60 million hospital applications in the DE/MD/PA area, she simply said "Oh, you know I have a charge nurse opening if you're interested..". She pretty much arranged for what needed to be done, which was an amazing help. (The job was 3 hours from where I went to school, so it wasn't the easiest thing to arrange for interviews, etc..) Unfortunately, she doesn't really know any hospital nurses. Trust me, I asked - lol.

Either way, I do agree with you. I was not planning on leaving until (like I said) probably September-November. As for quitting my job before I have landed another job- c'mon now.. I'm not that reckless- I have a rent and bills to pay, haha.

Part of the reason I wish to find another job is not just getting out of the SNF, but because i'm planning to relocate. I'm about 2-2 1/2 hours from Philly now. More or less eager to get out of this area and closer to the rest of my family and old friends.

[llg, PhD, RN]

Is there any way you can enhance your resume to improve your "attractiveness" to a hospital employer?

For example, are there special projects you can work on related to the more intensive patients you are now working with? Can you get certified in anything? Can you participate in a nursing organization that would be relavant to hospital nursing as well as the LTC world? Even if it is just a local nursing organization, it might help you network with local hospital nurses who could help you find some local possibilities to enhance your skills and/or credentials. Perhaps, through such local networking, you could find a part time opportunity to do some work for a hospital or for the Red Cross or something that expand your skills and credentials.

You may need to invest some time and money into some activities that will add to your LTC experience to be seen by hospitals as "experienced" in acute care. You might even have to invest a year in an "in between" job. It's good that you are thinking ahead so that you can plan to do that preparation for your move.

BTW: I grew up about 2 - 2.5 hours west of Philadelphia.