I am an RN working in MI. I graduated in May 2013. At the time I had been a CNA in a LTC/SNF for over 5 years. I loved being a CNA there. The relationships I developed with my residents and their families are priceless to me. I was having a hard time thinking of leaving behind those that I had become close to. In addition management was very flexible with me schedule wise while I was in school and I kind of felt that I owed them something. Nursing turnover was very high, and they were short staffed at the time of my graduation.
So I agreed to take a nursing position there. I was given 3 days of orientation.
The transition to my role as RN was very difficult. My work load consisted of 30-35 pts with a support staff of 3-4 CNAs. The patients were over medicated (my opinion), with some patients getting more than 15 oral medications in one med pass. My entire day consisted of crushing pills, mixing them in apple sauce and trying to convince my often confused/demented residents to swallow it down. Facility policy was any incident of nurse overtime that was not pre approved would result in a write up. It was the norm for nurses to clock out and then come back to the floor to finish up charting (off the clock) so as to avoid overtime and said write ups. On the plus side, I can't think of a better crash course in time management. It was my goal every day to be efficient enough that I wouldn't have to chart off the clock.
I was treated very poorly by a couple of the LPNs, who told me that I didn't deserve to be making more money than them because their years of experience were worth more than the 2 semesters of school I made it through that they hadn't (note: this is actually true, but I didn't set the pay scale, and I won't apologize for being a good student).
The only clinical skill that I gained any experience with was placing Foley/straight caths.
I quit that job with out having another one lined up, just out of sheer frustration. The job hunt was dismal. I was told by every hospital I applied to that they wanted experienced nurses or BSNs and that LTC/SNF was "not the type of experience" they were interested in. Finally, desperate for a job I took position at another facility but it was even worse, having what I considered to be a very low standard of pt care on top of the ridiculous pt load.
I finally got a break and landed a job with an in patient stroke/trauma rehab facility that is housed with in a hospital. The max pt load is 8 with one CNA for support. The other nurses have been kind and supportive when I have questions. On days that I would be low censused I am given the oportunity to float to other floors in the hospital to gain experience. I am extremely happy to say that last week I was offered a position on their acute care floor. :)
I apologize, this has gotten long winded, but I the point I'm trying to make is that taking that first job was a huge mistake. It gave me no credible experience, and I strongly feel it hurt me in my hunt for a hospital job. I got really lucky in the end.
Bottom line: I do not advise taking a job in LTC unless that is the specialty you want to stick with. Hold out for what you want, relocate if you have to.
