SNF DON with MSN Can't Land Hospital Position

[Nurse Beth, MSN]

Dear Nurse Beth,

I am having trouble getting interviews for jobs as a nurse with 5 years experience. I have applied to about 20 or so hospital nursing positions ranging from Med/Surg staff RN to Assistant Nurse Manager. I believe the issue I’m having is my current position and degree.

I have a MSN in Nursing with concentration as a Nurse Executive. I also have a BS in Biology. I am currently working as the Assistant Director of Nursing at a skilled nursing facility with about one and a half year experience in that role. I oversee nurse managers, supervisors, nurses and nursing support staff in this role. Prior to this position I was Nurse Manager at a sister facility for 2 years and prior to that I was a staff RN before I graduated nursing school. I was a staff RN for 2 years before I was promoted to Nurse Manager.

My question is, am I having difficulty landing interviews for staff RN positions and ANM positions in hospitals due to my education/work experience or is it because I am not experienced in the hospital setting? Am I not being considered because I’m overqualified or is it something else? These 20 or so positions are all non-managerial except for two assistant nurse manager positions. I have applied to these 20 or so positions in various local hospitals about 2-3 weeks now. Please help!

Dear Having Difficulty,

I would guess that you are seen as a flight risk by clinical nurse managers. It's not your MSN in and of itself, it's your MSN plus your current position as an Assistant Director. On paper your profile is more of a nurse in leadership than that of a clinical bedside practitioner. It's not clear if your bedside experience was all in skilled nursing or not. If so, if you have only skilled nursing experience and are applying to acute care, that could be another reason.

You say you worked as an RN for 2 years before graduating nursing school, do you mean before getting your MSN?

You've also applied to 2 managerial positions, and your skill set is managerial. But often in hospitals they prefer the managers to have a strong clinical background for credibility and for understanding of the inner workings of a hospital.

You are not only switching from leadership to bedside, you are switching from skilled nursing to acute care, which is challenging and can take longer. Anytime you switch tracks it takes longer to get your foot in the door.

You must tailor your resume and cover letter to each position. If you are applying for a clinical position, downplay your Director responsibilities and highlight any clinical experience you did have. Did you ever cover on the floor when it was short? In your cover letter, stress that you are passionate about returning to the bedside. Give them reason to believe this is your goal, not a stepping stone.

If you are applying for managerial positions, you have excellent skills sets. Landing a managerial position takes longer, so be patient.

You've only been applying for 2-3 weeks, which is a very short time.

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[Hoosier_RN, MSN]

I was wondering how you were working as a staff RN prior to graduating nursing school. Perhaps you misworded this? If this is on your resume, you may want to consider rewording or getting off of there. You can't work as a nurse prior to graduation or licensure, and any HR or NM would know this. I'm sure you meant something else, and would look to change that as needed.

I hope your search brings you the job you want. Good luck!

[Adonai Adonai]

Thanks for the advice! Yes, I meant to state that I worked as a Staff RN for two years after graduating from nursing school. I obtained my BSN during those two years.

[Forest2]

You only just started. Keep applying. It may takes months and months to find a job.

[Hoosier_RN, MSN]

You may need to factor in that with non-acute, managerial experience, and an MSN, they probably assume that you will want more money, that without some acute experience, they won't pay usually. Management positions in hospitals usually require the acute experience. If you have a friend who works in a hospital that can help market you there, use it!

[SummerGarden, BSN, MSN, RN]

OP: I agree with those that state your resume needs to reflect only one position. Also ANMs of clinical units are clinical entry-level managers. We are not Staff RNs, but we work the floors and can be pulled into the count as well as cover breaks. And so, you may be considered under qualified clinically for an ANM position in the hospital setting on a clinical floor since you have not worked as a RN in the hospital setting.

By the way, most department managers and directors within a hospital setting on the clinical side are typically those who grew up as RNs within the hospital setting. The politics (yep, it is a real thing) are not supportive of nurse managers without bedside acute care work experience in the hospital setting. However, breaking into management within the hospital setting is still possible.

You may want to consider positions that are for nurse managers (or ANMs), who are not managing direct patient care departments. Specifically, departments such as QA, Case Management, Risk, Clinical Education, Staffing, etc.. I know of some former SNF directors and managers who received their break as managers within the hospital setting going this route. I know of one who is now an executive after being a director of Case Management for two facilities for several years. Good luck!