So the ADN New Grad market is dismal in DFW...

U.S.A. Texas

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I am graduating in Dec 2012. I've been applying for new grad/intern/resident positions and can't even get an interview. I guess because I have no hospital experience?? Anyway, if I don't get a job, is it best to go ahead & start working on my BSN (after passing NCLEX) while I'm continuing to apply for positions? Should I apply for PCT or unit secretary positions now so that I'll have a foot in the door, or will a hiring manager see that & I'll look bad? Any advice on how to get on a career path is much appreciated!

I would work on getting your BSN. In Texas, you can not work as a PCA if your an RN. Just keep looking. Apply to everything!!

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Are you only applying to acute care hospitals? Since everybody (and their mothers) wants hospital employment, your chances of finding work might be better if you look for a job outside the hospital. Nursing homes, home health agencies, hospice, clinics, psychiatric facilities, and other workplaces outside the hospital might be more prone to hire and train new grads.

I do not know where you are in DFW, but the chances of finding a hospital job will increase in you are willing to commute to rural facilities just outside DFW. Texoma Medical Center, Weatherford Regional Medical Center, Wise Regional, Nocona General, and Palo Pinto General might offer better prospects for acute care hospital employment than the facilities in the city.

Also, do not forget about specialty hospitals. Ethicus Hospital, Kindred, Lifecare, Healthsouth, Regency, Vibra, Select Specialty Hospital, Texas Rehabilitation Hospital, Reliant Rehabilitation Hospital, and others will train you and give you a good foundation.

It brutal for BSN so i can't even imagine what ADNs are going through. I still have no job and im a BSN!

Have you tried rehab facilities and LTCs?

I haven't tried any of those other places yet! Thanks for that suggestion. Do you think it would be difficult to transition out of those roles later? I've always heard that if you go work at LTAC, nursing home, etc that you are not looked at highly for working at a hospital later. I don't want to risk that, but I need a job in a bad way!

And I had no idea that I couldn't be a PCT with an RN license!! Thanks for letting me know so I don't waste my time applying for that! I could be a unit secretary though right?

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I think you really need to look at these alternatives. But......an LTAC is not a nursing home. These are hospital patients that have "run out of days". The are vented, have complex ACTIVE medical problems. You will see HALO traction, vents, complex wounds, chest tubes, feed tubes, drain tubes. The hospitals that have BUs will have vents, multiple lines, including invasive monitoring PA lines (Swan Ganz) art lines with active interventions. They have telemetry floors that will have post open heart patients that have complicated post op courses. As a supervisor, I have seen some amazing stuff get transferred through the LTAC door. LTACS are licensed as acute care facilities and usually will perform same day surgery stuff like EGD's, G Tube feeding insertion and trachs.

These patients will be actively treated with staff MD's that are in house (most of the time) The goal is to wean and discharge to LTC/Skilled or home with services.

The problem with LTAC is the acuity. These facilities get all these medically complex patients from several facilities and house them in one place. They are not reimbursed as acute care and there has been some progress towards a middle tier reimbursement that is higher than LTC/skilled but lower than acute care. These patients have labs and can receive transfusions. They will have insulin gtts.......but you will have several because they are now all under one roof from the multiple facilities.

They will train new grads. Their training is usually longer than usual, for a new grad, they will invest time and money on training. But.....staffing is not all that great. Burn out is very high. They historically run a very tight ship supplies wise and have very frugal budgets. This burns nurses out quickly.

Working at a a LTAC will give any nurse experience beyond belief. Unfortunately.....Hospitals still view them as "nursing homes" due to their lack of understanding of what an LTAC is....even though they send the patients they failed to get home. So a nurse who has worked at an LTAC has more selling to do about her experience than other nurses in acute care.

It is worth the effort and training ....IMHO To quote myself....

LTAC's are a unique combination of very sick patients in a LTC setting. These people are the SICKEST of the sick AND they have had complicated hospital course. A 4:1 ratio may not seem like very much but in an ICU setting in an LTAC are the failure to weans so you will have 4 vented patients. Most will have multiple lines including PA Catheter's/Swan , including pressors and IV's.

Any LTAC I have seen or worked in is a tough environment. These patients are SICK!!! They have just "run out" of acute days and are sent to the LTAC. These patients are the ICU patients that remain critically ill but have run out of "paid days" on insurance/medicare. You will see a ton of stuff.......everyone else's failure to discharge home. Open hearts with complicated post op courses, trauma's with Halo traction, many unique disease process with complicated recoveries, open wounds, chest tubes, vac dressings, wound irrigation's. You will give TPN, blood, do labs learn valuable IV skills. These patients are mostly full codes and every attempt is made to get them home.....but with a fraction of the nursing staff in an acute care setting.

The LTAC I am familiar with had an ICU and these patients were not DNR's, they were vented, with lines and drips. They are a collection of the most medically complex patients that have suffered complications and rough hospital courses due to co-morbidities. The floor patients can be vented, multi lumen lines, feeding tubes, IVF, antibiotics with complicated wounds still receiving aggressive treatment to get them well enough to got to a rehab, SNF or home.

The nurses perform like any other "acute care nurse" and more "acute care" nurses and hospitals/administrators need to respect what these nurses do with little to NO help. They process labs, drugs, give blood, pass meds. I have seen HALO traction many times on the elderly who have fallen. There are a ton of young trauma victims that are not doing well as well as the complicated open hearts on telemetry. They will seen neurological diseases like ALS and weird meningitis like listeria.

Any nurse will work very hard....I think a new grad who is bright and a go getter with a thirst for knowledge and confidence is a good candidate. They usually have extensive orientation programs and are will to invest i the nurses education....but you will work very hard. The patient load is double...example most ICU patients are 1:1's or 2:1's when they leave the hospital....they are 3:1, 4:1 at the LTAC.

You will gain a TON of experience and at least they do have great orientations. I wish you every bit of good fortune and luck in your new journey. Visit the LTAC/LTACH forums. I think you will find them helpful. You will get that acute care experiences and they are willing to hire/train new grads.

If you have any other questions about and LTAC....PM me.

AS a new grad you will need brain sheets to help organize yourself. :)

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‎critical thinking flow sheet for nursing students

student clinical report sheet for one patient

Specializes in Critical Care; Cardiac; Professional Development.

You would not likely be hired as a unit secretary. Honestly if you are graduating in a few weeks it is too late to try to get a " foot in the door" job. Keep applying anywhere and everywhere. Home health, ESP pediatric, seems to be very open to new grads in DFW. Given the state of the job market here you can't really evaluate based on whether you will have a hard time transitioning later. Not if you need to pay the bills now.Good luck and just keep on applying and using connections you made during clinicals.

Specializes in being a Credible Source.
Do you think it would be difficult to transition out of those roles later? I've always heard that if you go work at LTAC, nursing home, etc that you are not looked at highly for working at a hospital later.
There is some truth to that but there are exceptions. A manager in one of our ICUs told me, "At least I know the folks out of LTC know how to manage when we're overcensus, and they know how to work, and they're good at simple things like assessing fall risks and aspiration risks."

And I had no idea that I couldn't be a PCT with an RN license!!
Simply not true (universally, that is)... one of our PCTs is an RN, just doesn't practice as one. It's entirely up to the facility.

The job market isn't that bad. I live in Dallas, got my ADN at TCC in Fort Worth. I graduated in May 2012 and was freaked out because everyone was telling me how bad the job market is. I got hired at Parkland in June maybe 3 weeks after graduation so it isn't impossible to get a job. Some might look down on parkland, but they're hiring new nurses ADN's and all, all the time.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
The job market isn't that bad. I live in Dallas, got my ADN at TCC in Fort Worth. I graduated in May 2012 and was freaked out because everyone was telling me how bad the job market is. I got hired at Parkland in June maybe 3 weeks after graduation so it isn't impossible to get a job. Some might look down on parkland, but they're hiring new nurses ADN's and all, all the time.
Even though you were fortunate enough to secure your first nursing job relatively soon after graduation, there are masses of new nurses in the D/FW area who have been looking for more than one year for employment.
Specializes in Critical Care; Cardiac; Professional Development.

Sadly that is true. Ask the folks at Parkland how many applicants they had.

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