That First Job

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I need advice regarding what I should do for my first RN job. Here is my background:

- I just got my BSN at the beginning of May

- I am licensed as of two weeks ago

- I have been working in a major hospital system as a NA in their float pool for about 1 year, nights and evenings.

I applied to a small community hospital last Monday. A week later I was contacted regarding two phone interviews for two different departments, one of which I did not apply to.

1) Skilled Nursing

2) Sub-Acute Rehab (unit I applied to; I didn't realize at the time it was sub-acute, thought it was acute)

I interviewed today (over the phone) with the sub-acute rehab and was offered a job at the end of the interview. During the interview I was incredibly honest with the manager regarding my 5 year goals, my 1 year goals, etc. I told her I wanted to work as an ED nurse, and to eventually go back to school and get my DSN in order to teach. She said that if I worked in her unit for 1 year, or perhaps a bit less, if an ED job opened up at the community hospital she would support me in applying and transferring to that unit. I told her I would think about the position and get back to her next week.

Tomorrow I interview with the Director of Nursing--Skilled Nursing for the SNF position that I didn't apply for. I am not that interested in skilled nursing, but I don't want to make a decision without hearing all of my options.

Here is my question: I just graduated, I just got my license. I have a year to keep applying to New Grad positions in acute-care hospitals, while I continue to work as a NA. Is it better to turn down the job offer I currently have in case I get a better one in the future, or is it better to take the nursing job because at least it will be experience and allow me to work on my skills. If I take a job in a sub-acute care facility, does that "doom" me from ever getting a job in an acute-care facility?

Any advice is helpful!

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Specializes in Family Nurse Practitioner.

Take the sub acute job. It can open up doors for you and you will get the magic year of experience. Many sub acute patients are still sick.

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Specializes in Pediatrics, Emergency, Trauma.

^This.

Get that experience, then transfer.

I worked in LTC and was able to get a hospital job; your advantage is that you are a part of a hospital system that includes a Sub-Acute floor.

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I rarely post but am on here lurking and reading several times a day but feel the need to respond to this post. I don't understand where the mentality comes from that you will "lose your skills" or be "doomed" if you work in a SNF.

I currently working in a SNF and we do IVs, PICC and central lines, trachs, wound vacs, etc... If we have a code there is no code team to call - we run it. If a patient is going bad there is not always a Dr in house we assess and intervene. If there is an angry or distraught family there isn't always a supervisor in house - we deal with it. Time management - you know that patient that you just discharged from your unit st the hospital? Now I have them and 20 more just like that. 5 or 6 admissions in a day between 2 nurses is not unusual.

I am in no way saying acute care is easier than SNF but I do feel that we deserve some respect for the work we do. We are hesitant to hire nurses with only acute care experience because most of them don't last because of the difficulties with time management.

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I rarely post but am on here lurking and reading several times a day but feel the need to respond to this post. I don't understand where the mentality comes from that you will "lose your skills" or be "doomed" if you work in a SNF.

I currently working in a SNF and we do IVs, PICC and central lines, trachs, wound vacs, etc... If we have a code there is no code team to call - we run it. If a patient is going bad there is not always a Dr in house we assess and intervene. If there is an angry or distraught family there isn't always a supervisor in house - we deal with it. Time management - you know that patient that you just discharged from your unit st the hospital? Now I have them and 20 more just like that. 5 or 6 admissions in a day between 2 nurses is not unusual.

I am in no way saying acute care is easier than SNF but I do feel that we deserve some respect for the work we do. We are hesitant to hire nurses with only acute care experience because most of them don't last because of the difficulties with time management.

Thanks for your insight. I am not trying to insult SNF nurses, I'm just not sure how all of this works. In nursing school it's ALL about the hospital jobs; nothing else is really covered (at least at my school) except community (and that coverage was a joke). All I heard was rumours about "snfs" being sub-par and it does get into your head.

I decided to take the sub-acute job because I do think it will be good experience. My eventual goal is to go into education, and I want to be able to present a fair point of view about different nursing jobs to my students.

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Specializes in Pediatric.
I rarely post but am on here lurking and reading several times a day but feel the need to respond to this post. I don't understand where the mentality comes from that you will "lose your skills" or be "doomed" if you work in a SNF.

I currently working in a SNF and we do IVs, PICC and central lines, trachs, wound vacs, etc... If we have a code there is no code team to call - we run it. If a patient is going bad there is not always a Dr in house we assess and intervene. If there is an angry or distraught family there isn't always a supervisor in house - we deal with it. Time management - you know that patient that you just discharged from your unit st the hospital? Now I have them and 20 more just like that. 5 or 6 admissions in a day between 2 nurses is not unusual.

I am in no way saying acute care is easier than SNF but I do feel that we deserve some respect for the work we do. We are hesitant to hire nurses with only acute care experience because most of them don't last because of the difficulties with time management.

I don't understand either. I could see if OP was worried about losing skills doing private duty home care.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I'm at a loss. There have been two posts by two different people upset because they didn't get their dream job. You're a new grad & had TWO interviews AND a job offer! Do you know how many new grads would kill to be in your position?! Take the job offer then in a year if you find an ED position, apply. Any experience is better than no experience. If you work as a tech & not as an RN for a year then try to get an RN position you will be an "old" new grad going up against new grads. Guess who will get a job?

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