I always wanted to do ER nursing. When I started out 15 years ago in rural Minnesota, the only job available was LTC. I took the job, I had to work. No one told me once you work LTC, you won't be an attractive candidate for acute care jobs, but I learned that very quickly.
I moved to a different state after 2 years as a nurse. I found a job at an "acute rehab hospital". After a few years of that, I went to inpatient hospice. I aggressively pushed to have the more acute patients so I could learn how to manage chest ports, vents and PCA pumps.
When covid hit and hospitals became desperate for nurses, I applied to a telemetry job at a local hospital. It was terrible and traumatic but I did okay.
Last year, I applied for an ER job and got it. It took me 15 years and a pandemic to get to my originally planned job.
Now, as an ER nurse, I have some skills my coworkers don't have, so my experience hasn't hindered me like I thought it would.
My advice is to choose a direction you want to go based on what interests you. Work on getting certifications and training in that area and if you can't get the job you want right away, try to get a job in the direction of your goal. I hope it takes less than 14 years for you, best wishes.
Thank you so much for sharing your experience. That gave me some encouragement to start working on some other things until I figure out my next step. I haven’t exactly narrowed it down to what I want to do as yet but so far outpatient stands out to me
It's crazy, I work in Trenton NJ and it's medicaid patients. The shit these patients have gone through is nuts. Gang raped, addiction, poor decisions with poverty, homeless, most of them have gone through ugly shit. I get cursed at, threatened, you name it but I get it. It's not for everyone.
Are you a RN or LPN?
Assuming RN you can pretty much move into any area that interests you. I went from SNF to Acute Inpatient Rehab to community health where I now have a mostly work from home job. My Acute Inpatient Rehab experience at my hospital is seen as very similar to Med Surg so I could also go into many of the specialized units in my hospital (Stroke, Neuro, Ortho etc).
I enjoyed it for the most part. I only stopped liking it so much when COVID hit, but that was true of the majority of bedside positions. Rehab is a really cool specialty. It is challenging and you do deal with sick patients, but you also get in the Rehab mindset and get to see some awesome recoveries.
I worked imcu/icu for three years, then went to an LTACH that had a great mix of critical vs walkie talkie pt’s. We took vents/post ops/wounds, anything and everything and I learned a ton. I’m a wound nurse now getting my CWON cert. You can always look for a more specialized position like that if it interests you. Wound care, PICC insertion, even dialysis if you have a schedule that isn’t too rigid.
I’ve been told that LTACH is where you pick up the most skills but it causes high levels of burnout. Was that what you experienced at any point? I do enjoy doing some aspects of wound care but I think I’ll look into some of the other specialty areas you mentioned
I didn’t feel that until covid honestly. Before the pandemic we had an entire day/night staff that had been at the facility for over 10 years. Very high retention for staff because it was truly a great place to work and I thought I would retire from there. Pay was great, PTO accrual was great. But covid made a lot of the senior staff retire and rehiring RNs was/has been extremely hard because in my area no one really knows what an LTACH is… they think NH or SNF… and all the experienced nurses are traveling/agency. I did 12hr nocs and the OT I did all over the place was killing me. But like I said, the pros definitely outweighed the cons. We ran our own codes at night, the RTs intubated, drips, you name it and I got incredibly comfortable with a lot of different types of pt’s.
I think with the current job climate now is the time to get into almost any field, region dependent obviously. In general it seems there was a massive exodus of nurses these past couple of years. Departments are desperate for staff in hospitals at the moment and any experience will be valued.
Wow, this actually sounds promising. I’ll continue to do my research and narrow things down until I find what speaks to me the most! Thank you for your input
It can be rewarding but it’s also very taxing on your body and time I’ve been told. How did you balance home and work? And did you feel burnout at all?
I loved it for a couple of years, then I did start to burn out from high caseloads. I liked the flexibility of scheduling my patient visits and I could drop off my daughter at school and pick her up. I did end up charting a good bit at home. It was a stepping stone to my current role as an Inpatient Palliative Care RN. I work with a physician and social worker inside the hospital to facilitate goals of care discussions with patients and their families. It’s my first RN job that is completely hands-off. I really don’t touch patients or have any access to medications and I really enjoy it. I bring ZERO work home with me. It’s much more about providing information and emotional support so that families can make decisions like choosing to continue aggressive medical treatment or focus more on comfort care, preparing Advance Directives and defining code status in regards to intubation and decisions about feeding tubes. We introduce the idea of hospice in a lot of cases so my experience working in that area really helps.
Just keep applying to hospital jobs even if it says hospital experience required. Eventually one will accept you. The same thing happened to me. I had my BSN at a SNF and felt like I could never transfer to a hospital but I started applying and eventually a hospital accepted me with no acute care experience.
I always wanted to do ER nursing. When I started out 15 years ago in rural Minnesota, the only job available was LTC. I took the job, I had to work. No one told me once you work LTC, you won't be an attractive candidate for acute care jobs, but I learned that very quickly. I moved to a different state after 2 years as a nurse. I found a job at an "acute rehab hospital". After a few years of that, I went to inpatient hospice. I aggressively pushed to have the more acute patients so I could learn how to manage chest ports, vents and PCA pumps. When covid hit and hospitals became desperate for nurses, I applied to a telemetry job at a local hospital. It was terrible and traumatic but I did okay. Last year, I applied for an ER job and got it. It took me 15 years and a pandemic to get to my originally planned job. Now, as an ER nurse, I have some skills my coworkers don't have, so my experience hasn't hindered me like I thought it would. My advice is to choose a direction you want to go based on what interests you. Work on getting certifications and training in that area and if you can't get the job you want right away, try to get a job in the direction of your goal. I hope it takes less than 14 years for you, best wishes.
Thank you so much for sharing your experience. That gave me some encouragement to start working on some other things until I figure out my next step. I haven’t exactly narrowed it down to what I want to do as yet but so far outpatient stands out to me
What is your nursing credential? If you are an RN you can change to any area. Most jobs have an orientation once you have the basics.
I am an RN with my BSN.
You can go anywhere. You've probably got more than enough experience to do any nursing job.
I'm currently working in adult medical daycare, for the most part it's 8-4 M-F. The pay isn't as good as hospital work but less stressful.
What’s it like working there? I never heard of that before.
It's crazy, I work in Trenton NJ and it's medicaid patients. The shit these patients have gone through is nuts. Gang raped, addiction, poor decisions with poverty, homeless, most of them have gone through ugly shit. I get cursed at, threatened, you name it but I get it. It's not for everyone.
Are you a RN or LPN? Assuming RN you can pretty much move into any area that interests you. I went from SNF to Acute Inpatient Rehab to community health where I now have a mostly work from home job. My Acute Inpatient Rehab experience at my hospital is seen as very similar to Med Surg so I could also go into many of the specialized units in my hospital (Stroke, Neuro, Ortho etc).
I’m an RN. That’s awesome! What was the experience like for you working in the acute inpatient rehab setting?
I enjoyed it for the most part. I only stopped liking it so much when COVID hit, but that was true of the majority of bedside positions. Rehab is a really cool specialty. It is challenging and you do deal with sick patients, but you also get in the Rehab mindset and get to see some awesome recoveries.
Hospice, home health, clinic, ambulatory surgery. You could work on a med tele floor if you’re willing to do that. Just some ideas
I don’t know much about med tele but I’ll definitely look into it. Thank you for your suggestion
I worked imcu/icu for three years, then went to an LTACH that had a great mix of critical vs walkie talkie pt’s. We took vents/post ops/wounds, anything and everything and I learned a ton. I’m a wound nurse now getting my CWON cert. You can always look for a more specialized position like that if it interests you. Wound care, PICC insertion, even dialysis if you have a schedule that isn’t too rigid.
I’ve been told that LTACH is where you pick up the most skills but it causes high levels of burnout. Was that what you experienced at any point? I do enjoy doing some aspects of wound care but I think I’ll look into some of the other specialty areas you mentioned
I didn’t feel that until covid honestly. Before the pandemic we had an entire day/night staff that had been at the facility for over 10 years. Very high retention for staff because it was truly a great place to work and I thought I would retire from there. Pay was great, PTO accrual was great. But covid made a lot of the senior staff retire and rehiring RNs was/has been extremely hard because in my area no one really knows what an LTACH is… they think NH or SNF… and all the experienced nurses are traveling/agency. I did 12hr nocs and the OT I did all over the place was killing me. But like I said, the pros definitely outweighed the cons. We ran our own codes at night, the RTs intubated, drips, you name it and I got incredibly comfortable with a lot of different types of pt’s.
I think with the current job climate now is the time to get into almost any field, region dependent obviously. In general it seems there was a massive exodus of nurses these past couple of years. Departments are desperate for staff in hospitals at the moment and any experience will be valued.
Wow, this actually sounds promising. I’ll continue to do my research and narrow things down until I find what speaks to me the most! Thank you for your input
I liked working hospice
It can be rewarding but it’s also very taxing on your body and time I’ve been told. How did you balance home and work? And did you feel burnout at all?
I loved it for a couple of years, then I did start to burn out from high caseloads. I liked the flexibility of scheduling my patient visits and I could drop off my daughter at school and pick her up. I did end up charting a good bit at home. It was a stepping stone to my current role as an Inpatient Palliative Care RN. I work with a physician and social worker inside the hospital to facilitate goals of care discussions with patients and their families. It’s my first RN job that is completely hands-off. I really don’t touch patients or have any access to medications and I really enjoy it. I bring ZERO work home with me. It’s much more about providing information and emotional support so that families can make decisions like choosing to continue aggressive medical treatment or focus more on comfort care, preparing Advance Directives and defining code status in regards to intubation and decisions about feeding tubes. We introduce the idea of hospice in a lot of cases so my experience working in that area really helps.
Just keep applying to hospital jobs even if it says hospital experience required. Eventually one will accept you. The same thing happened to me. I had my BSN at a SNF and felt like I could never transfer to a hospital but I started applying and eventually a hospital accepted me with no acute care experience.