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Why is it so hard for me to transition from a nursing home job to a hospital position?

Monday January 31, 2011
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Dear Donna,

I have been trying to apply for a hospital job for the past several months. I have worked in a skilled nursing and rehabilitation facility as a charge nurse and supervisor for almost four years.

Before my present job, I worked in a hospital for about five months, but the agency that placed me in that hospital was negligent in working out my legal work status. I then had to look for another job. Despite my situation, I was offered this job by the skilled nursing facility. I was able to work out my work status almost two years ago. Unfortunately, it seems work experience in settings such as nursing homes is not considered experience at all. Most of the jobs out there require at least a year of acute care setting experience. Is there some kind of bias against nurses working outside the hospital setting? I am gaining certifications such as ACLS, Basic ECG, PICC Line Care just to add to my marketability. What more can I do?


Dear Donna replies:

Dear Grace,

First, let me say that I am glad to hear that you have a nursing job. I seem to be spending most of my time these days responding to letters from nurses who are out of work and can’t find a job in nursing.

Second, I’d like to put a few things in perspective for you. It’s not that your experience “is not considered experience.” It’s just that it isn’t recent acute care experience. The issue has nothing to do with bias. Hospitals have a legal and moral responsibility to hire nurses who are deemed well qualified to work in acute care. Because the job market for nurses is tight, there is an abundance of nurses with current and recent acute care experience from which to choose. Top that with the fact that many facilities do not have the money or the manpower to train, precept and mentor others, and you’ll see why you’re facing obstacles.

It is possible for you to transition back to a hospital job, but you must understand that it is a process and you will have to be patient with the process.

All of the training and certification classes you are taking are excellent. You didn’t mention your formal educational background. If you have anything less than a BSN, start making plans to further that education, too. More hospitals only are hiring BSN nurses. Even taking one class in that direction will boost your marketability.

Because you have been away from the hospital setting for at least four years, some facilities might want you to take an RN refresher course. Make some phone calls to nurse recruiters in area hospitals. Let them know you are calling only for some advice, and ask them what you would need to do to be considered eligible for employment there. If you repeatedly are told a refresher course is in order, look into it.

Because networking is a great way to get a job, you should shift your job search efforts to that. This includes getting on the telephone and using all of your contacts, in and out of healthcare. Let people know what you’re looking for and ask for their help by making referrals and introductions as appropriate and by “keeping their ears open” for you.

You also should attend nursing professional association meetings (go as a guest if not a member), attending career fairs, nursing conferences and conventions. Work on developing relationships and using word of mouth rather than relying on sending resumes to people who don’t know you.

In addition to all of the above, be sure you are putting your best foot forward in all networking and interview situations. This includes having a resume that is up to current standards and has high-impact content, a personal image that conveys confidence and professionalism, a positive upbeat attitude and outlook, and social savvy. You’ll find some help with all of the above in “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career” (www.Nurse.com/ce/7250).

Best wishes,

Donna Cardillo, RN, MA, well-known career guru, is Nursing Spectrum/NurseWeek’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/asktheexperts/deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://events.nursingspectrum.com/Seminar.