Everyone around me says you need a year in long-term care before a hospital will touch you, but I’ve got an offer from a rehab hospital at $16/hr days and an LTC at $18/hr nights — am I overthinking the “LTC first” rule, or is there a real skill gap I’m missing? I’m starting my CNA class on Jan 8 and don’t want to lock into the wrong path; would love counterpoints from folks who tried either route.
I skipped the “LTC first” route and went straight to a rehab hospital, then kept a PRN LTC shift twice a month — I’d take the $16 days for team exposure and grab a weekend PRN at the $18 LTC to keep your ADL reps. The only caveat is nights pay more but can be slower for skills, so weigh cash vs daytime learning before your Jan 8 start. Ask the rehab manager if week-one training covers lifts and bowel programs; if yes, I’d jump — open to a PRN add-on?
Building on @bsmith347, I’d lean rehab hospital if they offer a solid orientation, but first ask each manager: ‘What’s the CNA-to-patient ratio, what lift equipment do you have, and how many weeks of training/shadowing?’. Do a quick shadow at both and compare the flow on days vs nights — ratios are the difference between a jog and a sprint. If the hospital gives you 3–4 weeks of onboarding and reasonable ratios, that early team exposure beats the extra $2/hr.
I’d ask each manager, “Can I shadow two hours and see a typical assignment sheet?” Doing that showed me nights paid more but wrecked my sleep during class, so with your Jan 8 start I’d take the $16 days for now and reassess after you pass — could you squeeze in a shadow this week?
Do they offer ‘tele/PCT cross-training’? Also ask about weekend float expectations.
The ‘LTC first’ rule is mostly myth — if rehab will train you, take the $16 days and start learning acute routines now. Before you decide, ask each how often CNAs get ‘mandatory OT’ and how strict the weekend rotation is, because that can nuke your Jan 8 class and clinicals. If the rehab offers tuition help or a 6–12 month PCT track, that upside beats the extra $2 nights at LTC for where you want to go.
If the rehab hospital treats CNAs as PCTs with things like wound vacs or drains, that’s real acute exposure you won’t see in most LTC. Piggybacking on @franklin_x57, confirm the CNA-to-patient ratio on both offers and whether they have a lift team or ceiling lifts — your future spine will thank you. If orientation is skimpy (like one shadow day) or they won’t sign off that it ‘counts as acute experience’ on your resume, I’d lean LTC; otherwise I’d take the rehab and revisit nights after your class starts.
And check ratios; 1:6 rehab vs 1:12 LTC changes pace. With Jan 8 class, nights may crush studying — @franklin_x57, ask orientation length.