If I work in a skilled nursing facility as a new employee, will it be difficult for me to move a hospital afterwards?

By "new employee" I must assume you mean newly graduates nurse. Our population is aging, and most people on medical floors are older - not too many 20-30 year olds end up in hospitals compared to 60 - 70 year olds. So your former skilled nursing employment can be looked at as an advantage. That said... don't apply for the ER or ICUs right away. skilled nursing does not tranlate well to very acute situations where a lot of technical knowledge is essential and things move very quickly. Look for telementry or medical/surgical floors where your skills will be needed. Bring that out in an interview, pointing out how you have cared for an aged patient group and are quite comfortable relating to them and knowing their needs. Once you have a year or two of basic hospital experience it will make transferring to any specialty areas easier. Also, always find yourself a good mentor wherever you work.