my first job interview experience and shocking work environment - page 4
Hi guys! I just want to share my very first interview experience. After applying to almost all job posting online, plus personally delivering about 10 resumes to HR in different hospitals, nursing... Read More
May 1, '09Quote from TurnLeftSideAh, but remember---night shift "doesn't do anything". The residents are always asleep; they have no needs for toileting, dressings or PRN meds. They never have sundowner's syndrome; the residents with dementia are all snuggled in their beds and quiet for the entire shift. No one falls on nights. No one becomes acutely ill or has an emergency. No resident wakes in the middle of the night with chest pains. No resident is every sad or lonely or unable to sleep and needs a cup of warm milk and a hug.What I would like to know is how do people get away with staffing ALFs and LTCs like this? How do they expect 1 RN to care for 52 patients?
The reason the bean counters justify such poor staffing is that they're looking at numbers, not at human needs and conditions. If they think everyone sleeps all night, why should they hire more help than the bare minimum at night? Moreover, they don't understand nursing. They don't understand----or care---about educational preparation and they don't see why a CNA or TMA or universal worker is not the same as an LPN or RN. A warm body is just a warm body.
Another thing the OP said that scared me was the high acuity of the residents. I'm sorry but PICC lines, vents and trachs---and only one nurse for 50+ residents? Yes, these are becoming more commonplace in LTC but how can they be cared for properly when the only licensed nurse has 49 other residents? I've had as many as 49 residents on a night shift in LTC and some nights were okay---even very quiet---and others were utter chaos, often because of acute needs of only one or two people. I had many nights in which I ran from 11 PM to 7 AM without a bathroom break and other nights in which the biggest chore was trying to stay awake. If the latter were more common, I wouldn't have such a problem with the staffing ratios. But IMHO, the high acuity of the residents and the low staffing is a recipe for disaster.
BTW, I really liked LilPeonNo.1's post. Can I come and work with you?
May 1, '09What State do you live in? Here in Raleigh, NC there is NOTHING! I hear Texas has jobs. Any chance you can move? I would NOT move without a firm job offer on the table.
May 1, '09
Hi guys, thank you very much for kind words and insightful advices. It really helped me to realize lot of things.
To be honest, when I got that tour in the facility I just want to run away and disappear. I can't imagine how 150 residents can fit in that small facility. Actually the position is available for night so that means it just 1 nurse to all patients on the floor. She said she might put me in morning shift while orienting so I could ask for help from other nurses before putting me on night shift. With all the experiences you shared with me I got really scared, I worked hard to earn my license, I can't afford to lose it. I did also research about that facility and seems like that's not the real picture of what's happening in that facility.
Here's some information listed online regarding the facility which I believe is not really accurate with the real scenario in that facility...
"This facility is participating in Medicare and Medicaid. The type of ownership for this nursing home is for profit - corporation and it has 150 Medicare and Medicaid certified beds. At the time of the last inspection this nursing home had 138 residents and the occupancy rate was 95 percent. Nursing Home has a resident council to address issues and communicate with the administration and staff. The total number of resident care hours provided daily by licensed staff is 1.4. Registered nurses spend on average 0.68 hours with each patient daily. Certified nursing assistants spend on average 0.97 hours with every resident daily. This directory contains information about certified Medicaid and Medicare nursing homes. The information about nursing homes and skilled care facilities on this web site is for general informational and educational purposes only. This web site makes no representation that the information is accurate, reliable, complete or timely"
How can it possible that an RN can spend average of 0.68 hrs per patient when u have 50 of them???
I love nursing so much. I want to give my patients the best nursing care I can possibly give. Being part of the health progress of my patient would be a great achievement for me. I feel like it's a very rewarding profession. I am really excited to work and learn different things everyday. I imagine myself waking up, going to work in hospital or any facility looking forward of seeing my patients, in a safe work environment. But with that kind of workplace I feel like everyday will be a struggle to go to work and I am gonna get frustrated with my job because even if I want to give time with all my patients, it's going to be hard with that kind of ratio. I know with the economy right now you cannot afford to be picky. As most of the posters advised me, it's not really worth it to put my license at stake. That's totally true. I'll just try to be more patient applying for more jobs. I should not give up.
I decided to sign up for volunteer job in the hospital near my city while waiting for a job opportunity to come. I ve been spending my time lately staying home, applying for jobs. I want to be productive. Maybe it will be a good opportunity to get to know some people in that hospital and hopefully if they see my perseverance and a position come up, they might offer the job to me. It's a good way to start to get some reference. Plus it will help me gain more knowledge and skills by observing and assisting them with their needs in the hospital.
Again, thank you very much! I really appreciate all your help!
BTW, I live in Massachusetts
May 2, '09First, I want to say I believe you made the right decision. You were wise to go to the site and see that what they said didn't even make sense about house time a nurse spends with a patient. This is a very hard time to find a job. There WILL be one out there for you. Hang in there. No job is owrth losing your license over.
May 2, '09I JUST experienced the same thing last week! Night shift= 1 RN 1 LPN for about the same amount of patients...NO CNA's. The place smelled horrible. My eyes burned from the ammonia smell of urine. I would NOT work there. It was a for-profit facility as well.
Just a word about smelly facilities:
When you enter a facility you should NOT be able to smell foul odors. When you are in a patient room, you should not smell urine or feces unless they VERY recently voided. If you do enter a facility and the smell is strong, you are looking at a facility that is so overstaffed that the staff cannot (or perhaps will not) attend to hygiene issues. There is ZERO excuse for a stinky place. What happens sometimes in for-profit LTC is that they won't spend the money on disposable briefs..opting instead for reusable cloth. Those cloth briefs get tossed in a can where they stagnate until someone has enough time (or the inclination) to empty them. NOT COOL.
RUN Forrest, RUN!
May 2, '09Good decision. Let me also add that job searching is not a passive activity--especially in this market. Don't just drop off a resume---call!!! Then call again. Then send a follow up letter and resume to HR and a nurse manager. Be proactive in your search. Especially with the on-line ones. Make sure you also call. You can't guarantee that your application was seen.
May 2, '09Do you need $$$ right now?
One nurse to 52 patients might be a lot; but you might only have to give meds to 20 patients, 10 finger-sticks, and a couple of dressings in the sacral area for a night shift. Patients in the long term care facility are stable. After all, you might still have a couple of hours to sleep in the med room.
May 2, '09I can only hope that roadrunner-in-icu was joking. Sleeping on the job is grounds for loss of license!! Do NOT take this advice. Patients are NOT always stable.
May 3, '09I just wanted to add an extra note to this thread that echo's the sentiment of a few other posters. I know you need money right now being a new grad and all. But before taking this job please consider how much money it cost you in both financial terms as well as emotionally to get your degree. If that's taken away from you due to any adverse event that they can pin on you (even if it's not your fault) you lose your ability to make that much desired/needed income. It can turn into a zero sum game.
Go with you gut. For those who feel that getting experience by way of a "trial by fire" method, uh...I don't think that's the best route. I think the OP mentioned that the facility would "allow" her work SOME dayshifts to get up to speed--that doesn't SOUND like much of an orientation period to me. I think new grads (and even seasoned nurses) need a long orientation or at least one that the nurse feels is sufficient to make them feel comfortable. The facility should let the orientation be as long as the nurse needs (within reason of course) to feel competent.
OP: ALWAYS carry liability insurance--even in the best of facilities! Best wishes on your --I know exactly how you feel (I'm in the same position). If you hadn't mentioned your state, I could have sworn you were talking about the very facility I applied for, interviewed and toured at. I knew something was amiss quickly because when I got there they left me lingering in the waiting area for 1.5 hours and then I was told that the D.O.N. had been double booked for the interview. I ended up being interviewed by a R.N. who admittedly had never interviewed anyone. In fact, she had zero questions for me. I ended up having direct the interview. You'd think she would at least want to know what I was proficient at. But I suspect all they wanted was a warm body, regardless of the quality of my training. Bah!
May 3, '09I agree with DaFreak71 about them only wanting a warm body. Who puts a new grad or ANY nurse in charge of 52 patients? Theis a must no matter where you work. It only cost about $100.00/year. A good price for peace of mind. Keep on looking. You are worth more than this job which will do nothing but put you at risk for losing a license you worked hard to get.
May 6, '09I don't know what employment opportunities are like where you reside but if there seem to be other opportunities out there, IMHO, you should keep looking. The last two times I had gut reactions that made me feel that way, they were on the money and I would have rather stayed unemployed a little longer than to be in the horrible situations I found myself in.
Also, I think it indicates the way you will be treated, as the facility seems to lack concern for its own residents.
Just a note of encouragement: I have interviewed in two different states for RN positions and have gotten every job I interviewed for...Just make sure your cover letter and resume are well done, you want to stand out!! That will help get you in the door.
best of luck!!!