How scary does this sound to you? Or am I the only one -

[njgrl622]

I'm a new grad (RN) and just had an interview at an LTC/SNF.

It is a corporate/for profit facility that apparently doesn't want to have too many RNs on staff. There are 120 beds (2 wings of 60). For the 3-11 shift there is 1 RN on the skilled care floor (60 residents) who has the help of LPNs for med pass and CNAs for ADLs. On the other wing ---- NO RN. There is a highly competent, very experienced LPN who is handling the dementia/Alzheimer patients.

Now....as the RN I would be legally responsible for 120 residents! I don't think so....I just about RAN out of that place! Even the person interviewing me said it was a lot of responsibility and no nurse wants to find themselves sitting in front of the BON if there's an incident.

I did some research before the interview and noticed that Medicare only gave them 1 star for nursing. So, I figured their RN to patient ratio was probably high - but I NEVER imagined it was that high.

Thoughts??

[VictoriaGayle]

Each nurse is responsible for his or her own practice. Why do you think you would go in front of the board if someone else screwed up?

Key word nurse. Some LTC's use AMAPs. Don't their actions fall bck on the nurse they work under?

[wooh, BSN, RN]

That sounds typical for LTC. Quite often one RN in the building for a shift.

One in the building was rare for nights at the LTC I worked at as a CNA. Usually LPNs and CNAs.

[njgrl622]

Thanks everyone for your input! I'm not ready for something like this....it's a lot of responsibility for a new grad with no nursing experience. I was really surprised to even get an interview!

[wyogypsy, RN]

You are smart to turn this down if you are offered the job - you are not ready for this until you have a lot more experience. Best of luck to you and thanks for using your brain!

[irisheyesRsmilin]

I agree on turning down this position. You are a new grad and this is a lot to throw onto your plate. If you were very experienced in LTC nursing this could have been a position for you. Unfortunately you would be going into a situation that you arent versed in. Best of luck in looking for a better fit for you!

[lovingtheunloved, ASN, RN]

Welcome to LTC.

[VANurse2010]

Unless you're in a supervisory role, you are not responsible for what the other (LPN) nurses do with their patients simply because you're "the only RN in the building." If you didn't get report on them and assume their care as a floor, supervisor, or charge nurse, then what the LPNs do isn't going to fall on you.

[BrandonLPN, LPN]

If you are a RN charge nurse in LTC with LPNs to do all the meds, then you have it made in the shade. It's when you're the charge nurse AND you have to pass meds that you should be afraid.

[RNitis]

I had a horrible first RN job experience at a nursing home. It lasted 3 weeks. Not enough orientation for a new RN to have an assignment of 30 patients. Besides, once I started asking questions (that any new nurse would ask in order to know how to efficiently function in a new facility and new career) I was ousted by the other employees. This led to any minor mistake I made being magnified to the point that I was made to feel like an incompetent nurse and told that "I just didn't have what it takes" by the nursing supervisor. I was basically manipulated into resigning, but realize now that it was best for my nursing license. SO, to answer your question: "how scary does this sound? or am I the only one?"....yeah, scary and no, you're not the only one. Good thing you saw it and denied it before it effected you negatively. That's how I found this site, actually! After a few good nurses responding to me and calls to my nursing friends I went to school with and past coworkers to be reminded that I'll be a damn good nurse (in comparison to some nurses who actually are working at the moment), I regathered my self worth and am back to looking for a position that better suits me. Good luck with everything!

[DSkelton711]

If you are the only RN on shift you would automatically be considered in charge. LPNs would be considered to be working under your authority. So yeah, the BON would be asking questions if someone screwed up doing something that was out of their scope of practice, for instance. You were correct in not taking this job due to the fact that you have no actual working experience yet. Good luck to you.

[whichone'spink, BSN, RN]

I interviewed at a similar facility, at what must be the worst LTC facility in my city. I was in heels, but boy, I ran out of there.

[nurselovespurple]

Oh my goodness!! I got chills reading this thread. I'm a new nurse still in my first year since attaining my license. I had applied for a millions positions with local hospitals and even occupational medical centers but did not land one interview. Then one day, I stopped in a SNF/LTC center and filled out an application. I thought it was odd how they interviewed me on the spot but after reading threads(such as these) on the Internet, I came to the conclusion that is normal practice in LTC. I interviewed the same day and was offered a choice of three shifts and was told what my salary was going to be. I picked my shift, scheduled my fen orientation, and thanked them for their time. I remember going home and immediately sending them a Thank You letter. I was at my utmost professionalism.

Meanwhile, I spoke to my experienced nursing peers and was strongly discouraged from taking the job. They told me to wait until I gain some experience and that I may not even want to work in that type of environment. I thought thanks but no thanks. I have this under control. I'm a professional and my goodness my salary is going to be sweeter than Swedish Fish (LOL). I was so darn excited and psyched!! Against professional and experienced advise, I accepted the job offer and started my first job in my new career.

I believe the first several days of orientation were awesome despite having everlasting different preceptors orient me then before I reached week two, I was worried. By this point, I had trained with 9 different nurses of which 8 of them were LPNs. It seemed like I was holding them up from doing their job and was only being taught to push the med cart, turn the MAR pages to the right patient and give them their meds. Let's not forget to crush for those who take their meds in applesauce. I masted that by the end of week one but what about incident reports, sending someone out to the hospital, SBARs, labs, taking and taking off MD orders, receiving the pharmacy meds, etc... I had expressed these concerns and they were never addressed and I promise never!! Then one day, I made a mistake which was not life threatening or dangerous by any stretch of the imagination and was told I was not a good fit - asked not to come back. Now there were situations that had come up prior to this where I had to go to my boss' boss and this is where I remember things taking a turn. Reason being, I was finding out I wasnt performing well and what I was getting in trouble for, I had never been trained/taught to do. Feeling how unfair I found that to be despite my requests to clarify policies and procedures I was unclear of or just had not been taught, it was still my responsibility. After orientation was over, I was pretty much over. It didn't matter that no one showed me how to or how not to perform. I was responsible for 30 patients as an RN and was not and I mean NOT able to take a sip or bite of anything let alone use the bathroom because I had no backup. My aides were absolutely horrible but horrible with me. I wrote that off as I'm not getting support or respect from my manager and this is right in front of my aides then they won't do what they have to do and I will have to pay for it. In hindsight, had I gone along with the flow, I'd still be there but at the expense of my license. The LPNs who trained me were for the most part rushed and some resentful that they had to train me (an RN) and they were so darn good at how they carried out their jobs. Despite the tx I received, I really admired them and hoped I could be just as good as them.

I think if I had gone in there with at least a years experience, I would have been able to troubleshoot deficits on my own with as little help possible and that the confidence one gains when having so much experience would have made for a better fit.

It felt so down low being let go but I'm glad it's over and that I learned from the experience. I hacks to admit, I liked LTC/SNF and plan on returning later in life but for now I plan on sticking to the hospital setting where the organization and administration is far more organized fhan a LTC facility. I experience heavy retaliation and to come across CE courses on Workplace Bullying and Retaliation tells me this is a common and prominent part of Nursing. Nursing is a beast of its own. I've got so much to learn here. I'm more than willing and ready to learn and grow so that I can assert myself and express myself n my professional manner. I refuse to lose myself rede but I will incorporate m y experiences into me.

I hope this post makes some kind of sense...I keep falling asleep. LOL

BTW~ I did get another job surprisingly sooner than I had expected. I will be sharing that experience.

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