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??

[lindseylpn]

This seems very typical for ltc (at least in my area). Where I've worked there are probably 10 lpns to 1 rn some shifts might not even have an rn on staff at all. We had rn unit leaders that worked dayshift and on call but, other than that the rns and lpns did the same work.

[njgrl622]

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.

This is exactly what they told me in the interview - I wanted to run outta there! LOL. I'm a new nurse with NO experience BUT I'm not stupid - I know my limits! I would've been too overwhelmed and someone could've gotten hurt....

[LTCNS, LPN]

I am a LPN who had just returned to the floor after being a MDS Nurse for 14 years and was burned out. I felt I wanted to return to hands on patient care and was excited for the break from the office. Today was to be day 4 of my orientation but I was let go because I was apparently not a good fit, not fast enough, etc...because I had been an office nurse for so long and they didn't feel I would last. I was fully prepared to take the med. cart today on my own but was completely blind sided.

As for RN Supervisors? The home I was working in has 180 beds with one RN Supervisor on evening and night shift and three on day shift.

[RNitis]

@nurselovespurple. I thank you for writing your experience bc I resently left my first RN position at an LTC facility that was on strike, so they hired me on the spot and tried to (DID, with an epic fail on my part, throw me onto my own assignment....totally not able to do a med pass for 30 patients in 2 hours, poop, three and a half hours later, I wasn't done and two other nurses had to jump in and finish). This led to the snowball downhill turn. I, being a new RN with CNA experience, thought I could cut it if just given the orientation and time. I saw myself improving, but low and behold according to "the other girls" that wasn't the case. It really threw my for a loop. I came home crying and my poor boyfriend had no idea how to console me. I felt like a complete failure and that I just wasn't going to make it as a nurse, since the nursing supervisor did say "I just don't think you have what it takes, but you are caring and compassionate". I stayed in bed sulking for days, but started really thinking about it and even though I'm desperate to get a job, I shouldn't have to risk my license and really need to push getting one at a hospital or at least somewhere that will give adequate orientation to a new RN (and not try to "eat their young"-as I'm already a push over as it is!). I've learned from a lot of nurses that LTC's will hire any RN (because they need the RN for supervising), but that what it boils down to is they don't care how it could negatively effect patients or your license (but they'd never admit that! I questioned a floor supervisor about what to do about a new skin tear I discovered on a patient and got an attitude (bc I made her favorite nurse who was orienting me look bad...and I never got an answer..it wasn't documented or talked about! Also, while leaving my shift on the dementia unit, overheard that a resident punched another in the face and everyone turned a blind eye as if it never happened!) I've become weary of looking into LTC's, but am being told maybe it was just the facility and to try again. I gotta get my big girl panties back on and get out there, but I'm scared poopless!! If I fail twice in a row bc I go to another LTC, I don't know if I'll be able to pick myself back up to continue with my nursing career even though I haven't barely started it yet! (and everyone says I'll be a great nurse, friends, people from school, nursing/clinical teachers, temporary nurses at the new facility, nurses I worked with as a CNA-besides the scary ones who say "I've been a nurse for 15 years!" with a snotty p'd off attitude bc you ask a question bc your a nursing student/cna and want to learn all you can before you get out on your own-). It was the other nurses, either stayed through the strike or hired after that, I feel, "stepped on my head to stay afloat themselves". I'm not anything near an overachiever, kiss-butt or a "know-it-all", nor do I have that attitude, but it seems me asking questions and being personable with the patients instead of just a "cookie thrower" (throw pills to patients and run on to the next) put me at a disadvantage and any small mistake I made was magnified to its fullest, not to mention the "nose in the air" attitudes I received while I was there. I just hope I'm able to get a position soon, as you did, before it's too late. I'm not a "new grad", but I am (got RN license NOV 2010, took a much needed break from everything for awhile thinking it wouldn't be difficult to get a nursing job. So I find with no nursing experience and a little time since I've been in school, I'm not exactly first pick for employers. Anyway, just writing to thank you for the inspiration. I thought I was alone in this type of situation!! Thanks for the inspiration (and sorry for the long write!!)