work in a nursing home, can i do it?

  1. I am a nurse from the philippines, came here to the US early last year. Have'nt worked here yet but recently i passed the CA licensure exam on my first try. I finished nursing school in 1990 but never practiced up until 2005 when i took a 5-month clinical refresher course in a tertiary hospital in manila, to get some nursing experience before i leave for the states. Last week i applied for a nursing job in a nursing home here in sanfran, they scheduled me for an interview and they're considering me for the job, they will employ me under their new grad/ rn refresher program which is 6-8 wks in length. I'm not so sure though because i feel like i need more than 8 wks knowing my very limited nursing background and having finished nursing a very long time ago, i might not have the confidence to be on my own after the 8 wks, especially a nursing home which usually has big loads of patients. I sent my resume to some hospitals here offering an rn residency program, which is more comprehensive averaging 3-5 mos. and i would prefer more to work for a hospital because of the experience i will get, but i didnt get any replies yet, though i just sent my applications last week. I was wondering if their program limited only to recent grads of a US school, or maybe a lot of new grads apply and they only accept a limited number of applicants for the program and of course new grads, US-educated are preferred, gosh a lot of things are entering my mind, hope i'm wrong. I need advise, will i accept the nursing home offer or just wait for a hospital to get interested in me, how much time should i give myself to wait.
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  2. 16 Comments

  3. by   Cmariehart
    YOU CAN DO IT!!!!!!!!!!!!!! Nursing homes are a great place to get your feet wet. You can work on your basic skills and then some. And you even see some things there that you don't get to see in the hospital.. Who knows you may like it, but give it a try.... Most places will extend your orientation if you ask them too and explain to them that you are uncomfortable!!!!!!!!!!

    Good Luck!!!!
  4. by   nindot
    Quote from Cmariehart
    YOU CAN DO IT!!!!!!!!!!!!!! Nursing homes are a great place to get your feet wet. You can work on your basic skills and then some. And you even see some things there that you don't get to see in the hospital.. Who knows you may like it, but give it a try.... Most places will extend your orientation if you ask them too and explain to them that you are uncomfortable!!!!!!!!!!

    Good Luck!!!!
    Thanks so much for your encouragement! i needed that. By the way do you work for a nursing home?
  5. by   nindot
    Quote from nindot
    Thanks so much for your encouragement! i needed that. By the way do you work for a nursing home?
    oh sorry i asked a stupid question, of course you do, why would you give me such advise if you dont work for one, anyway thanks once again, wish all the best!
  6. by   Fancy Face
    If I were you, I would accept the nursing home while I waited for acceptance from the hospital. Then, after being accepted by the hospital I would re-evaluate my goals and go for it. I wouldn't worry too much about working for a nursing home in the mean time, sounds like you have a good education and if you put your mind to it, you can do it.
  7. by   Cmariehart
    Quote from nindot
    Thanks so much for your encouragement! i needed that. By the way do you work for a nursing home?




    Yes I do work in a nursing home and I love it. I'm an LPN and I'm going to school to get my RN. My first day of clinicals as a student LPN we were at a nursing home and I threw up all day and swore I would never ever work in one... And now I do...

    You see I LOVE blood and guts and trauma stuff more than most people I know. But I love my crazy old people at the nursing home.
    If I had to choose between the 2 I would pick the nursing home. You get to know the residents and their families, their routines and all that fun stuff and you know when something is wrong.

    It's not the same in a hospital the people are there for a couple days and their gone!!! You only see them at their worst & usually the families worst too.

    I still love it when people are all bloody and there's wounds and dressings and things like that. And there are days that I wish I was back at the hospital in CTOR running ABG's and watching the MD saw into someone but I do love my crazy old people......
  8. by   nindot
    Quote from Cmariehart
    Yes I do work in a nursing home and I love it. I'm an LPN and I'm going to school to get my RN. My first day of clinicals as a student LPN we were at a nursing home and I threw up all day and swore I would never ever work in one... And now I do...

    You see I LOVE blood and guts and trauma stuff more than most people I know. But I love my crazy old people at the nursing home.
    If I had to choose between the 2 I would pick the nursing home. You get to know the residents and their families, their routines and all that fun stuff and you know when something is wrong.

    It's not the same in a hospital the people are there for a couple days and their gone!!! You only see them at their worst & usually the families worst too.

    I still love it when people are all bloody and there's wounds and dressings and things like that. And there are days that I wish I was back at the hospital in CTOR running ABG's and watching the MD saw into someone but I do love my crazy old people......
    its good to know that you love working in a nursing home, hope i could say that someday too. I just gained my CA license, never worked here in the US since arriving from the philippines early last year, never worked for a nursing work for a nursing home(we dont have that back home) so practically im clueless about working for a nursing home, just want to know how do RNs function in a nursing home setting? I'm really quite scared right now, im just new here in the US, and i finished nursing school 16 years ago and i was inactive for so many years, only got back to nursing when i took a clinical refresher course in a tertiary hospital in my country and that's over a year ago. I didnt even know how the hell did i pass the CA boards knowing my background. But the good thing with this nursing home is they're taking me under their RN refresher program which is 8 weeks in length and i do hope its enough for me. I guess anyone in my situation would have this low confidence level, i feel like i dont know anything skills wise, i just hope and pray i would have a very patient and supportive preceptor to get me by.
  9. by   CapeCodMermaid
    Quote from Cmariehart
    YOU CAN DO IT!!!!!!!!!!!!!! Nursing homes are a great place to get your feet wet. You can work on your basic skills and then some. And you even see some things there that you don't get to see in the hospital.. Who knows you may like it, but give it a try.... Most places will extend your orientation if you ask them too and explain to them that you are uncomfortable!!!!!!!!!!

    Good Luck!!!!
    Nindot-You are extremely lucky to have found a place with an 8 week refresher course. No LTC that I've ever worked in has offered one. Most orientations are less than a week long.
    I DO NOT think nursing homes are the place to get your feet wet as Cmariehart has said. Most nurses on a long term floor have 40 patients to give meds to....or on a subacute unit you will have 20 patients many of whom are post op. It is NOT the place to be without a med/surg background....one guy will be a fresh hip fracture, the guy in the next bed might have flash CHF, the lady down the hall is delusional and psychotic from a UTI, and the family member at the desk is hollering because her mom didn't get her hair done. LTC/Subacute is no place for beginners or sissies for that matter. You need excellent clinical skills because most of the time YOU are the only one looking at the patient. You need time management skills, people skills...
    Best of luck to you and I hope you get what you need in your refresher course.
  10. by   juan de la cruz
    Quote from CapeCodMermaid
    Nindot-You are extremely lucky to have found a place with an 8 week refresher course. No LTC that I've ever worked in has offered one. Most orientations are less than a week long.
    I DO NOT think nursing homes are the place to get your feet wet as Cmariehart has said. Most nurses on a long term floor have 40 patients to give meds to....or on a subacute unit you will have 20 patients many of whom are post op. It is NOT the place to be without a med/surg background....one guy will be a fresh hip fracture, the guy in the next bed might have flash CHF, the lady down the hall is delusional and psychotic from a UTI, and the family member at the desk is hollering because her mom didn't get her hair done. LTC/Subacute is no place for beginners or sissies for that matter. You need excellent clinical skills because most of the time YOU are the only one looking at the patient. You need time management skills, people skills...
    Best of luck to you and I hope you get what you need in your refresher course.
    Just wondering about your comment. I have been an RN in LTC in the remote past and have not been lurking in this LTC forum 'til now so I'm sure I'm way behind on what is current as far as LTC is concerned. Are you describing a typical day for an RN in a sub-acute care facility? Because if that's the case, I can't imagine how any nurse can safely handle all that aquity with 20 patients to care for. In my opinion, that is just impossible and I don't care how many years of experience the nurse has. How can you even possibly know that your patient is in flash pulmonary edema or CHF when you barely have time to pass your meds and they are not being monitored by someone else? Do you just walk in the room and then all of a sudden your patient is in agonal breathing and needs a stat intubation from EMS? I'd be scared I'd lose my license if I was the RN.
  11. by   CapeCodMermaid
    Unfortunately in most states, there is no requirement for staffing ratios. Most corporations have their own...some better, some worse. It is not at all uncommon for one nurse on a subacute unit to have between 15 and 20 patients on the day shift. You have to hit the floor running and hope your CNAs come get you quickly if someone has a change of status. We try to call rescue BEFORE the agonal breathing or before the person who wants to be al full code gets that bad. As much as we would try, we are really ill equipped to be doing codes in a SNF.
  12. by   Simplepleasures
    Quote from CapeCodMermaid
    Nindot-You are extremely lucky to have found a place with an 8 week refresher course. No LTC that I've ever worked in has offered one. Most orientations are less than a week long.
    I DO NOT think nursing homes are the place to get your feet wet as Cmariehart has said. Most nurses on a long term floor have 40 patients to give meds to....or on a subacute unit you will have 20 patients many of whom are post op. It is NOT the place to be without a med/surg background....one guy will be a fresh hip fracture, the guy in the next bed might have flash CHF, the lady down the hall is delusional and psychotic from a UTI, and the family member at the desk is hollering because her mom didn't get her hair done. LTC/Subacute is no place for beginners or sissies for that matter. You need excellent clinical skills because most of the time YOU are the only one looking at the patient. You need time management skills, people skills...
    Best of luck to you and I hope you get what you need in your refresher course.
    CapeCod, we may have our differences in opinion, but you gave this nurse EXCELLENT advice.
  13. by   Simplepleasures
    Quote from CapeCodMermaid
    Unfortunately in most states, there is no requirement for staffing ratios. Most corporations have their own...some better, some worse. It is not at all uncommon for one nurse on a subacute unit to have between 15 and 20 patients on the day shift. You have to hit the floor running and hope your CNAs come get you quickly if someone has a change of status. We try to call rescue BEFORE the agonal breathing or before the person who wants to be al full code gets that bad. As much as we would try, we are really ill equipped to be doing codes in a SNF.
    Once again Cape Cod, EXCELLENT description!
  14. by   nindot
    Quote from CapeCodMermaid
    Nindot-You are extremely lucky to have found a place with an 8 week refresher course. No LTC that I've ever worked in has offered one. Most orientations are less than a week long.
    I DO NOT think nursing homes are the place to get your feet wet as Cmariehart has said. Most nurses on a long term floor have 40 patients to give meds to....or on a subacute unit you will have 20 patients many of whom are post op. It is NOT the place to be without a med/surg background....one guy will be a fresh hip fracture, the guy in the next bed might have flash CHF, the lady down the hall is delusional and psychotic from a UTI, and the family member at the desk is hollering because her mom didn't get her hair done. LTC/Subacute is no place for beginners or sissies for that matter. You need excellent clinical skills because most of the time YOU are the only one looking at the patient. You need time management skills, people skills...
    Best of luck to you and I hope you get what you need in your refresher course.
    Thanks for your advice! actually i really prefer a new grad position med-surg in a hospital and i have sent my resume to several hospitals offering new grad/residency programs here in the bay area recently but unfortunately i have'nt gotten any replies yet, except for this one nursing home. I passed the interview but right now they're still doing background check, so i still have time to think whether to accept their offer once cleared with the background check. I think i'll give it a try first, while i'll wait for a hospital to consider me.

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