Need advice from hiring nurse managers please!

  1. I need some advice from hiring nurse managers. I'll start with some background and try to keep it short at the same time.

    I graduated nursing school (ADN) in May 2010. My first job out of school was at a prison, basically clinic nursing. I was there for 7 months. I left that job because my husband retired from the Navy and we had to move to another state.

    Once we got to our current state, I found a job at an LTACH (not SNF... long term acute care). I was there for 7 months as well. Conditions at that facility are not the best, and since I had never worked in a "full-service" hospital, I applied for a NOCs position on an onco floor. Night shift did not work for me or my family at all. I was sick all the time from the change in schedule and I never saw my family. After only three months there, I knew I had to make a change back to days. The only positions available in that facility were PMs or NOCs, so a transfer was not an option, and in any case, the facility required one year on the current floor prior to applying for a transfer.

    I spoke to the manager at my previous facility, who asked me if I would come back to a days position (I had been on days there before). He "assured" me that things were changing for the better, a new administrator had been hired who was making major positive changes. He "backed" these comments up with examples of how things had changed. I liked what I was hearing, and trusted him. After much soul searching, I decided to take the position. I regretted the decision almost immediately. Things had gotten FAR worse than they had been when I was there just a few short months before. Staffing ratios are often unsafe, protocols and policies are non-existent. The few that are in place are often written "under fire" because we have new patients coming in that day with situations most of the nurses have never been in before (critical drips such as heparin, dopamine or insulin; peritoneal dialysis, etc.). The policies/procedures often do not cover everything that should be covered to ensure safe and high quality care.

    A new "clique" has formed in the past couple of months, and the people in it are running the show. If you're not in the group, then you're targeted or completely overlooked for learning opportunities or opportunities to advance your practice.

    The manager that re-hired me has just quit and our QAPI director has taken his position. Already, staffing ratios have changed (not for the better... the Charge Nurses had been taking it upon themselves to do what they could to improve them, but they have little authority)... who knows what else will change next. The QAPI has only been CNO since Friday and already is changing things quickly. Just to clarify, I am not against change, and in fact, I thrive on it. However, change should be well thought out and planned. It should be pro-active, not re-active and every change at this facility so far has been re-active.

    I am trying to be patient and give this person a chance, but I've been back at this facility for only 5 months and already have been looking for the door for a couple of months. The culture is terrible and I feel that nurses have no support at all. I feel like I am completely on my own with no back up.

    I have always tried to keep an eye out to see what trends are in nursing as far as open positions, education and experience required, so that I can better plan my career. While looking online this morning, I saw a position that really caught my attention.

    The position is a clinic nurse in a family medicine clinic with a major health system in my area. The hrs are 7a to 6p (varying days) with 7a-12p on Saturdays (the posting doesn't specify if it is every Saturday, but my guess is that it does.

    My question is this: Since I have changed jobs four times now in two years, with 7 mos being my max at one facility, how do you, as a hiring manager, view this? Would you consider someone with my history for a position in your facility?

    I feel that I have had legitimate reasons for leaving my positions (a move, health and family reasons). I am qualified for the position and I really am committed to my employer, whatever establishment that might be, but it is difficult to accurately describe the conditions at this facility. It truly is dangerous for patients and nurses alike.

    Should I go ahead and apply for this clinic position or should I stick it out another six months (which I honestly don't know if I can do... I can definitely give it my all and try, but I've started experiencing depression and burnout because of the culture and practices of this place).

    I am looking for honest career advice from those who are on the other side of this... i.e. hiring nurse managers.

  2. Visit RNikkiF profile page

    About RNikkiF

    Joined: Jun '11; Posts: 115; Likes: 95
    Registered Nurse (ADN); from US


  3. by   wincha
    first job 7 months
    2nd job 7 months
    3rd job (same as first job) 5 months so far

    couple of things. It never hurts to look, the next place will be wondering but you went back and forth. You can speak to the staffing ratios ect... but do not mention the cliches bad environment or complain at all about the job. If you move onto the other job I would recommend you stay there at least 2 plus years.

    If you do not get the other job and you don't feel like your license is being compromised I would recommend you stay for at least 1 year. Any position you should stay for one year, but really longer.
  4. by   RNikkiF
    Thank you for your feedback. You basically confirmed what I was already thinking. Honestly, I DO feel as though I could be putting my license at risk but because of my short tenures, I feel that I need to stay. That's where the struggle is for me. I am the primary earner for my family and I don't want to compromise that by putting my license at risk or by changing positions so often. I REALLY want to find my niche in nursing and settle in at a facility, but I don't know how to go about that. I am considering prn positions while staying where I'm currently at but the facility I'm at drains me so much emotionally that I don't know if taking on more is the answer. Lots to think about. Thanks again.
  5. by   wincha
    You might also consider joining linked in and building up your profile. Look at the requirements of other jobs that you would like to explore. If you get into the door for the interview, you really can speak to staffing ratios ect... never hurts to look but make sure before you make a change again, it will be long term. Talk to people, look around, see if it looks like people are happy. Questions would be why is the position open, how long was the prior person in that position ect... Before you interview google some behavioral interviewing questions and know the about the business/clinic you are interviewing for, have some history about the company ect...
  6. by   RNikkiF
    I have a LinkedIn from years ago. Time to update now. Thank you SO much for the tips! I really appreciate it! Another question though... As far as talking to people etc, that isn't really something you can (or should) do while in an interview, how would you recommend going about that? A shadow experience maybe??
  7. by   wincha
    Google information about interviewing. There are so many tips out there. Linked In, Monster have good information. You can even join forums for nursing for linked in to learn more about different areas in nursing. You might consider learning more about managed care and case management which can either be face to face/ telephonic/ or a combination of both. Those positions will want 3 years of a basic nursing background to get into those areas.
    In an interview you are selling yourself. You need to have a good resume and always include a cover letter. Link up to hiring managers of hospitals ect... in linked in. Never provide negative information. Your weakness should be something that is also a positive ie balancing your work life balance. Practice with someone prior to going in. There are so many resources. Find out if they use behavioral interviewing and if so once you learn how to answer in that format you will be able to draw on experiences to draw on to answer the questions.
    Dress professionally, if you have a jacket wear one, if not a dress or nice shirt and slacks. Be early for your interview, be composed, be confident. Learn to problem solve and be able to show you can think on your feet and are enthusiastic and positive, team player, works well with others.
  8. by   RNikkiF
    Thanks for the interview tips. In my second question, I was actually referring to talking to current employees to get a feel of the culture etc, but the interview tips are very helpful as well. Thank you!
  9. by   wincha
    I like glass door. You need to take some of these reviews with a grain of salt since most people who post might be unhappy but you can at least see a trend, the culture, how interviews go, and salaries

    You can go to Glassdoor - an inside look at jobs and companies and review companies, salaries, and interviews Best Places to Work |

    CareerBliss - Search Salaries, Company Reviews, and Jobs | CareerBliss

    If you google you can find more sites like glass door, just google sites like glass door