New Grad RN Alone in Rehab at Night??

Specialties Rehabilitation

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I'm a new grad RN and I was just offered a really great night-shift position in a freestanding rehab facility. The place is 5 minutes from my house, extremely nice (the Four Seasons of rehabs), good pay, good nurse-to-patient ratio, and no weekends.

The only caveat is that sometimes I would be the only RN in the building with about 3 LPNs.

Is this a bad idea for a new grad??

I wouldn't be too worried. You'll have other nurses there to help. My question to them would be, how often is there full staff? I worked a VERY brief time in a rehab facility. I was promised there would be 3 nurses. It was a good night if 2 showed up.

Specializes in Transitional Nursing.

The LPNs will probably be doing the same job as you, I think you'll be fine.

I'm not sure if they will orient me on day shift, but they said I will have about 5 days of orientation on the floor

There's your red flag. No new grad should be expected to function ANYWHERE with 5 days of orientation. You need experience with med-surg skills and assessment before you can be the only RN in the building. Ask yourself WHY is the facility so desperate for a nurse , that they will hire a new grad. Also ask, why/ how the last one left.

Three thoughts:

First, I would bring up your question to the HR recruiter. I know it sounds counter-intuitive (you don't want to appear unqualified), but they know that you're a new grad, and I think it's a reasonable for any nurse to feel a bit cautious about not having a 'higher-up' to go to if the **** hits the fan (be it a charge nurse, a provider, a house sup, or whoever). Ask them how you would be expected to handle an emergent situation (i.e. a sudden deterioration in condition or a code). You don't have to frame it as a concern or weakness; rather, you can ask about what type of support you'd have available and what would be expected of you in case of emergency.

Second, be extra nice to and appreciative of the LPNs. I can see the potential for the LPNs to get ticked off if an inexperienced new grad is considered their 'supervisor' when they have much more experiential knowledge than you. You obviously already know that, but I'd try to be very gracious (and clearly express that gratitude) to avoid hard feelings.

Third, five days seems way too short. I don't know if that orientation is at all negotiable, but I can't imagine flying solo after only five days (even if you do have experienced LPNs to help you out).

Best of luck

Specializes in LTC, Rehab.

Not necessarily. Some LPN's have a lot of experience and are very good. But of course, you won't get a feel for that until you've worked there for a while.

Specializes in ICU, trauma.

When i floated at my previous hospital there was only one nurse on for the entire rehab unit, she always had to call me down to witness because she was truly the ONLY nurse

Specializes in Unit Nurse.

While that is a valid concern. At our free standing Rehab in the event of an emergency, we call the ambulance to come and take them to the ER. That would be something for you to look into too. Granted we have to run the code until the ambulance gets there, but we are not equipped or staffed to take care of guarded/critical patients.

Med-Surg experience would be beneficial in recognizing when someone is going bad, before they actually do, and therefore you could possibly get them out of your facility before they do. However, with little to no experience you will need to lean heavily on your LPN's and hope they are good. I have worked with some LPN's whom where much better than most RN's that I have worked with in the past and vice-versa. Good Luck on whatever you decide.

What type of acuity does this rehab do? Rehab facilities can vary widely in the level of acuity they take. Generally speaking, for acute status changes at night you'll be notifying the physician and if warranted, sending the patient to the hospital.

I'm not exactly sure, but the DON said in the interview that the patients are pretty close to med-surg patients.

Only five days of orientation for a new grad blows my mind! Surprisingly, all the rehabs I've interviewed with (5) have told me my orientation would be about five to six days.

Specializes in Stepdown telemetry, vascular nursing..

"Rehab" as in "Skilled Nursing Facility" or drug and alcohol rehab? And would your role be that of a supervisor, admissions, and IVs, or will you have your own patients assigned?

Sometimes LVNs have years of experience, and would be able to help in any emergency. I would be aware of your DNR patients, and review your BLS/ACLS.

Learn the questions to ask, like previous posters said, what is your turnover rate etc. If you decide to accept the job, learn as much as you can during your orientation. I pushed the med cart my first day, my first med pass lasted 3.5 hours, and it only became easier after that.

I pushed the med cart my first day, my first med pass lasted 3.5 hours, and it only became easier after that.

I feel better about my day today...med pass on my 3 patients took me 3 hours because the new patient had their meds all messed up and there were things missing that had to be pulled from the storage supply of common meds. On the plus side by noon med pass I got it down to an hour...I'm learning I think :)

Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.
I'm not exactly sure, but the DON said in the interview that the patients are pretty close to med-surg patients.

Only five days of orientation for a new grad blows my mind! Surprisingly, all the rehabs I've interviewed with (5) have told me my orientation would be about five to six days.

I would push for a longer orientation. I've interviewed with places like that, but I never said "yes" because even with some (meaning less than a year of) med-surg experience, I knew that was not even an option for me. 5 days isn't long enough to learn much of anything, especially if the acuity is similar to med-surg.

There are facilities out there that will offer a longer orientation. You just haven't found them yet.

I will definitely try and negotiate for a longer orientation after hearing from you guys. How many days of orientation do you guys think is appropriate?

Thanks :) :)

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