Advice Please! Skilled Nursing to Assisted Living

[Jesshayesatx]

Hello! Thanks for taking the time to read this! I have 2.5 years experience in a skilled nursing facility doing treatments, wound care, IVs, meds, trachs you name it and I have med surg experience. 

I recently had a job offer close to my house at an assisted living memory care facility. The hours are perfect 6a-2pm M-F but I’m not sure what to expect. I’m a little surprised they don’t have a DON or even a ADON. They said there will be one nurse per shift and no nurses overnight just CNAs watching 80 residents. I do get two meds aides during the day but even my boss who is the nursing director is an LVN so no RN on site. I understand most residents are stable but is my license in jeopardy?

I like to think my assessment skills are pretty good but I was always taught to  protect your license & never work as the only nurse. Any advice or thoughts? 

[pinkandpurple]

It is highly dependent on your state as to what you are expected to do within your role. In my state, we do not provide any skilled care. Nursing is only needed in memory care where an LPN or RN has to administer medications and RN have to perform monthly and comprehensive assessments and keep care plans up to date. It is designed to be a chill job due to the "stable residents" but keep in mind they are elderly and easily turn to unstable within the blink of an eye.. and this could happen when there is no nurse on duty. A nurse will always be on call, but it would mean coming back to work in the middle of the night for an assessment. I have spent many nights returning back to work for anything as minor as a skin tear or headache to true emergencies that I had to sent to ER. Pay is also highly dependent. I made more in SCALF than any other job I have had, but I also had the most responsibility there as the only RN. If your main concern is being the only nurse, do not take the role as that is the norm. In fact many ALFs don't even have a nurse at all because the residents are supposed to be high functioning and able to protect themselves from med errors so they use caregivers that have been trained to "assist" them with their medications. If you choose to give it a try, don't harp on the ratio. Truth is, the minute they become unstable you simply send them to the ER as you cannot perform any skills except basic first aid. You won't be providing care to x amount of residents a day. You will be overseeing the care for x amount of residents a day. Think of it like you are a wellness nurse and not a skilled nurse because the only skill you need is assessment in the SCALF role. ?