Agencies and Skilled Nursing Facilites

[Ginger's Mom, MSN, RN]

I have some posts where agencies are soliciting Internationally Educated Nurses. Coming from a country other than the US you maybe unfamiliar were their agencies employ nurses. There contracts are with Skilled Nursing Facilities. Other then the Nuclear Energy the SNFs have more rules and regulations than any other agency.

If an agency employs a RN it is because they are done a RN. Depending on what services provided a RN has to be in the facility once a day or once a shift. Many SNFS have over one hundred patients and the CNAs and LPN are working under your license. As a RN you are responsible for assessing any new admission, any changes of care, and all patients. If a patient goes to the hospital and a decubitus ulcer is found, they will look to see who the supervising RN is.

If you work on the LTC unit you could have up to 30-40 patients per shift, you would be responsible for all the meds and documentation. Everything is documented, even taking out a hear aide. If you work on the sub acute unit you could have up to 9 patients which require frequent lengthly assessments.

The state comes in frequently with out telling you. The write up everything and will report any problems with your nursing care to the BON. The BON will do an investigation and remove their license. All disciplinary actions are reports on the BON webpages.

If you are new grad, you will need a 6-8 week orientation. Any less you will not be able to function. If you are an agency nurse you are responsible to know all the polices and procedures the minute you walk into the door. If the census is low, and they don't need you as an agency nurse you will be canceled without pay.

[suzanne4, RN]

There is a difference when a foreign nurse is brought over to the US by an agency. They are under a different type of contract then the per diem nurse here in the US. The employer is required to provide documentation that they are going to havefull-time work for the nurse. Most placements are for the same facility for the length of their contract, not moving around on a daily basis as we can do here in the US.

But most LTCs only provide a week of orientation at the most, more may be advertised or in the contract; but then someone calls off or they are short for the day and the nurse is pulled from orientation for that day, and then the next. And the saga continues.

LTCs have one of the highest rates of lawsuits as well as highest number that lose licenses. If a license is lost, then the Visa Screen Certificate is cancelled and this means that the green card will be cancelled as well.