New grad-I went to an interview today for an RN position in acute rehab. 60 beds, freestanding facility. Pt/nurse ratio is 8:1 most days, sometimes 9 per the nurse manager. But this facility also uses LPN's...but not all days. So....wouldn't my workload be higher than 8 actually if an LPN was on board? Anyone know how this works? She tried to explain but it was all over the place and I don't get it-not at all like the hospital. She said that she thinks I would like it much more than I thought, that it is not like "what you are thinking". Hmmm. guess I looked susupicious, lol. I would get 4 weeks preceptor training-no classroom-more if I needed it.
It was a very strange interview. I don't know the turnover rates of this facility but the interviewer didn't even ask any real questions about me. Just basics like when I graduated but nothing they usually ask ("give me example", strengths/weaknessness, etc). In fact, she went right into whether I wanted full time or POOL right at the beginning of the interview. POOL would be 3 shift per WEEK requirement (like full time), so it would be more like pay-in-lieu of benefits. I did not think new grads could get these jobs! Anyhow, the pay difference is $13.00/hr!!!! Is that typical? Jeez, if so, their benefits sure must be good, lol. There has to be something she isn't telling me, right? I don't need bennies so I am somewhat interested but this seems too good to be true.
It was just fishy. Not enough q's about me, quickly laying out for me the pay, etc. She didn't offer the job but asked if I wanted to go get drug tested today. I told her that I would call back tomorrow with my decision and come pick up the form for drug testing tomorrow afternoon if I decide yes. As far as the type of patients, well, it seems like I'd get enough experience as a new grad here-all kinds of diagnoses. Some IV meds. Dressing changes. Hanging blood, even, sometimes.
This is only my second interview as a new grad so I just don't know what to make of this. The POOL/in-lieu rate is $36.00/hr, with 3 day/wk committment. Why would she offer me pool? She said I would get POOL level 3 (3 shifts per week commit-so it would be like FT for a new grad) but they do have levels 1 and 2, so I assume that once I was trained I could move to those if I needed to (a major plus for me)...Full time benefited new grad rate is 23.90, BTW.
Well, she called it "pool" but said it was exactly the same as full time except no bennies. Very rarely float to the other side, etc. She said I would be trained exactly like someone hired on as a full time new grad. So, I don't know about that. I guess they'd rather pay me 36 bucks + an whatever an LPN makes rather than pay 2 RN's to be there. But either way, the pt-nurse ratio is NOT looking like 8:1. It is actually 8:1 + whatever the LPN can't do for her 8 pts which = 16 assessments at the bare minimum, right? What bothers me is the interviewer did not even mention the LPN's until I asked if they were employed there. And when she told me the ratio she just said 8:1, not 8:1 plus whatever the LPN can't do. Do you think that means she was trying to hide it?
Maybe they just can't get anyone to stay for 23.00 an hour so they decided to start enticing with the POOL rate. It does seem like a lot of work for one RN!! It probably be a lot easier night shift.
It is not LTC. It is acute rehab. Stoke rehab, bilat knees, quads...apparently they see everything..trachs, lots of PICCS, etc. Sounds too acute though for 8+ pts, don't you think?
I don't have any friends in the "nursing community" so I can't ask. I posted another thread to try and gain info but no one is responding.
Well, I just don't know...hmmm...doubt I could shadow, but just don't know how to gain more info. I could go there at midnight and interview the first available nurse, lol. The charge nurse seemed to like it, play it up as being a good job, but guess he's charge....grrrrr...??????????????????????????????????????
But either way, the pt-nurse ratio is NOT looking like 8:1. It is actually 8:1 + whatever the LPN can't do for her 8 pts which = 16 assessments at the bare minimum, right? What bothers me is the interviewer did not even mention the LPN's until I asked if they were employed there. And when she told me the ratio she just said 8:1, not 8:1 plus whatever the LPN can't do. Do you think that means she was trying to hide it?
No, it does not mean 18 assessments. It means that the LPN will gather the VS, lung and bowel sounds, cap refill and edema and bring you the data for review. There is someone doing the legwork.
Again, all the LPN can't do in this setting is hang the first IV bag, assess the data she gathered (and assessed, unofficially), and care plan, and the care plans are stock.
Now, if you don't want the job, fine, but please consider us LPN's as nurses who do more than whatever little something it seems you think we do.
I work in a LTC with acute rehab. Most acute rehabs are skilled nursing faciity which have federal and state guidelines that they have to abide by. One of the most important is the cna/patient and nurse/patient ratio. As an LPN I am a unit manager and I am the MDS coordinator. I can tell you that finding RN for LTC in Florida can be very challenging. Skilled nursing facilities in Florida require 8 hours of RN supervision regardless of how many LPNS are on staff. The 8 hours of RN coverage cannot be the Director of Nursing and/or anyone that does not have direct patient care. It is quite possible that they saw you as the warm body RN needed for their coverage. Possibly that is why pool was presented. Pool typically means you fill the need or open slot. For example, they have no RN coverage for that day then you are called in. It also warrants the higher pay since you have to usually be readily available. Pool might also mean on call coverage. Turnover ratio, staffing census ratio with nursing and CNA coverage are important facts to get out in the open. I am not sure how it is in your state but as a nurse in a florida with a sister who is an RN that works in a hospital, her ratio on a med surg floor can be 8:1 with 1 PCT for a med surg floor of 20-24 patients. On a good day in a PCU unit she has 5:1 and typically ICU for her 3:1 with no PCT. There are variables to every nursing situation and the best thing for you to do is ask all the questions you can such as agency usage, number of admission/discharges per day, orientation policy, etc. Good luck.
Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.
I work agency for a rehab facility and I LOVE it. Rehab is so much more fun and rewarding than I thought it would be. That said, this sounds like a weird place. They are looking for a warm body and you look like "fresh meat" to them. Facilities that only hire new grads are difficult to work in as a new grad because there are no experienced nurses to help when your "orientation" is over. I would suggest you keep up the job search... :)
No, it does not mean 18 assessments. It means that the LPN will gather the VS, lung and bowel sounds, cap refill and edema and bring you the data for review. There is someone doing the legwork.
Again, all the LPN can't do in this setting is hang the first IV bag, assess the data she gathered (and assessed, unofficially), and care plan, and the care plans are stock.
Now, if you don't want the job, fine, but please consider us LPN's as nurses who do more than whatever little something it seems you think we do.
:angryfire
Also, keep in mind "the restrictions" on LPN's duties vary from state to state.
In GA, the only requirement by the State BON is that RN's do the admission assessment and care plans. Per the state, LPN's can do anything else.
Myself, I work in the ICU - you'd be amazed at what I can do in there.
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Don't take the job.
On a side note, when I was a LPN the RNs did do some things, like my IVPs, etc. However, I had 8 patients where they had 6 (med/surg). As stated above, LPNs are nurses and should be counted in the nurse-to-patient ratio.
When I got hired as an RN on a med-surg floor (new grad) they gave me 12 weeks orientation. I have been off orientation for one month and I work nights. I have had no more than 5 pts. (except one short-staffed night with 6 pts)
I would not take a job that has that short of orientation and that ratio. It is a new grad nightmare waiting to happen.
Even nurses that are hired with experience are given at least 4 weeks orientation. Just getting used to the facility alone takes time much less the experience you need to take care of patients.
I would not take the job even if I was desperate for work.
Do they use team nursing? I hate team nursing because oftentimes you are the only member of the team! :angryfire
4 weeks orientation is not very good; I think you would be better off to start in a hospital. With night shift bonus and weekend bonus you could come pretty close to 37/hr and also have insurance benefits.
I am so sorry if what I am saying is coming out as offensive to LPN's out there. I in no way am intending to demean you or what you do. I just meant that you have to trust the LPN that is working for you to just glance at her assessment and agree, without doing a full body assessment of your own. I would not feel comfortable agreeing with data without assessing that patient....especially as a new grad!
Plus, I am a new RN. I know NOTHING. There is no doubt in my mind that whatever LPN I worked with would know loads more than I. So, that makes me very uncomfortable having to be in charge. I'd just feel stupid! Seems like that would create a lot of conflict. The whole team nursing thing. I don't think it is team nursing, though. The pt-nurse ratio is 8:1. LPN's have 8 pts. So do RN's. But the interviewer never went into anything about what I would have to do with the LPN's 8 pts. She just acted like I have my 8, she has her 8, and that is it. And clearly, that is NOT IT.
What bothered me about it all most is her not asking me ANY questions...not about my values, priorities, past employment, NOTHING and her evasiveness when talking about ratios. That, to me, cannot be explained and was a dealbreaker.
So, I think I will pass on this one. I did work one month in med surg and was overwhelmed with 4 pts. You don't have to be a genius to understand that this may not be the best opportunity for a new grad. I don't think I could handle hiring on and then failing at this job..even if it wasn't my fault. I am ready to feel GOOD about what I do.
Thanks everyone for helping me out. I wouldn't have had a clue what to do otherwise! And again, sorry LPN's. Believe me...this lowly RN new grad bows down in your presence!
I think that as a new nurse that's just far far far too much to take on at once...especially being up for pool...that's beyond crazy. I think you made a good choice. Good luck in your search. And remember even tho the pay sounds teriffic, be realistic and ask yourself if it's really worth it.
Curious1alwys, BSN, RN
1,310 Posts
Well, she called it "pool" but said it was exactly the same as full time except no bennies. Very rarely float to the other side, etc. She said I would be trained exactly like someone hired on as a full time new grad. So, I don't know about that. I guess they'd rather pay me 36 bucks + an whatever an LPN makes rather than pay 2 RN's to be there. But either way, the pt-nurse ratio is NOT looking like 8:1. It is actually 8:1 + whatever the LPN can't do for her 8 pts which = 16 assessments at the bare minimum, right? What bothers me is the interviewer did not even mention the LPN's until I asked if they were employed there. And when she told me the ratio she just said 8:1, not 8:1 plus whatever the LPN can't do. Do you think that means she was trying to hide it?
Maybe they just can't get anyone to stay for 23.00 an hour so they decided to start enticing with the POOL rate. It does seem like a lot of work for one RN!! It probably be a lot easier night shift.
It is not LTC. It is acute rehab. Stoke rehab, bilat knees, quads...apparently they see everything..trachs, lots of PICCS, etc. Sounds too acute though for 8+ pts, don't you think?
I don't have any friends in the "nursing community" so I can't ask. I posted another thread to try and gain info but no one is responding.
Well, I just don't know...hmmm...doubt I could shadow, but just don't know how to gain more info. I could go there at midnight and interview the first available nurse, lol. The charge nurse seemed to like it, play it up as being a good job, but guess he's charge....grrrrr...??????????????????????????????????????