Afraid to quit job after 2.5 weeks

[kjan]

Right now I feel kind of lost. Don't know where or who to turn to about this.

So 2 weeks ago I got an offer to work at a home care agency. I met the boss who owns the company and (for privacy reasons..) he/she interviewed me in person after calling me a few days prior.

I come in for the interview and ask about training/orientation. He/she said that I will have a 1 month orientation shadowing an RN. I am a BSN prepared RN. At the company there are no medical staff, only 5 other RNs, and many CHHAs. Me, being the 6th RN.

I accepted the offer, trusting the position would be a fit for me. I accepted the offer on a Wednesday and they wanted me to begin the next day. I asked the RN that has been "orienting" me about the orientation and how it would be for a month and she shook her head 'no' and that a month orientation is too long. A few days and you should be ready to go out to pts homes on your own. I accompanied the Rn the next day and she showed me how to document etc. The day after that I was in the office alone waiting doing nothing, not knowing what to do. Minutes before my shift is over to go home, all the staff scramble me and rush me to go to a pts home to give an injection. Mind you, I was around all staff for the past 3 hours and then they didnt even say one word. The Rn then says very quickly, go there now and that is your pt every single day, you will go to this pt every day from now on. Its as if the RN told me last minute so I could just agree and say yes. I was dumbfounded and did not want to argue so I went on my way. Pts family member called the offices asking why I was taking long to get there, and they lied to the pts family and said "the rn is lost on the road" right in front of me. I was late to the pts home and said next time to be on time..?

In a nutshell, I have not even been on "orientation" for more than a week. I feel uncomfortable, unsafe, and I really feel like I could lose my license. This is my very first job as a new grad after almost 1 year graduating. I know I should not be complaining, but I'm overwhelmed. The staff are not medically licensed whatsoever and just coordinate cases/pts and place the Rns and aids to the pts home. Also the Rn who I'm "orienting" from is not BSN prepared, is a 2yr degree and is called the Nurse Director. I was told I could "do whatever you want" you can plan your visits whenever however etc.

I was told that I would be on 90-days probation, but I dont even believe that anymore. All staff are too laid back, chat and gossip all day at the office. IDK I don't want to lose my license. I need to leave this position, I feel ike theres alot of loopholes going around in this agency.

The nurse director started calling potential employees to come in and interview and the next day they would be hired w/o any training. Just to have bodies and to fill hours. The company is extremely understaffed and there are over 600 cases.

Please help. What should I do? I have only been working here for not even 3 weeks. I'm already in the system, I gave my ss, went through HR etc.

[Marshall1]

Disorganized, lying to patients and you feel unsafe and afraid of losing your licenses...trust your gut on all these red flags. If you can afford to leave, leave..if not..you are going to have to look out for yourself, set boundaries and in the meantime look for something else. If they are like this with the staff I can only imagine how creative they are in billing medicare/medicaid and insurances... I agree with another post about not placing this on your resume if you leave so soon. Does not sound like a good place to work at all.

[twinmommy+2, ADN, BSN, MSN]

I'm not HH, but I would think that a great thing about that job from others who have worked it is the autonomy and being able to schedule out your day. I don't see how you can have that great feeling though if you don't have any experience as an RN. Even being BSN prepared, it doesn't prepare you to just jump in and swim with the rest of them. If it were me I would try to find another place to work while attempting to discuss this with the DON.

[Blue Roses]

Whoa... yes the lying to the patients without blinking like that makes me uncomfortable. The lack of orientation also makes me uncomfortable. I would go to your manager with your concerns. Give it some time and if the issues don't get resolved, start applying to other places, before the home health company gets cited or sued and brings you and your license down with it.

[MatrixRn]

Quote "The day after that I was in the office alone waiting doing nothing, not knowing what to do. Minutes before my shift is over to go home, all the staff scramble me and rush me to go to a pts home to give an injection. Mind you, I was around all staff for the past 3 hours and then they didnt even say one word. The Rn then says very quickly, go there now and that is your pt every single day, you will go to this pt every day from now on. Its as if the RN told me last minute so I could just agree and say yes. I was dumbfounded and did not want to argue so I went on my way. Pts family member called the offices asking why I was taking long to get there, and they lied to the pts family and said "the rn is lost on the road" right in front of me. I was late to the pts home and said next time to be on time..? Quote

While I do not agree with an out and out lie, that person covered your bacon. You were sitting in the office for 3 hours with nothing to do and did not take the initiative to ask anyone what you should be doing? You got paid to do nothing. Did you not think that they should be training you on something??

Moving on. After you were late for your visit the family calls and complains that you were not there to deliver the insulin injection? This part was a miss in communication between the agency, you and the preceptor. Bad form by them to leave you in the lurch.

To fuss afterwards, I am not sure is justified, having worked home health I will say going and delivering an insulin injection is the one of the easiest cases in Home Health.

[netglow, ASN, RN]

You know, many HH and Hospices will hire anyone who carries a license to manage them. All it takes is a financial partner and a dirty RN.

I get people contacting me and begging me to DON. "Name your price," they say. ROFLMAO.

More and more, dirty RNs start their own HH or hospice these days.

So many HH and Hospice are rackets now that the few GREAT ones are gonna hurt from all the bad out there.

I'd like the Feds to investigate all of these companies.

Look, it needs doing, or every nurse will suffer from what is a fast growing RN subgroup that will give us all a poor future.

[MrChicagoRN, RN]

Quote "The day after that I was in the office alone waiting doing nothing, not knowing what to do. Minutes before my shift is over to go home, all the staff scramble me and rush me to go to a pts home to give an injection. Mind you, I was around all staff for the past 3 hours and then they didnt even say one word. The Rn then says very quickly, go there now and that is your pt every single day, you will go to this pt every day from now on. Its as if the RN told me last minute so I could just agree and say yes. I was dumbfounded and did not want to argue so I went on my way. Pts family member called the offices asking why I was taking long to get there, and they lied to the pts family and said "the rn is lost on the road" right in front of me. I was late to the pts home and said next time to be on time..? Quote

W

While I do not agree with an out and out lie, that person covered your bacon. You were sitting in the office for 3 hours with nothing to do and did not take the initiative to ask anyone what you should be doing? You got paid to do nothing. Did you not think that they should be training you on something??

Moving on. After you were late for your visit the family calls and complains that you were not there to deliver the insulin injection? This part was a miss in communication between the agency, you and the preceptor. Bad form by them to leave you in the lurch.

To fuss afterwards, I am not sure is justified, having worked home health I will say going and delivering an insulin injection is the one of the easiest cases in Home Health.

Am I missing Something? Did the OP say it was insulin?

And yes, insulin injection is very easy. So easy, the patient and family should be instructed, and independent, very quickly.

[MotherRN]

It all does sound rather chaotic, but (with few exceptions) you aren't at risk of losing your license over the way they run their business.

Have you tried talking to your DON again about your concerns?

Yes, but you are at risk for losing your license if you are on assignment and expected to perform nursing procedures which you have never been trained to do. Your state scope of practice will hold you to your level of expertise, which will say that an RN should have been able to do xyz procedure. Well, sure, with training you would be able to do it. It's a risk. Been there, with LTC- no training yet expected to flush central lines etc etc.

I understand your frustration. I am a new grad from a year and a half ago. Still struggling to find the training I need. Starting to think I will never get it!

[Despareux]

When I was a new grad, I was offered many home health care positions I did not even apply for and was kind of shocked, especially considering my lack of experience. No way on earth would I have worked for home care as a new grad. These companies should only hire experienced nurses. Even nursing homes should only hire experienced nurses, simply because, their orientation time tends to only be a few days.

[LakeEmerald]

Don't cheat yourself out of the training and orientation you deserve! How you are trained in your first few months of working will form the foundation for your skill and proficiency level as a nurse. You deserve to be well-trained.

Insist on a month's long orientation as promised, this way, you are working underneath another RN's license as an orientee and will be protected. Then, look for another job during that time. DO NOT let them send you out without a preceptor! Anything could happen! A diabetic pt could be in a coma when you arrive! The place you are working for is putting you at risk!

Don't go out on your own! You are brand-new and this is all wrong! YOU DESERVE BETTER!

[Needles McGee, RN]

I once worked as a HHA, with NO certification. I had two clients, and fortunately they were fairly easy cases. But, I had veeeeeeery little orientation and I wasn't even CPR/First Aid certified! Our HH nurse was a flipping idiot, I do NOT know how she made it through nursing school. The company I worked for was the biggest scam, definitely out for the money!

[Geslina, BSN, RN]

might want to forget the opinion that a nurse that is not "bsn" prepared is somehow lacking. I know LPNS that could put some RN BSN's to shame. It's about experience, not how well you can remember all the facts for the tests in school. My SIL is about to get her masters, and she is one of the dumbest people I know.

Second, this job sounds shaky to me, like they are unprepared and a little too eager to throw you into the pit with the wolves. You are right - in the end, it is your license that is on the line. Don't do anything you do not feel comfortable or qualified to do.

[jadelpn, LPN, EMT-B]

What you should remember is that most Home Health agencies do not make it up as they go along, as most of the clients have doctors, who need to order home health. Unless they are private pay aides that go in to do personal care. Someone has to prescribe medications that you would give ie: the injection.

Even if a nurse has one more year experience than you, if the nurse has been with the agency for that time, they can certainly give you an orientation to the paperwork, the charting, that type of thing.

And if you are finding yourself sitting about for hours, then by all means I would look at some of your patient's charts in full. Meaning get a good idea of the care plan, their meds, that type of thing. I don't mean go through 600 charts, however, if you have a couple of people that you have seen, look at the chart so you are more informed as to why the person is a Home Health patient, what you will be doing for them, and what you may need to know that you may not. Then ask. If you are bound to run into wound care, IV therapy, I would take those certifications.

You may need to be proactive as to asking for orientating to what you are not sure of. And in some (not all, but some) instances, you WANT an ADN or even dare I say an LPN to actually show you how to be a bedside nurse. All the bells and whistles. ADN's can and do have extra certifications. And in some states, LPN's can be wound care and IV certified. So they can show you the ropes.

If you are finding it all way too overwhelming, and there's no shame in that, be honest. "I really feel as if I do not have enough experience to be effective in home care." Find yourself a Med Surg job, so that you will then have the experience you may need. BUT I would find that Med Surg job first. Then by all means keep the Home Health job and go per diem. The 2 could marry very well.

And I do absolutely understand there's some shady agencies out there, where all of the above comment do not apply. So be mindful if in fact they are not certified by any agency up on the food chain, then perhaps it is not something you would want to be involved with. And run, don't walk to get malpractice insurance. It is a good thing to have in any forum.