New Grad Charge Nurse for Rehab to Home Unit

Heart 2 serve · Sep 14, 2011

Hello everyone!
I just got hired as a charge nurse for a 20 resident rehab to home unit in a nursing home. I am a brand new graduate, and besides clinicals and a nurse externship, I have never worked in healthcare before. I am very excited and intimidated about my new position, and was just wondering -- can any of you tell me how the rehab to home units work? I have been in a nursing home before to visit a family member, but that's it. Before I got this job, I didn't even know that nursing homes did rehab to home.
I believe I am in a good facility. I have six weeks of orientation, and when I went in last week to fill out new hire paperwork, I noticed a really good 'team' atmosphere, between all the nursing staff (CNAs to DON), but also between the different disciplines (therapy, social services, etc). I feel like I'm going to be well supported there, but I also want to hit the ground running, and be the safest practicing new grad that I can be.
Any advice?

So how have you been doing? I'm looking into a similar position. I'm a new grad as well.

Keila · Oct 24, 2011

I'm so sorry, Heart, I'm just now seeing this or I would've replied sooner.

Arabstar was right -- I am the 'charge' nurse because I am the direct supervisor for my team of CNAs. From what I've seen of the charge nurse role in the hospital, the two are totally different and, like Arabstar, I would absolutely decline an offer to start out charging in a hospital setting.

When I originally posted this thread, I did so because I was scared to death (and excited, too) that I had landed my first healthcare/RN position. That transition, from student to nurse, was my most difficult hurdle and lasted about 2 months. It really helped that I had an amazing preceptor who trained me for 7 weeks. The first few days I was by myself, she even called to make sure I was doing okay.

It's me, an LPN, and four aides for 37 residents. I have the same 18 every day, and my LPN buddy has the same 19. I work 12s, she works 8s, and most of the time another LPN comes in for her hall on the 3-11 shift. There have been maybe 2 times that I've charged all 37 residents with a med tech. There are days when it seems like I don't have enough time to get everything done, but all in all, I love my job. We have great nurses on every shift, so if there's something one shift can't get done, the next one picks it up with no problem. Most of our aides are awesome, and let me tell you, they have really been patient with me. I jump in and help them whenever I can, but since I've never done transfers/toileting, they've had to teach me from the ground up. It's very different when you're transferring a mannequin in CNA school, lol. With a few exceptions, we all help each other, and that makes all the difference in the world.

So to answer your question, I've been doing great, and I plan on staying with this facility for a long time :)

alexdelsols · Aug 18, 2014

I work the night shift at a health and rehab facility. I am the charge nurse and was hired as a new grad. I have been working there for over 3 months and anybody who says don't take the charge nurse position because you don't have experience should see what the job market is at least in Oregon and Washington. Of course I wanted to get hired in a hospital, but unfortunately things didn't turn out that way. I worked as a NAC/Nurse Tech at a level 1 trauma hospital in the float pool and I know that this really increased my experience for being a RN charge nurse. The first day at my health and rehab job I did CPR and thanks to my experience I think I really helped the person that was orienting me who had never done CPR.

The thing that I find difficult particularly difficult recently is managing the NAC's I work with. For the most part it is me as the RN and 2 NAC's for between 30-38 residents at night. One NAC recently has been very lazy, to the point where I have to check his residents and make sure that they are not incontinent of urine or feces and ask him to clean the resident even though he should be on top of this. I was a NAC and know the demands of the job. This particular NAC I have asked where he is at when a call light has been going off for over 10 minutes and he says that he was in the bathroom... There are always excuses. I am going to have a verbal one on one with him the next time I work tomorrow. I never expected an incompetent NAC to be one of my biggest struggles with doing my job thoroughly, but this particularly NAC is so lazy. On top of it he is a really nice guy, and has 3 kids. I know that I need to tell this NAC something before I go to higher management, but I know that I need to come across as being serious. Before I knew that this NAC was so lazy him and I would joke around. Any ideas would be appreciated. Thank you.