work in a nursing home, can i do it?

[nindot]

I am a nurse from the philippines, came here to the US early last year. Have'nt worked here yet but recently i passed the CA licensure exam on my first try. I finished nursing school in 1990 but never practiced up until 2005 when i took a 5-month clinical refresher course in a tertiary hospital in manila, to get some nursing experience before i leave for the states. Last week i applied for a nursing job in a nursing home here in sanfran, they scheduled me for an interview and they're considering me for the job, they will employ me under their new grad/ rn refresher program which is 6-8 wks in length. I'm not so sure though because i feel like i need more than 8 wks knowing my very limited nursing background and having finished nursing a very long time ago, i might not have the confidence to be on my own after the 8 wks, especially a nursing home which usually has big loads of patients. I sent my resume to some hospitals here offering an rn residency program, which is more comprehensive averaging 3-5 mos. and i would prefer more to work for a hospital because of the experience i will get, but i didnt get any replies yet, though i just sent my applications last week. I was wondering if their program limited only to recent grads of a US school, or maybe a lot of new grads apply and they only accept a limited number of applicants for the program and of course new grads, US-educated are preferred, gosh a lot of things are entering my mind, hope i'm wrong. I need advise, will i accept the nursing home offer or just wait for a hospital to get interested in me, how much time should i give myself to wait.

[nindot]

Nindot-You are extremely lucky to have found a place with an 8 week refresher course. No LTC that I've ever worked in has offered one. Most orientations are less than a week long.

I DO NOT think nursing homes are the place to get your feet wet as Cmariehart has said. Most nurses on a long term floor have 40 patients to give meds to....or on a subacute unit you will have 20 patients many of whom are post op. It is NOT the place to be without a med/surg background....one guy will be a fresh hip fracture, the guy in the next bed might have flash CHF, the lady down the hall is delusional and psychotic from a UTI, and the family member at the desk is hollering because her mom didn't get her hair done. LTC/Subacute is no place for beginners or sissies for that matter. You need excellent clinical skills because most of the time YOU are the only one looking at the patient. You need time management skills, people skills...

Best of luck to you and I hope you get what you need in your refresher course.

Thanks for your advice! actually i really prefer a new grad position med-surg in a hospital and i have sent my resume to several hospitals offering new grad/residency programs here in the bay area recently but unfortunately i have'nt gotten any replies yet, except for this one nursing home. I passed the interview but right now they're still doing background check, so i still have time to think whether to accept their offer once cleared with the background check. I think i'll give it a try first, while i'll wait for a hospital to consider me.

[Fancy Face]

That is what I would do nindot. Don't be scared of the nursing home in the meantime, in any nursing situation (hospital too) you probably will be dealing with less-than-desirable staffing ratios at times. Goes with the territory of nursing unfortunately.

[Cmariehart]

I have a question for Capcadmermaid.... What kind of nursing home do you work at???? We have 40 pts on our unit.. 2-3 nurses and usually 3-4 CNA's not the best staffing ratio but better than most. There's nights when we have alot less. I think starting out in LTC is alot better than being tossed in a hospital on med surg and saying good luck.... I've had pts go crazy from UTI's and we have 5 rather nasty and abusive pts too but you learn how to get through things...... Isn't that part of nursing learning by experience????? In my opinion hospitals are an acquired taste, not everyone is meant to be in an ER or med/surg floor... just my 2 cents worth

[CapeCodMermaid, RN]

We have 3 separate units..a long term, dementia, and subacute/rehab. Day shift there are supposed to be 5 CNA's on all units, 2 nurses (one does the meds, the other everything else) on the dementia and long term units, and an extra nurse on the rehab floor....those 2 nurses have 20 patients each to give meds to and do treatments on.

Evenings...4 CNAs...1 nurse on the long term, 1 on the dementia unit and 2 on the sub acute plus a nursing supervisor who helps on all 3.

Nights...2 CNAs each unit,and the nurse/patient ratio stays the same.

I have no say as to how many hours of staff I get....I can only change them from shift to shift.

[traumahawk99]

the worst for me is 37 patients for meds and treatments. aides who don't have enough sense to even take accurate vital signs. it's simply impossible to handle that many patients and stay within the time limits for administering meds.