Interviewing for MDS

Ruas61, BSN, RN · Mar 26, 2014

Honestly, no disrespect, but you are not qualified to be an MDS nurse as you stand right now.

You certainly could be trained in to do it.

However, you would need support and guidance and feedback for a good length of time.

The financial impact that the MDS has in bringing in and sustaining revenue is paramount.

Unless they are willing to train you extensively, you are being set up for failure.

How big is the place? Is it really rural? Is there another MDS nurse on staff? Is it a stand alone facility or with a corporation?

MichelletheRN · Mar 26, 2014

It's not a very big place, and is rural-ish....town has a population of 7500, with larger towns near it.

They have not had an MDS nurse for awhile (how is that possible??) like the job has been advertised for about a month and a half. Is maybe the director of nursing doing it? I don't know. Maybe they have brought in someone from another facility to do it until they find someone.

They want an RN, with a bachelor's degree, and a couple years experience, and would really like someone who has done MDS before. Apparently, no one has stepped up, so they are interviewing me, but what they really want is one year of experience at it. I have lots of nursing experience, and am definitely clinically competent, but as an administrative nurse, I have not done that, and am afraid.

Can i talk with the patient, family, staff, doctor, and review the chart well enough to make a good care plan, and understand the patient's history and condition well? Sure. But I don't want to screw things up. The fact they haven't had one in a while means I could be walking into a mess that I don't even know how to clean up.

My co-workers gave me shining references (i got them from my DON, two RNs, two APRNs, and an LPN). They say I'm smart, friendly, kind. BUT that really doesn't matter....if I am not sure what is even expected of me.

Should I just lay my cards on the table, and say, look, I am a decent nurse, a hard worker, pleasant, and intelligent. I don't know how to do this job (they know ive never done it already), but if you have training available to me, I promise I will learn and will always work to the best of my ability. I know this is a serious job, and I'm not willing to make light of it and come in here and hang my degree on the wall and set my "RN" coffee cup on a desk and say, "Here I am! Now what?" That's not fair to me, the facility, or the patients. If I am offered this position, I MUST insist upon training beyond the typical "on the job" stuff...and I need ongoing support from corporate, from administration, etc. If I am shown what to do, properly, I can promise you won't be disappointed in my work. But I must know these things in advance, if it is offered to me, because it has to be done RIGHT.

Does that sound totally stupid, for me to put it that way?

MichelletheRN · Mar 26, 2014

Oh, it is with a corporation which runs a chain of such facilities throughout the midwest.

What I KNOW how to be, is a floor nurse or charge nurse, on a med/surg floor. I can put in an IV, stick an NG tube in, and read telemetry strips with the best of them. I can manage the care of relatively complicated patients, on multiple drips, with multiple illnesses. This hospital in our town here, is little, and if all hell breaks loose, I've handled it. I've ran codes because the doctor was ten minutes away, it was the middle of the night, and we couldn't wait...just called and said, "Get here, NOW, please hurry!" I've seen it all, I will think, and then something new happens. We delivered a baby, from a mother who didn't realize she was pregnant. I mean, it is ridiculous sometimes, I think, come on! I've had a meth head try to throw a TV at me. Lol. I could right a book on crazy.

Surely since a corporation runs it, they would offer training, I would hope. But, I don't know, and I am not going to fly blind.

MichelletheRN · Mar 26, 2014

Any more thoughts on this? Help lol! I am freaking out!

If I tell them I would be more than happy to take the certification and class, as there is one being offered near me in about a month, do you think I would be okay? The corporation operates three other facilities within a half hour or so drive of this one, could those people help me to learn?

If they are okay with this, I see there is a national association which i could join, and I will, no problem, in fact it is the one teaching that class.

I dont want to do the wrong thing.

silverbat · Mar 26, 2014

I learned to do MDS, on the job training with 2.0. Now that 3.0 is here, and with the changes coming in Oct, I would NOT want OJT!

I would want a preceptor with me daily for several weeks. I would want time to read/study LEARN the RAI manual(you can find this online at CMS.GOV.)

Another thing to think about...MDS is generally included in the oncall rotation((at least it is every where I have worked)-if this is true at your facility, can you do the 12 hour charge nurse/med nurse duties with yur bad knee??

Consider also, if they are desperate for MDS, they may tell you whatever it takes to convince you to take the position. Can you find out why the prior MDS left?

Find out how far behind you will be and know that it wil take you quite awhile to catch up. Will you then, be "in trouble"for nonpayment, or bad state surverys related to the time before you took over? It happens.

Will you be the only MDS? What are your other duties? (There will be other duties). Many things to find out...

Be careful and think very carefully before accepting this position..

LTCNS, LPN · Mar 27, 2014

I've been doing MDS for 15 years and am ready to get out of it due to the fact that with the implementation of MDS 3.0, the job has become much more stressful. Precise, accurate coding is crucial and care plans must be well...perfect. Maybe I'm just burned out on the whole MDS thing, but as mds1 suggested, I would be careful and think long and hard before I took the position.

Where I work, had I known I was the third MDS nurse in less that two years to have been run off by the other MDS nurse and her friends, that they were more than a month behind, that I would be responsible for more than 90 residents by myself, and that they had been tagged over and over for care plans, hence why they are blaming it all on me now since I "inherited" the problem, I would have either taken a floor position or ran for the hills.

If you decide to take the position, I wish you much success and happiness. You will know in your heart what decision you should make. Good luck to you.

MichelletheRN · Mar 27, 2014

You guys, thank you so much, for giving me advice and suggestions. At least now i have alot more of a clue. I am stepping totally out of my comfort zone in considering it at all, but in some ways thought, well that's good...im to comfortable and complacent in my work and need to shake things up a bit, explore new things.

I will feel it out carefully, wont commit to anything yet, and am just going to straight up ask why the other one left.

If it seems "okay", and they are receptive towards me, etc, idk...we will see, I guess. I will never do anything if I'm not sure I can deal with it, or if I think I am going to screw up something.

I may be reading too much into casual comments, but initially the lady who called me back seemed slightly baffled as to why I had relatively little LTC experience, and I was just like, I don't know...I liked my job and coworkers and it was right here in town, so I just stayed there...she asked me what my salary requirements were, and I said I don't know, about what you would expect for someone with 17 years experience...what would be the pay offered for this? She said well what were you making an hour before? I said a little over 30 dollars, so I guess it would be around 65-70k a year...she said, oh, it won't pay that much...this is a desk job...it's like, well yes, i know part of it is, but isn't it considerably more than that?? To me, it is...it's a HUGE deal...

Sometimes I think I take things wrong, though.

I will report back how it pans out...it's tomorrow and I'm really stressed about it.

silverbat · Mar 27, 2014

I make about 30/hr as RN MDS. So I think that is good for the area I live in. In my prior position, for the state, the median salary for RN MDS was 26/hr. Don't forget to findout about on call, pulled to the floor,etc.

MichelletheRN · Mar 27, 2014

It went pretty well from what I could tell. To my complete suprise, the administrator used to run the home about 20 minutes from where we moved from, and was the one who hired our daughter who is a dietary aide there. She is extremely fond of her.

They will provide both on the job and formal training if i am hired and accept it. The start time and hours are flexible. They said i will be generally working around 40 hours a week, though there is flexibility in it.

I won't be on call per se, but if they are short handed, it is what it is.. as a rule, most of the responsibility is on the DON and ADON for this. The vast majority of my time would be spent in assessments, care planning, MDS, meetings, and staff education.

The facility HAS a coordinator right now, but she is an LPN who is in college to become an RN right now, and is doing this in addition to being in college full time. She is behind, stressed to the max, and wants someone else to do it. The DON is helping her now. I thought they were without one, but I was incorrect.

The facility was clean, the people seemed nice. I felt at ease with them as much as possible for an interview.

I need to clarify "staff education" and what that means.

Overall, i found the facilty to be older yet clean and maintained and the people there were friendly. It is something I will continue to think carefully about before proceeding in any way.

MichelletheRN · Apr 25, 2014

I did decide to go ahead and accept this position when it was offered to me. Despite a slight pay cut, the benefits package more than makes up the difference, and in actuality, with that, I will actually come out ahead financially.

I had a good feeling about the administrator and DON immediately, they seem very competent and caring. The DON, ADON, and the current MDS nurse all know how to do MDS and care planning. So there are plenty of people to help me learn. I have been reassured that I will always have support. I have 12-14 weeks of training, which is a combination of computer, book, teleconferences, and one on one. The corporate MDS consultant interviewed me as well as the administrator and DON, and she and I have had two phone training things so far (this is my first week), and she seems to think I am doing good. I am studying hard, and tomorrow the LPN who currently does the MDS and care plans but is also in college full time (!!!!) is going to be there, and is going to help teach me. I am also encouraged to take a certification class. I do feel that there is good support and do not feel abandoned and helpless, though I am indeed nervous and understand the importance of what I have been entrusted to do. I deeply want to do my best for my patients and employer. I do not take it lightly.

The MDS and care planning, along with some meetings, are my entire job. Possibly a small amount of staff education....about MDS coding and care plans. I will not wear many hats or be expected to be running all over filling in for everyone. I am not expected to take call or fill in, unless it is a slow week and I want to. I will need to go in on a Saturday once every two months to be a manager on duty, for about three hours, and this is rotated. I can work in my office or just help out where needed on those days. The HR guy told me this will be good also because it makes me visible to everyone as both a manager and a nurse.

I find it hard to not go out and start answering lights or helping on the floor when they are short of help, but I keep reminding myself that my job right now is to LEARN everything I can, and I have enough on my plate with that. I just feel bad because I know it is so hard when people call in and stuff. And also reminding myself that doing a good job will enable the facility to hire more staff, reducing their workload, improving the care, and raising wages. They really do work hard an care about the patients. So far I have been treated well and respectfully. My title is RNAC, and there is much excitement over this as they have not had one before, instead spreading care plans and MDS out between the present coordinator, the DON, and the ADON. I've done a few assessments to help out, not MDS ones obviously, but what they have had me to do, when I have had a chance. This will take some burden from the floor nurses. I have made sure everyone who is a nurse, aide, patient, housekeeper, whatever...that I have come into contact with, I have introduced myself, smiled, shook hands, and said how happy I was to meet them, and I hoped to talk with them again soon...and I MEANT it. I am humbled that so much trust has been placed in me.

LTCNS, LPN · Apr 25, 2014

Congrats! Sounds like you have all the support you need, and that is so important in a position such as MDS Coordinator. I sincerely hope and pray you enjoy every minute of it. Keep us updated on how you're doing :)