LPN Starting RN program - Job Offer Advice

[LJT347]

General Info: I am a new grad LPN starting my RN program in a couple of weeks. I am going to be working day shift and attending classes in the evening. 

I have two job offers, but don't know which to pick. One is a regular nursing home with short term and long term care and has good pay. The patient load is 1 or 2 nurses to 40 residents. Even though the patient load is a bit much, I feel like I would gain more experience here, which might help me in the future. 

The other job is an assisted living facility. The patient load is not as much as the nursing home. There are no PEG tubes or IV treatments. The most, I have been told I'll do is giving insulin. Most of the patients are capable of taking care of themselves, physically, requiring no use of CNAs. The environment is great also, but the downside is that the pay is $10 less than the nursing home. 

My thoughts: I have loans to pay so I'm leaning towards the nursing home. But, at the same time, the workload may be lighter at the assisted living facility, making it easier to focus on my studies. 

What do you think? Any advice is helpful. 

[ponderingDNP]

It's been a while since I was a surveyor (7 years ago). But during my surveyor days, assisted living environments had certified medication aides (CMA) to administer medications. I can understand the need for a licensed nurse to administer insulin.

That being said, the assisted living environments had the LPNs in an administrative/oversight role. During inspections, you would be in the 'hot seat' (so-to-speak), and you'll likely be the only LPN in the building. As I said, it's been a few years and facilities vary by owner and state regulations. I would ask for more details of the job duties if I were you.

Assisted living residents require more care that those residing in personal care homes, and not quite as much care as those living in nursing homes. So, on-duty licensed staff regulatory requirements vary per type of facility. You may find yourself in the position of being the go-to person.

It may be conducive to downtime for educational studies, but if you are a brand new LPN with no resource should YOU need it in the event of a patient declining, I wouldn't recommend it (based solely on what I know as a past surveyor, and a precious 24-yr LPN history).

Call me ole school, but I believe new grads being placed in positions to perform independently are a disservice to the new grads and a safety issue to the populations being served. All patients are stable until they are not. Don't let anyone convince you otherwise because in the end, it is your license that you're responsible for. If you lose the LPN license (or become encumbered for any reason), you'll likely encounter challenges with the board of nursing regarding any other nursing license. 

All of the above is the worst case scenario. Speak with the employer to see what kind of back up you will have. Every nurse needs that kind support no matter the level of experience. Good luck and I hope I was able to give some helpful information here. 

[kp2016]

If they are telling you it is 1 or 2 nurses to 40 residents you can be sure you will routinely have 40 patients. You mention the assisted living has no PEG tubes or IV treatments, I assume that means the nursing home does?? That is crazy. Who exactly will relieve you for a break?? Just kidding, no one there is getting a break, not with a patient load like that.

Please please please do not be blinded by the $10 per hour. The Nursing home job sounds like a nightmare. Take the job with the manageable work load, have an enjoyable job that you won't be desperate to quit in the first month. 

[Davey Do]

Agree with kp2016, in that enough energy will be needed for the RN program, sounds like there'll be more downtime with the AL position for your studies, plus work will be in nursing, so, why not?