LTC for new grad RN?

[ijuanabhappy, ASN, RN]

This is a follow-up post from a couple weeks back. I had posted "Am I setting myself up for failure" after being offered a weekend supervisor position in an LTC facility. I do have some experience working in a clinic over the last year, but nothing really in the way of skills. I graduated nursing school (RN) one year ago. After most of the responses told me that I might place myself in a position of losing my license, being inexperienced, I decided to decline the offer.

Now I am still out of work and no hospitals are calling me. The same facility would like for me to work now as a "Charge RN", not a weekend supervisor. They said that basically I would be over a hall of 30 residents and do assessments on Medicare clients and new admits, giving meds and treatments that the medication aides are not able to give, and paperwork. I would be responsible if there is a fall in determining what is to be done and in a code situation.

Is this really that different from the weekend supervisor in terms of being risky for my license. Would this be valuable experience that I could possibly transfer to a hospital someday?

Thanks in advance. I tried commenting on my old post but no replies so far.

[tyvin, BSN, RN]

I missed your last post because I don't know why it would be risky to take the weekend job thing. Was there something that made everyone recommend not to take it?

[Raquel8]

If this is same place, I would try somewhere else. To get skills and use them working at a hospital is the best place. You can always transfer later. I know jobs arent as easy to come by as they were before but A) I think that will change, B) you'll feel better about making judgments.

Just a thought but its what I recommend.

[ijuanabhappy, ASN, RN]

I missed your last post because I don't know why it would be risky to take the weekend job thing. Was there something that made everyone recommend not to take it?

Most people were saying that my inexperience as a nurse would place me in a precarious position of losing my license because all responsibility would be on my shoulders. Prior to nursing school, I was not an LVN or CNA and I feel since I have not used any of my skills learned in clinicals, I have forgotten everything. They said there would be three days of orientation which does not seem like a whole lot, but that there was plenty of staff to back me up. Just don't know what to do. It just seems like maybe I would need med-surg experience first to be able to make critical decisions like whether someone needed to go to the hospital or not? Or am I being too overly cautious?

[hkrntobe]

do you mind if i ask what state you are in? normally as a charge nurse you are not only reasonable for falls, codes, ect but you are also (in a sense) reasonable for all of the nurses that work underneath you. i wish you all the very best but please! be extremely careful with your decision. any facility willing to lay that type of responsibility at the feet of a nurse with approximately 1 years experience may not have your best interest in mind.... also go to salary.com and see what charge nurses are getting paid in your area. if there not giving you a serious offer than they may just be trying to take further advantage of you. even the best salary isn’t worth it if something happen to your license..... so please weigh the pros and cons carefully.

[color=aqua]the times when you have

[color=aqua]seen only one set of footprints,

[color=aqua]it is then when i carried you."

[ijuanabhappy, ASN, RN]

do you mind if i ask what state you are in? normally as a charge nurse you are not only reasonable for falls, codes, ect but you are also (in a sense) reasonable for all of the nurses that work underneath you. i wish you all the very best but please! be extremely careful with your decision. any facility willing to lay that type of responsibility at the feet of a nurse with approximately 1 years experience may not have your best interest in mind.... also go to salary.com and see what charge nurses are getting paid in your area. if there not giving you a serious offer than they may just be trying to take further advantage of you. even the best salary isn't worth it if something happen to your license..... so please weigh the pros and cons carefully.

[color=aqua]the times when you have

[color=aqua]seen only one set of footprints,

[color=aqua]it is then when i carried you."

i'm in texas. thanks for your advice :)

[Dalla]

As a new grad with no experience, I would stay away from charge nurse positions. Leave those to those with a couple of years under their belt. I started at a LTC/rehab place as a new nurse with only 4 days orientation. Other new grads hired there got 4 weeks orientation when they asked for it. 3-4 days is not really enough. Especially if your school clinical experiences were not very complete. I never did trach care in clinical. Very little wound care. Didn't know how to hook up a wound vac. Never dealt with an ostomy. Got all those under my belt my first week on the job.

[LTCangel, ADN, BSN, LPN]

Well as the previous poster said, she learned all of those skills in the first week! So will you. Hospitals don't always give the best orientations either and when they are finished you are also on your own so to speak. My very first job was as an LPN in LTC. I was Charge Nurse. At that time the facility didn't even staff any RNs at night. I learned so much in that 1 1/2 years that I can't even begin to list it all! You will NEVER learn your critical thinking skills if you don't start using them! I would definitely ask for more orientation time but if there are going to be other RNs or experienced LPNs in the building there is nothing that you cannot learn to do! I know jobs are hard to come by right now and you really need to get some experience in order to even go to another job. Sooo... I say go for it!!

P.S. If it sucks you can always give your notice,

[TheCommuter, BSN, RN]

I'm going to go against the grain and suggest that you accept this job offer.

30 residents with a medication aide to pass all your pills is a dream come true for the average LTC nurse. You would only be responsible for injections, finger stick blood sugars, breathing treatments, wound care, assessments, and charting. Without the medication aide, you would have to complete all of the aforementioned tasks in addition to passing oral medications to 30 residents x2 (at least two med passes per shift). Oral medication pass is the most time-consuming task of the LTC charge nurse, and I loved having a medication aide to take the load off me.

A charge nurse in LTC is different than a hospital charge nurse. LTC charge nurses are in charge of their hall, their residents, and the CNAs who work on their hall that day. They are not in charge of other nurses unless they carry the title of unit manager, house supervisor, or ADON (assistant director of nursing). In my area, every floor nurse in LTC is designated the charge nurse of their hall.

Your option is to take this job or continue to be unemployed. I would take it.

[ijuanabhappy, ASN, RN]

I'm going to go against the grain and suggest that you accept this job offer.

30 residents with a medication aide to pass all your pills is a dream come true for the average LTC nurse. You would only be responsible for injections, finger stick blood sugars, breathing treatments, wound care, assessments, and charting. Without the medication aide, you would have to complete all of the aforementioned tasks in addition to passing oral medications to 30 residents x2 (at least two med passes per shift). Oral medication pass is the most time-consuming task of the LTC charge nurse, and I loved having a medication aide to take the load off me.

A charge nurse in LTC is different than a hospital charge nurse. LTC charge nurses are in charge of their hall, their residents, and the CNAs who work on their hall that day. They are not in charge of other nurses unless they carry the title of unit manager, house supervisor, or ADON (assistant director of nursing). In my area, every floor nurse in LTC is designated the charge nurse of their hall.

Your option is to take this job or continue to be unemployed. I would take it.

I think I would love working with the residents and feel that I was doing something meaningful. I've never been in a position where I had to make sure others were on task (CNAs) and hopefully I have the personality for it. I guess I worry about that and lack of experience in critical situations. The LVNs are going to know soooo much more than me and I hope they will help me succeed and not fail. I think I am going to take it. It is weekends only, two 16-hour shifts. Thanks!

[TheCommuter, BSN, RN]

The LVNs are going to know soooo much more than me and I hope they will help me succeed and not fail. I think I am going to take it. It is weekends only, two 16-hour shifts. Thanks!

Do not be afraid to ask the LVNs for assistance. They are a wealth of information, especially in nursing homes.

I worked 16-hour weekend doubles in nursing homes for four years and loved having my five days off during the week. You will be exhausted by the end of your second 16-hour shift, but you'll have plenty of time to recover on Mondays.

[ijuanabhappy, ASN, RN]

Do not be afraid to ask the LVNs for assistance. They are a wealth of information, especially in nursing homes.

I worked 16-hour weekend doubles in nursing homes for four years and loved having my five days off during the week. You will be exhausted by the end of your second 16-hour shift, but you'll have plenty of time to recover on Mondays.

Can I message you everyday with questions and advice?? just kidding, lol. Thanks!