New Grad BSN RN...offered position into LTC post hospital unit as charge nurse

[CallMeNurseNek]

Hello, I am a recent BSN grad who just received state license but has no RN work experience. I interned on a Neuro ICU floor my senior year and has since not been hired into a ICU or general floor at a hospital. Although I had an interview with the Neuro ICU in which I precepted but did not receive my RN license for 2 months later and they had given the position away. I was recently talked into applying for this Jewish nursing home even though I always said I would never work at a nursing home. I have family members that work there and they persuaded me that this facility was different than most as far as quality care, cleanliness, etc. I was offered a position as a charge nurse first shift in the post hospital care unit with a starting pay rate of $29. Any suggestions? I am trying to convince myself that this could be my foot in the door and I could always apply to a ICU once I get RN experience. But on the other hand I feel like I am wasting my degree going into LTC when I really want to be in an ICU or should be in a hospital.

[BiohazardBetty]

The fact that its LTC isn't what bothers me, I would be TERRIFIED to be a charge nurse, even with my years's experience as a floor nurse... I barely know how to survive as a nurse, much less supervise other nurses. If its such a great place to work, why are they having to recruit new grads to be supervisors? Also, I'd hesitate to work to closely with family, but that's a personal decision. You have a tough choice to make... Good luck to you!!

[LadyFree28, BSN, LPN, RN]

Being in the LTC setting IS nursing...

Sometimes the path you want comes later rather than sooner.

You will be giving meds, treatments, especially "post-hospital care" which my area, can range from trach/vent patients, IVs wound care, continuation of post-OP care, dialysis care, etc...patients you will see in acute care.

I think it's important to start your career, and get valuable nursing experience...you might just like it! :)

[MunoRN, RN]

A little skepticism on your part can be healthy in situations like this. It's possible that this is a great opportunity and you should jump all over it, it's also possible that this is open to a new grad because no experienced Nurses in their right mind would take the job.

Make sure it's the first possibility and not the second.

[carolinapooh, BSN, RN]

Some folks can handle this sort of responsibility right off the bat. Some can't.

Think about what's required of a charge RN, and determine if you're up to that challenge. This is a post-hospital care unit. This means these folks are recent d/c's from inpatient facilities. Given what state patients are now d/c'd from hospitals, my guess is you will see everything. Post-ops, post-chemo pts, people still on IV abx. You'll be in charge of making assigments, determining acuities, and assisting if someone goes south. You might even be the person making the call to the MD to say hey, this person needs to go back/is coding/is tanking - here's your SBAR, and I need to get him/her out of here.

I'm not trying to scare you. There are extremely experienced LPNs who are now 'new grad' RNs who could do this - they might falter a bit, but they could make the determinations necessary. But this is the kind of stuff I'm guessing you'll be in charge of. As I said, some can handle it straight out of school - I don't know your background, so I can't pass judgement. My judgement isn't necessarily what's key here.

But I reeeeeeaalllllllllly agree with MunoRN - if they want a CN as a new grad, I'd be sure it wasn't because all the experienced people said, uh, no thanks.

[VANurse2010]

Be careful. Many times "charge nurse" in LTC means nothing. You'll probably just be pushing a med cart and doing treatments like the LPNs.

[carolinapooh, BSN, RN]

Be careful. Many times "charge nurse" in LTC means nothing. You'll probably just be pushing a med cart and doing treatments like the LPNs.

Wanted to add that this may very well be the case - I'm just speculating based on 'post-hospital unit'.

[CallMeNurseNek]

Yes, well in this case the CN just does treatments and medications and is in charge of 6 nurse aides. I was very skeptical as far as the duties that are involved with being a CN until I found out the actual responsibilities I would have as a CN.

[CallMeNurseNek]

Thanks for all the advice, I have some decisions to make now!!!

[VANurse2010]

Charge nurse means different things in different LTCs - but in many it's just a BS buzzword for "floor nurse" - and trust me you have far less authority over the CNAs (in practice, if not in theory) than you would in the hospital as a regular floor nurse. This facility is using it as a BS buzzword.

Yes, well in this case the CN just does treatments and medications and is in charge of 6 nurse aides. I was very skeptical as far as the duties that are involved with being a CN until I found out the actual responsibilities I would have as a CN.

[Sun0408, ASN, RN]

I don't know but to me it sounds scary and risky.. As a new grad, would you know what to do if a pt is going sound, getting ready to code, having resp distress etc.. As a charge nurse, you should. A facility offering a NG this, sounds like desperation.. As another poster pointed out, many offer this but in reality they still do the same work as everyone else pushing a med cart with 20-60 pts and supervise 2 CNA's..

You could always accept and see what happens. You can always put in your notice if it is not what you expected :)

[pinkiepieRN]

I just started working in LTC and all of the floor nurses are called LPN or RN "supervisors". We all do the med cart and treatments. There's 2 nurses to a hall so there's not really much to be in "charge" of, you know, other than the patients under your care. Sure we've got 2 GNAs as well, but they do their thing and we do ours, meeting in the middle when the situation calls for it.