New grad LPN, interview with peds HH agency

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I'm a newly-minted LPN with zero nursing experience besides my school clinicals. I have an interview with a peds HH agency on Monday that has hired a lot of new grad LPNs from my school. I'm a little familiar with them because we did peds clinical at their medical daycare and at some of their group homes. I will be doing shifts at individual patients' homes to start. I told the HR lady that I had no experience and she said "we'll work on that." Needless to say I'm still nervous! Especially knowing I'll be on my own. I was thoroughly honest with the lady - I am a bit familiar with administering meds and feedings through g-tubes as we did quite a bit of that during our peds clinicals, but I've never really had any experience working with trachs or vents, unfortunately.

I'm really happy I have an interview and potentially a job lined up, I like working with children (although I don't think peds will end up being my specialty), I think it'd be less stressful and more flexible than working in a nursing home (basically my only other job prospect as an LPN in my area) which will be especially important when I go back to school to get my RN.

Anyone have any advice for a nervous new nurse with no experience starting out in HH care? Pearls of wisdom? Thanks in advance.

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The parents of peds home care patients tend to be very involved and concerned when a new nurse without experience shows up from the agency. Be sure to stress that you are willing to learn how they want things done and that you hope they will give you a chance to help them out. Try to get some kind of training from the agency, even if it is nothing more than going to a case and observing another nurse while she does trach care, GT care, GT feeds, etc. While most families will be willing to train you and to actually supervise you until you feel comfortable, do not be disheartened by the family that tells the agency they don't want a nurse without experience. Don't take such a rejection personally.

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As a parent, I completely agree with Caliotter. Make sure you are with a good family. There are parents that expect you to walk in ready to go because they have a job to get to and there are other parents that flat out suck. Stay away from those families. At our house, I orient nurses new to our case for a couple of days and am more than willing to work with a new nurse. Trach care and trach changes are two-person events for routine care but each nurse must know how to do an emergency trach change, circuit change and troubleshoot the vent on her/his own.

When it comes to suctioning, listen to the parents for depth and method. We dumped two agency nurses just because of suctioning. If you have an awesome family to work with, you can get a lot of great training and experience.

Be honest with the parents about your skill levels. Nothing will break their trust faster than you telling them you know how to do something that you really have never done before.

Is your DON or RN case manager experienced and supportive? Our nurses (and both of us) could call our DON and ADON at any time with any question.

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I'm not sure how supportive this company is to their nurses, I haven't interviewed with them yet. I understand about parents being concerned about a new, inexperienced nurse taking care of their child - I would be too. I am hoping they will start me out on less acute cases (such as a child with only a g-tube) and gradually introduce me to more acute children after more training. I have no qualms about being honest with the company and the parents about my skill level because my #1 concern is patient safety. I am hoping I'll get at least a few days of orientation from another nurse to each new case and not just thrown in on my own.

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Insist on orientation to the case. That is a given. Normally two hours to four hours is provided, with pay. In more complex cases, an eight hour shift or even two may be provided. Often, you will report two hours early to an assigned shift, get oriented, then move into the shift, unless the family objects to you and doesn't want you working (which won't happen, normally). You will be oriented by a nurse already working on the case or by a family member. Be sure to take notes (many people will say they are not impressed by someone who does not take notes). Ask questions as they come to you. You might be verbally oriented to the case by the nurse supervisor before you go to the home. As a minimum, they will provide you with a copy of the Plan of Care, (485), so you can familiarize yourself with meds, procedures, etc.

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Thank you for your advice Caliotter. Since this company is known for hiring new grads, I'm sure they have some sort of decent orientation procedure. If I feel like I am not getting sufficient training/support, I'll be vocal about it and if it persists, I'll quit.

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Unfortunately, the companies that are known for hiring new grads are also usually known for throwing their new grads out there, so be prepared to run into flak if you speak up for getting good orientation.

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I guess the only way to find out is to accept the job if they offer it to me and see how it goes. I forgot to ask them if they pay mileage - I would assume so, with gas prices being so outrageous. I also worry about putting so many more miles on my car, it's a '97 and I don't trust it for very much longer. I need a new one anyway though.

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To:ComeClarity,

Can you tell me what State you are from? I am also a new Grad and found a HH agency in my Area that is willing to train new Grads. I have always wanted to do home care, and excited but also a little nervous about not getting adequate training.

Bea

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i am a new LPN in New york city too and i took my boards Sept 2012 and pass, i am still jobless, how is that possible, nobody wanna hire a new nurse. if anybody know an agencies or nursing home, that hire new LPN please let me know. i went through hell and back to go school just to find out that i will never get a job. i applied everywhere. somebody kind enough please me, i have child to feed.

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Specializes in Home Health.

I say no flippin' way to a new grad being in home health. Just my $0.02.

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