New grad LPN just got offered a job at an ALF help!

JustBeachyNurse, LPN · Feb 12, 2012

Simple question..do YOU feel prepared to be the only nurse in a facility overnight? IMHO it depends on the facility, in a true ALF (independent individuals with chronic conditions that need some help and assistance) it might not be much of an issue. The emergencies that might occur could likely be the same as anywhere else in life---gravity wins and someone breaks a hip, heart troubles, etc.

However my concern as a new grad would be if the trend is like some facilities in my area where the ALF residents are admitted with the motivation being $$$ revenue, you may end up with residents who are inappropriate for ALF but family can't afford private duty or LTC. (Alzheimer's with significant behavior, cognitive and/or functional limitaitons. Significant impairment due to uncontrolled chronic conditions such as DM or COPD).

I was told to become an 'expert' in my primary patient population. (In my case medically complex pediatric patients.) and the conditions/diagnosis, medicaitons, and treatments commonly used. Find out how long you are scheduled for orientation and what happens if you feel you need more time.

kazz32 · Feb 13, 2012

I can only tell you MY experience when I was a nurse for only 1 year.

I went to work for an ALF, over nights, I was the only nurse in the building from 11p-7am. Even then the DON did not come in until after 9am!

I left that job after 1 week. Too much responsibility for a NEW nurse. Esp when I had "med techs" administering medications after me. What made me resign quickly was when a MED TECH attempted to give a hospice patient morphine only 2 hours after I medicated the patient and the order was for every 4 hours, as needed. I refused to give her the narcotic keys! I called the DON who would not answer my calls.......not my license!

You have to be able to handle any emergencies that arise, by yourself. Passing medications for the entire building. Monitoring the CNAs and making sure they are doing their jobs.

loumomoftwo · Feb 14, 2012

It sounds like a full plate to me, as I just passed the NCLEX last week. I will not risk my NEW license. To start off as running the whole show may be a bit overwhelming. I had an interview the very day I passed, with a home care business with 2 patients who have TBI & are Quads. It may be a bit slower but Rome wasn't built in a day, Good luck

tiredmomof2 · Feb 15, 2012

I started my first job in a ALF and I love it. The biggest hurdle I have is when to send someone out to the ER. I just go with the motto when in doubt send them out. So far everyone I have sent out has been admitted. Honestly, you get to know the patients quickly and learn when something is just not right with them. I love my job, but I would not want to do it during the day. There are too many people around.

I never see my supervisor since I finished training on days. I bring my laptop and have free internet at work, so I usually put on a movie and take care of the paper work. Some nights can be a little crazy and the first couple of weeks was really scary, but now I just roll with it. Relax and enjoy, hopefully you ended up at a good place.

aruiz · Feb 15, 2012

Hi to all, I'm a LPN and I'm looking for a school where i can get my wound certification, does anybody knows any school in Portland Oregon area?

cayenne06, MSN, CNM · Feb 15, 2012

I just got offered a job as an RN, overnight, with only 4 CNAs to help me care for 60 patients. After orientation, I would be the only nurse on the floor. I couldn't believe it. I just got my license a few weeks ago! Thank goodness I ended up getting a better offer.

AJayG3310 · Mar 11, 2012

Thank you all for your advice and for sharing your experiences with me. A lot has happened since I wrote this. I'm on my 7th day of training. Instead of working the overnight 7p-7a PRN shift I was offered a full time position on the 3-11 shift. At first I was trained by the charge nurse during the 7-3 shift for 5 days (she was wonderful!!!)...and now I'm being trained by a fairly new nurse herself...who really doesn't have a grasp on the paperwork aspect of this job (new admissions, re-admissions, charting etc...and I really feel overwhelmed now. She is horrible! Last night she was trying to get me to sign off on things I DID NOT WRITE...like the assessments and charting paperwork on a res. that was back from the hospital....I had not seen the paper work or been shown the process yet and she was trying to make me do it with no help or guidance...she kept reiterating that once I'm on my own I'll see how hard this job is and to count my blessings that I'm just training now that once I'm on my own it will be hell......I'm a "by the book" person and she is absolutely NOT doing her job the way the charge nurse or DON would expect her to do. She is constantly being told she did something incorrectly... I'm nervous to be training under someone who doesn't have their ducks in a row so-to-speak.

HELP!!! :cry: Any advice for a new nurse being trained by a cruddy nurse???

Nurse1abee · Mar 11, 2012

Alway talk to the DON or supervisor if you are unsure of how to do something...ask another nurse. 9 times out of 10 the other nurses are aware that this particular nurse don't know what the HELL she doing lmao

newpn04 · Mar 11, 2012

now I'm nervous! I just got a position to be the Charge nurse overnight for a ALF. I am a new nurse but I'm not new to the healthcare field. I'm confident in my assessment skills, dealing with an emergency, just a little nervous! I had a friend who worked PRN in a ALF and she said she really didn't do a lot, I don't want to lose my skills, but around here you got to take what you can get to get experience. As far as this current situation I WOuld definitely talk to ur manager or DON about what is going on and just explain the situation. If you feel something is not right than the best thing to do would be address it, and just do so in a professional manner. hope it goes well!