new grad, PDN, and experience for the hospital

PerfectlyPlump, ADN, RN · Sep 21, 2013

It seems universally believed that as a new grad it is best to get hospital experience. In Texas I even think the BON had stated that new grads need to be in facilities and have supervisors and coworkers. You discuss, you learn, you question, and are NEVER alone.

I have one friend who graduated and had missed the internships in her area for various good reasons. She ended up going over to Oklahoma and being hired by a hospital there that was still open to new grads. Is probably a more rural area. Well she loves her job and is gaining the experience she needs...and it is in a specialty.

LTC is the next best thing...some are acute. I think a job in any facility is better training and will look better on your resume if you wish to try for a 'real' hospital job in a year or two.

CloudySue · Sep 22, 2013

LTC is great in that you have a number of residents that you get to know medically and personally over time. You know their baselines and can see for yourself any change of status and you witness the entire arc of their illness and recovery (or demise). It's great practice for making assessments. You get a lot of practice on wound care and you witness the healing progression. You learn meds, I mean, you REALLY end up knowing your meds, giving them every way, shape, and form. Also, you get good at the basic procedures- tube feeds, trach suctions, foley cath insertions, wound vacs, enemas, ostomy bag changes, pleural taps, etc. You will probably also get to see and treat some decubitus ulcers. Strangely, we saw them mostly w residents who came back from lengthy hospital stay. You'll be involved in codes. You may get to try out your CPR skills. And you'll give your heart away to a lot of these people- a big difference from hospital work because these folks are a part of your life, not just passing by. Writing this makes me actually miss LTC quite a bit... but until the logistics problems are solved, I won't be doing that type of work again.

LadyFree28, BSN, LPN, RN · Sep 22, 2013

Hi there,
I have posted on here a couple of times about PDN and being a new grad. I really want to be in the hospital on med/surg but the way things are going, that isn't too promising since I have no healthcare experience and jobs are hard to come by without that where I am. If as a last resort, I do PDN (on a very stable case with lots of training, as I am very nervous about the idea of PDN with an unstable patient as a new grad) will that help me get a hospital job or hurt me? My other option is LTC I suppose, but boy have I heard some nightmare LTC stories from the ladies that graduated before me and took those positions as a last resort. I have a connection to a case that is very stable, lots of training, and would be nights while the patient is sleeping. AND it pays great. I was thinking of that as a way to also get my BSN at the same time since I could do homework on the job...I am home with my little ones during the day so a stressful day time job AND homework would just be too much. I would just do maybe 2 12's and get childcare for 2 days which would be doable. Do you PDNs feel trapped in PD or like it is a good thing to now be able to put on your resume? thanks in advance!!

I wanted to share my experience.

I started in PDN as a new grad LPN, and was in PDN at least 40-60% of my career; I did Acute Rehab, LTC, clinics, while I worked in PDN.

I choose PDN because at that time, they stopped hiring new grad LPNs acute care settings...same thing they are doing in some areas to ADNs. I needed experience.

Depending on the agency, you do get extensive training, as well as assistance in getting to know the basics; I also was sent to a vent training class for 4 days ran by vent nurses and RTs; I got to know the ins and outs of the vent; adjusting settings; calculations, I:E ratios, output, handling emergencies, and appropriate documentation.

Every agency I worked for required competency in the home, and in the office; when taking vent cases, one must completed at least 16-24 hours with another nurse.

If one chooses as a new grad to be a PDN, be VERY prepared to advocate for your practice and your patient; ask questions thoroughly, even ask for additional training; PRIOR to taking a T/V patient; find out if there is an organization or hospital that has vent classes that your agency can send you to it they don't have a more "formal" program (ie no classroom time, just showing up in the home.) Be prepared to say NO if you are not comfortable, as well. Take advantage of as many educational opportunities as possible....there are plenty in this line of work.

I enjoyed being a PDN T/V nurse in the home setting for 7 years; my experiences have helped me land acute care positions as well as supervisory positions as an RN. The best experience that PDN can give you as a nurse is great assessment skills; advocacy-meaning you must have confidence in making prudent decisions, ability to actively collaborate with other providers and your agency when you see something and they are relying on your suggestions; and educating parents and family members.