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New grad private duty offer

Private Duty   (2,025 Views 9 Comments)
by amberlt91 amberlt91 (New Member) New Member

903 Profile Views; 10 Posts

I am a new graduate LPN and have been offered two jobs recently.

One is for a private duty. I would be working with chronically ill pediatric patients, one child per shift. I would get trained for vents and trachs after 6 months of working but as a new grad would work mainly with patients who have g-tubes, oxygen etc.

I would stay with the child wherever they are. I am allowed to attend doctors appointments but not actually take them. I would even go to school with the child if that's what they needed.

The pay is one dollar lower than other places I could work, no shift diff for weekends (but weekend work is not required), and no mileage reimbursement. Although they did say I can chose how far I am willing to travel.

The other job I was offered is at an assisted living facility 5 minutes from my house. I would have stable hours but would not get to use my skills very often since the patients are pretty independent. Every other weekend required. I don't like the idea of having to be the supervisor of CNAs and having so many patients. But I know it would be good experience as a new grad.

Would you all recommend I take the private duty job?

Thanks in advance!

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2 Followers; 4,127 Posts; 29,419 Profile Views

What are your long term goals? I wouldn't want to start at either one of those jobs as a new grad, although they don't sound bad.

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10 Posts; 903 Profile Views

Just curious as to why you wouldn't want either? Would a SNF be better to practice skills?

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2 Followers; 4,127 Posts; 29,419 Profile Views

Just curious as to why you wouldn't want either? Would a SNF be better to practice skills?

I'd avoid assisted living as a new graduate for exactly the reason your said ...not much room to grow, skills-wise. Private duty would be one of two things to me ...boring, because I'd get simple cases that offered no growth ...or scary, because I'd get complicated cases and have no one around to learn from.

I do believe SNF would be a better option than either of those two if you're looking to grow.

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7 Followers; 68 Articles; 295 Posts; 28,636 Profile Views

In reading your post, you identified more cons than pros when explaining the ALF job. I would choose the job you feel is best fit overall. I did teach a nursing student who went on to graduate and first job was private duty nursing. She loves it... good fit for her.

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nursel56 specializes in peds//ambulatory care/HH-private duty.

1 Follower; 6,653 Posts; 43,404 Profile Views

It's difficult to say for sure between the two because there are drawbacks to each. With the private duty job you would be doing "hands on" bedside (or school plus outings) but with one patient, your skills growth will be limited. Trach and vent cases are interesting and challenging, but you've got to hang in there for 6 months first.

Then another point is how busy is the agency? Your work hours can vary quite a bit during the phase of getting the nurse+patient+hours+driving distance agreeable to everyone. Something to consider if you need to work a certain number of hours to make ends meet.

Considering the Assisted Living Facility, I can certainly understand not wishing to supervise a group of CNAs as a new grad, but I know from other people posting here they've successfully managed the role. However, I've never worked as a charge nurse in an ALF, so unlike with private duty, I can't base my opinion on firsthand experience.

Just a couple of things to think about, best wishes on a successful job hunt!

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Avill is a BSN and specializes in School Nursing, Home Health.

3 Articles; 295 Posts; 6,988 Profile Views

Depends on your long term goals. Every nurse is different. To me, that private duty nurse job sounds ideal, especially if you have a family (or for the future family in mind). I personally don't care for the long hours, weekends ect. I went to school to be able to pay my bills, not to be rich. So I enjoy what I do (school nurse/HH nurse).

SNF is more work than what it looks. Lots of patients, lots of charting and you depend on your CNA's since you can't be anywhere. I started at a LTC facility worked there for 6 months, it was hard to be in charge of the CNA's but I got more comfortable with time.

So do what you feel is best for you. Weigh out pro's and con's, pay VS time. What is valuable to you? You also have the rest of your life to work, and nursing is one of those careers where you can go different places. So you don't have to work at a SNF or private duty forever if you don't want :)

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Alex Egan is a LPN, EMT-B and specializes in Home Health (PDN), Camp Nursing.

6 Articles; 852 Posts; 23,038 Profile Views

I used to say that all new grads should do a year or two in LTC, but at this point PDN has stabilized enough in my area you can feel pretty solid in job prospects and support (mostly). I think the biggest problem I see with you thinking is that your skills are not being used in AL. Your a nurse not a factory worker, you have thinking not necessarily skills. I can teach skills to anyone. What I need is someone who can think like a nurse. Prioritize, assess, manage, and delegate like a nurse. Know when to teach and when to pass, know how to talk down an angry family. These aren't things that happen with the same frequency in PDN as in other settings. As a mater of fact if your not well established coming into it and confident the family's will run you over in a second. Other life experience can help but in all reality PDN is not setup to handle new grads. You have to walk into the situation with a fair amounts of caution. Get a mentor, and find an agency that is willing to give a long and varied orientation (don't let them plug you on one case to start out, follow a few nurses on a few cases and see how everyone is doing it). Also realize this is an industry that will require a lot of self advocacy on your part, the way a lot of agency's work no one in that office is on your side you have to look out for you and if necessary fight for your patch

Edited by Alex Egan

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1 Post; 69 Profile Views

The most difficult job that most new grad RN's start with is Skilled Nursing Homes/LTC if they can't get into a hospital, like many cannot, especially in Massachusetts. Unlike nursing homes of the past, these patients have been discharged in only 2-3 days from the hospital, these "today" sub-acute" nursing home floors are what used to be Acute Care hospital patients, due to insurance companies, and the scary thing is, there is 1 nurse for 25 patients!! yes, you will have some stable patients, but 10-12 hospital level patients....but here's the big problem, no Supervisor to get help from, no Preceptorship, minimal supplies, missing meds on cart, many treatment supplies missing - if the desk nurse manager is absent or on vacation, too bad, you better know how to fill out all that "Transfer or Discharge" paperwork, OH, and even though you have NEVER been taught how to do an Admission, the ambulance will show up 10 minutes before the end of your shift and the 3-11 will say its not hers, so you'll be stuck there until 8:00pm with no help from the DON or anyone else who left at 5:00 - SO YES, do private duty nursing, but the family( often the mom) is EVERYTHING, not the child, you either click with the mom, or you don't...you have a lot of non-nursing time in between meds and treatments, so you become part of their family and their daily life! You need to be able to do that, older nurses who have their own children tend to blend in better since they have been there/done that with their own kids.

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