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New Grad Select Specialty Hospital

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by CHnurse79 CHnurse79 (New) New

426 Profile Views; 5 Posts

Hi everyone,

I am a new nurse who hasn't had a job yet and was wondering if anyone would advise for or against taking on a job where the patient ratios are high and the patient acuity is high. I have an interview at Select Specialty Hospital and their patient population is vented, with lots of wounds and tracheostomies. They did say they train you as a resident. While it may be good experience, I am concerned about safety as a new grad.

Thanks!

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Pangea Reunited has 6 years experience as a ASN, RN.

1,547 Posts; 21,381 Profile Views

That doesn't sound ideal, but you would get plenty of experience with everything. The patients are usually there long term, if it's the type of place I'm thinking it is. So while the patients are very heavy, at least you get to know them and their needs. Hopefully, that speeds things up at least a little bit.

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457 Posts; 9,928 Profile Views

My mother was a patient at a Select Specialty Hospital. We checked with a family friend who worked 30+ years at one of Select Specialty's competitors in another state. The friend spoke highly of Select Specialty.

I asked about their patient ratios before we agreed to her transfer there. Where my mother was treated, they have a ratio of 2:1 when the patient is first admitted. After a few weeks when they feel the patient has improved enough, they will move them to an area where the ratio is 4:1. Even where the ratio was 2:1, they still had CNAs helping with ADLs. When mom was in a hospital ICU, the ratio was 2:1, but there were no CNAs.

Select Specialty is LTAC which specializes in weaning patients from vents. Patients are supposed to be stable before they are transferred there. They are always located inside of an acute care hospital. Where mom was the unit was on the same floor and next to ICU and ER.

Where my mother was a patient, they had at least 2 RT on the 35 bed unit at night. More during the day. RT handled everything vent related. I was very impressed by the knowledge of the employees at Select Specialty. The employees spoke highly of the company and said the company sent them to a lot of training. I also noticed that every employee who cared for my mother had been there 15+ years.

The local management of a facility has a lot to do with the level of care and employee satisfaction, so what you encounter at your Select Specialty could be a lot different.

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Here.I.Stand has 16 years experience as a BSN, RN and specializes in SICU, trauma, neuro.

1 Follower; 4,943 Posts; 42,606 Profile Views

I worked for a Select hospital for a while. It's "busy med surg" on steroids. You will learn a ton but it is very hard work. Days when thd WOCN was rounding on 1+ of your pts wasn't so bad, but some of that wound care could take 2 hrs. Meanwhile everyone else is busy too, so hard not to worry about your other pts. Many are on tele/bedside monitors so not so much worried about them coding and nobody knowing, but about them having call lights on for a long time, waiting for meds etc.

Clarify what they mean "train you as a resident" -- as an experienced RN, I only got 5 days orientation on the floor.

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5 Posts; 426 Profile Views

Hi,

Thank you so much for your reply. I am a completely new nurse with zero acute care experience. The HR person I spoke with on the phone said that they have a 12 week new grad training that they offer. She called it a residency. I live in an area that has the most nurses in the country and so there are no jobs here. I want to get my foot in the door and eventually work in trauma or ICU so I was hoping that this job would be a stepping stone to that. But I also want to be safe in patient care and supported in my training.

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5 Posts; 426 Profile Views

Thank you so much for your detailed reply. This put my mind at ease. I guess I can ask any questions I have during my interview. I'm so glad your mother got excellent care.

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TheCommuter has 10 years experience as a BSN, RN and specializes in Case mgmt., rehab, (CRRN), LTC & psych.

1 Follower; 228 Articles; 27,607 Posts; 317,917 Profile Views

The Select Specialty Hospitals in the area where I reside have good reputations. Select is an LTACH (Long Term Acute Care Hospital), so you'll get good experience.

Can you afford to turn down this job? Beggars can't be choosy in an ultra-competitive employment marketplace. Here's the equation:

Select Specialty Hospital = RN pay + RN experience

 

Holding out for another job = No pay + No experience

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RN Hart has 3 years experience and specializes in Med-Surg, ICU.

4 Posts; 281 Profile Views

The select specialty hospital from where I am has a bad rep for people working there. The pt ratios are high and the turn over is high. The nurses make great money because they work so much overtime. The cnas are responsible for pts on multiple floors. I have heard horrible things and would not consider working there but apparently it is different in different locations. Good luck!

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KatieMI has 6 years experience as a BSN, MSN, RN and specializes in ICU, LTACH, Internal Medicine.

1 Article; 2,331 Posts; 41,685 Profile Views

I work in Select too.

It is true that LTAC is a golden opportunity to learn things. Most of Select hospitals either do not have "specialty teams" or only allow their use when it is really necessary, not when someone feels lazy to put an IV in. So, you will learn it all. Wounds (including vacs), vents (including trache changes and more, if you want it), sedation, even elements of dialysis - you name it. You will be able to jump into any specialty you might fancy after a couple of years. Most "acute" Selects keep ratio to 3-5 :1 at day and 5-7:1 at night.

Only one thing which would make LTAC a problematic choice for a new grad is extreme complexity of these patients. People come in Select precisely because their multiple needs cannot be addressed anywhere else. Caring for these patients requires critical thinking of ultimate lelel and the broadest base of knowledge. I do not tell that a new grad cannot succeed in Select, but the learning curve is going to be exponential.

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TheCommuter has 10 years experience as a BSN, RN and specializes in Case mgmt., rehab, (CRRN), LTC & psych.

1 Follower; 228 Articles; 27,607 Posts; 317,917 Profile Views

This thread has been moved to our Nursing First Job Hunt Assistance forum in order to attract more responses and feedback. Good luck to the original poster.

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HouTx has 35 years experience as a BSN, MSN, EdD and specializes in Critical Care, Education.

9,051 Posts; 45,018 Profile Views

Be careful - several Select Specialty locations have closed in recent months. From all indications, reimbursement changes are at fault & there may be more to come. LTACs are under fire.

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Clarysage has 7 years experience as a ADN, BSN and specializes in PCU, LTAC, Critical Care.

9 Posts; 645 Profile Views

I have experience with Select. It was my first RN job out of school, 5+ yrs ago. I went through an orientation period with a preceptor, I am sure that is what they are referring to. You will not be practicing alone.

LTAC is hard work! In my location we have day shift patient ratios of up to 5:1, although this is not the ideal. Depending on acuity, you may only have 2-3 patients. These patients are sick. They have been released from the ICU, too sick to go to a regular med surg/tele floor, but no longer qualify for ICU. This is insurance-driven, so sometimes you will get a patient from the ICU who needs that level of care, but the insurance won't let them stay. So, you will get so much experience that you may not have gotten anywhere else outside of the ICU-ventilators, trachs and airways, dialysis, extensive wounds, cardiac drips, blood transfusions...you will always be learning something new. You will develop critical thinking skills and time management skills. You will work long, hard hours (it's nursing, after all ;-), but you will learn so much! And if you give it a couple of years, the time it takes any new nurse to become proficient, you will have a knowledge base that will prepare you for anything.

Best of luck in whatever you do!

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