New LPN/Agency work

Posted

So I'm looking for a little bit of information/guidance here. I recently got my LPN license (YAY!) and I have applied to a few positions, one of which is an agency. I picked up a shift through the agency and within minutes realized I was way out of my element. The facility put me on a COVID unit and though I arrived an hour early to get adjusted to where things are and such it still wasn't enough. I am a very fast learner but with them being understaffed and my being so new to being a nurse I felt I really did a disservice to not only my patients but the facility as well. My question is: Am I just too new to Nursing to have taken on an agency position or was it just the facility that I worked at? Though I was a bit horrified to be thrown on a COVID unit without any kind of hand-off report I really loved the fast pace and the experience was still worth something.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

Any temp agency that will hire a new grad for temp facility staffing is one to run away from --- and inform all your friends to stay away.

New grads need a structured orientation + support of another nurse for at least 3 months to learn the ins and outs of nursing---all the things that were glossed over or not taught in school, developing confidence in hands on skills and communication with health team members--especially physicians. You worked so hard to earn that license.

Please find a supportive environment to grow your nursing wings.

9 hours ago, NRSKarenRN said:

Any temp agency that will hire a new grad for temp facility staffing is one to run away from --- and inform all your friends to stay away.

New grads need a structured orientation + support of another nurse for at least 3 months to learn the ins and outs of nursing---all the things that were glossed over or not taught in school, developing confidence in hands on skills and communication with health team members--especially physicians. You worked to hard to earn that license.

Please find a supportive environment to grow your nursing wings.

. . . and new or not, it’s your license being put at risk. Being a new nurse with a different group of people all the time is hard enough; adding Covid to that makes it that much more difficult. Unscrupulous companies take advantage of new nurses by offering the most pay but inadequate training and supervision. The onus is on you when care falls below the standards of nursing practice because you sign on-boarding paperwork affirming that you are competent, and you take an oath to practice safely. Also, we are supposed to call Safe Harbor if we feel we are being pushed into an assignment that is not safe. That’s how the companies gets away with it.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

3 hours ago, Queen Tiye said:

Also, we are supposed to call Safe Harbor if we feel we are being pushed into an assignment that is not safe. That’s how the companies gets away with it.

Only Texas has Safe Harbor regulation.

JadedCPN, BSN, RN

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 15 years experience.

1 hour ago, NRSKarenRN said:

Only Texas has Safe Harbor regulation.

I believe New Mexico added a Safe Harbor law last year too. But yea, that option is not available in almost all states.

I didn’t know that. I thought all nurses had the right to invoke Safe Harbor.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

3 hours ago, JadedCPN said:

I believe New Mexico added a Safe Harbor law last year too. But yea, that option is not available in almost all states.

Thanks for NM info... your correct, found

New Mexico’s Expanded Employment Protections: The Safe Harbor for Nurses Act

https://ogletree.com/insights/new-mexicos-expanded-employment-protections-the-safe-harbor-for-nurses-act/

Remainder 48 states without Safe Harbor protecction

Been there,done that, ASN, RN

Has 33 years experience.

That assignment was unsafe for your license, the patients and "probably" the facility. Facility most likely knows what is going on with the agency.

Consider reporting the agency and the facility. In the future, NEVER accept an assignment without a hand off.

LadybugNurse1, LVN

Specializes in Hospice Nursing. Has 9 years experience.

I'm an agency nurse as well. NEVER AND I MEAN EVER ACCEPT RESPONSIBILITY FOR A PATIENT FOR WHOM YOU HAVE NOT BEEN GIVEN A REPORT. When I am given an assignment,  I'm only given the reason crisis care has been initiated. I know nothing else about him/her. Most of my patients are in the home as well, though some are residents in a facility.  When I am relieving a nurse after his/her shift, I get report from him/her.  However,  if I am the nurse starting a case (which is often late at night), these hospice nurses think that giving me report isn't necessary or required. WRONG! It blows my mind that this goes on! 🤯🤯🤯🤯 If you aren't given report, how can you possibly provide appropriate care tailored to that patient's unique needs? If something goes wrong,  you will be the one to answer for it, and "I didn't know about it" will not protect you from Board discipline or professional liability.  Any time I am starting a case,  I refuse to take that patient until I speak to the hospice nurse who initiated crisis care and get report. If get no report, I don't even leave my house. My agency once told me that once I tell them I'll go to an assignment,  they see it as me accepting/taking responsibility  for that patient.  I educated them on the risk that poses to my license and that upon arrival at the patient's home, I may find that there are details about the patient or situation that makes that assignment unsafe for me and/or the patient that I wasn't privy to prior to my arrival and getting report either from the offgoing nurse or initiating hospice nurse, ergo I do not accept that patient into my care until I have received report. Period. Does it sometimes p*** people off? Yes. I've had hospice company nurses get irritated and ask me why I'd need report 😳🤯🤦‍♀️ I ask them why WOULDN'T I need report just because the patient isn't  in a hospital setting. The requirements for accepting that patient is exactly the same. In the hospital or other nursing facility,  a nurse doesn't even enter the patient's room before  they get report from the offgoing nurse.  They may not like me insisting on it, but they give me that report. Another time, the hospice nurse wasn't answering her phone or responding to my text requests for report and that I can't leave to go to the assignment until I get it. I informed my agency I was ready to go as soon as the hospice company nurse calls me back to give me report  and I included screenshots of my texts to the hospice nurse.  They got upset and replied they'd just get someone else to go. I was like well alrighty then 👍 I don't care who gets mad about it. I'd rather lose my job or assignment than lose my license.  I could report these nurses to the Board because not giving adequate report to the oncoming nurse is a violation of the NPA.