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New PDN...which case to choose

Private Duty   (3,860 Views 23 Comments)
by xyra_01 xyra_01 (New) New

559 Profile Views; 7 Posts

Hi everyone. I'm a long time lurker who is finally a member. A little background info. I've been an LPN for 2 years now in a long term care/rehab facility and have had both long term residents and rehab patients. I've been exposed to and feel comfortable with g - tubes, wound vacs, and trachs. I needed a change and a flexible schedule since I'm going back to school for my RN. I've been offered a position by two different agencies.

Agency #1 is 3 days a week and every other weekend (I need the hours) on 2nd shift. Opportunities to pick up shifts available. Benefits included after the probationary period (which I need). The patient is a quadriplegic adult with a trach, vent, g-tube, ostomy, and foley. I have no vent experience. Training is a few days with another nurse with the option of a vent class at a later date. I was hired on the spot. Pay decent with a dollar raise after probationary period.

Agency #2 is 3-4 days a week depending on parent needs on 3rd shift. This is a child (I have no peds experience). Patient has a g-tube and seizures. Agency has you go through classes before they move you up a level with cases. No benefits unless schedule is 36hrs a week and mine won't be. Unsure of opportunities for extra shifts. I had a face to face interview with HR then phone interview with clinical director the same day. Was hired a few days later. Pay is about the same (before agency #1 raise).

So who do I go with? I need the hours and benefits, but I want to feel like I have support if I need it. I will say I'm leaning towards agency #2. I just don't know about the hours and benefits, but I don't want to jeopardize my license. I guess I'm just looking for validation.

Thanks to anyone who read my novel:)

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brattygrl has 15 years experience and specializes in Peds critical care.

51 Posts; 2,652 Profile Views

If they're willing to train you on the vent, then it sounds like that case is more of what you need.

Can you pick that one full time and the other one per diem?

Just wondering. Some peds parents can be difficult.

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3 Followers; 36,918 Posts; 97,861 Profile Views

Go with both agencies. Make the better situation your primary agency and limit your hours with the second agency. Best to have feet in both doors for that time when one or both cases don't work out. Good luck.

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nursel56 has 25+ years experience and specializes in Peds/outpatient FP,derm,allergy/private duty.

1 Follower; 6,655 Posts; 43,543 Profile Views

I think the first thing to evaluate is the overall "feel" of the agency. Are they easy to communicate with, do they thoroughly answer all of your questions, do they seem genuinely concerned about their cases vs staffing those cases? Are they encouraging and pro-active about giving you the help you need?

That is all very important because once you are hired by an agency, the hours, shifts and cases you get are up in the air and there is generally no obligation on their part to give you what they said they would before they hired you. Some of them are downright unscrupulous enough to "bait and switch".

When they staff a case it is generally a two-way street in that the family or patient has to choose you as well. Sometimes they say they don't want a nurse for the flimsiest reasons!

I got very lucky when I started PDN as the person who hired me let me pester him to death with all my questions and said to me "just go out and meet the patient" and see how it goes. From this I learned that meeting the patient and a thorough orientation are absolute musts. Sometimes you can tell the minute you walk in the door whether you want to be there or not.

If you feel satisfied that the agency is one you want to work for, and I had a choice I personally would want to take the vent patient. I have found that this is a highly valued skill and there is so much to learn.

This is just my personality and experience and two cents. I know everyone is different, though. Welcome to PDN! :-)

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7 Posts; 559 Profile Views

Thank you all for the responses. I have actually thought about working both agencies and making one case my primary. I'm just so conflicted because even though there are positives with agency #1, I still feel a little uneasy. Some of the office staff seemed supportive and others seemed iffy. And new employee orientation was only an hour. Agency #2 seemed overall supportive and their new employee orientation will be 8hrs. I'm planning on going to it so I can make a final decision.

I'm really looking forward to working private duty either way. This seems like an ideal environment for me.

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3 Followers; 36,918 Posts; 97,861 Profile Views

Don't look for perfection from the agency office staff. More often than not, you will be dealing with less than the ideal. Learn to overlook the negatives as long as you are working on at least one case with said agency. If you hold out for good vibes from your agencies, you will never be working.

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7 Posts; 559 Profile Views

caliotter3, that is true. Even though I'm looking forward to PDN, it's a whole new world for me. I'm actually grateful to be in this kind of dilemma with the job market the way it is. I'll keep everything in mind.

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SDALPN specializes in Peds(PICU, NICU float), PDN, ICU.

997 Posts; 16,260 Profile Views

What most agencies won't tell you is that benefits require your arm, your first born child, and your soul. And that's if you get lucky enough to get a benefited position as they usually"only have a few spots". They also promise hours that don't always exist. If the family doesn't like your hair color, car you drive, or the sky being blue that day, you are gone. So multiple cases are better. If a pt goes in the hospital, you are out of work unless you can fill in at other places. You sound ready with your experience. But these agencies like to paint a picture that isn't reality.

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3 Followers; 36,918 Posts; 97,861 Profile Views

Really perplexing? Look at the periodic ads on the job websites. The agencies will advertise away. But when you call the staffing coordinator or go in person to remind them that you need work and you saw the ad, you get told that "they don't have work" or "they don't have work for you". Just have to be realistic in dealing with these employers. One good reason for being signed on with two or more agencies at the same time.

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229 Posts; 5,169 Profile Views

Agency health benefits are usually expensive and/or terrible.

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389 Posts; 7,141 Profile Views

Go with both. I learned the hard way not to put all my eggs in one basket. No matter how tempting it is at times because I get asked by the agencies that pay me more to take more days with the same patient. Like it has been said already, that patient goes to hospital, you don't work, you don't get paid. The family decides they don't like the way you blink your eyes, you lose the case, you don't get paid. If that was your ONLY case.... I am signed with 5 agencies. Two I work steady with and the others I work per diem when I can. I love it that way. Also, family goes away for vaca, you don't get paid. You get the point.

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7 Posts; 559 Profile Views

I'm going to work for both agencies but it's still up in the air for who I want to be my primary case. I have 2 more days of training with agency #1 and then orientation for agency #2. I just don't feel comfortable with the vent yet. I also received a call from another home care agency and plan on checking them out. Might do all 3 if it works out.

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