HopefulRN7

Seems like either someone's trolling or in a major conundrum... if the latter: If you're not happy with your situation then change it. I've been a floor nurse for years and have never dealt with that you've described. Surely there's better opportunity for you out there somewhere. Genuinely hope your work situation improves.

I would venture to guess because there is not a chance they could advertise the position to outside nurses with experience in the Mgr role at the salary they can offer. It's a privately owned facility and our area is experiencing a major nursing shortage in all settings, staffing is a big problem currently among the nursing staff (another red flag that screams- do not take the Mgr role!) Thank you for the solid advice and suggestions, very much appreciated!

I've been offered a position as a Unit Manager on a LTC wing at a SNF I work part-time at. I've previously only done skilled nursing assignments, never on the LTC side and the majority of my experience has been in Pediatric Oncology. There's also a charge nurse position available on the skilled wing that I'm familiar with. My dilemma is I don't know which position to take! The UM position salary really is not up to par with the state average, however I will not be responsible for 24-hr oversight- I would only take call one weekend a month. I'm confident I would do well with the management position due to my previous experience in long-term care (non-nursing) but not sure it's worth the stress. Anyone out there with current hiring responsibilities care to chime in on whether this would be a resume booster in the future? Im interested in the position for reasons other than to further my career but would like opinions of those who have been in my shoes or can provide some insight. Thanks in advance!

eeeek! Thanks for your honest reply, it is much appreciated!!

New to Rehab nursing here, and some days (most) I find myself looking around for hidden cameras, thinking I'm being Punk'd or a subject matter on some cruel nursing reality show. I accepted a job at a LTC center on a skilled rehab unit a few months ago. With anything new, I expect there to be a learning curve, I understand that but lately my shifts and patients have been total train wrecks (acuity and needy, I'd like to ask you 528 questions and monopolize your time- oh and while I'm at it, my vitals are going down the toilet and I'll try to die on you). On my unit, I'm on the med cart for 12 LTC patients and 8-10 skilled (lots of knee and hip replacements fx and repairs, post-CABG, pacer placements, loads of CHF'ers- just to name a few off the top of my head). I work with another med "nurse" (sometimes that's a med tech) who is on the cart for the other unit on our floor as well as a Charge who ideally should do vitals for parameters, step in if a pts status changes, etc... We typically run with 4 aides (on a good day) but lately we've been average 2-3 after call-outs, scheduling errors, etc... As a med nurse, we should be solely responsible for passing meds per my facility "rules". On my shifts, because Charge is usually tied up with working as an aide when we're short-staffed/administering insulin, giving controlled meds, for med tech, I find myself transferring pts to the bathroom to avoid falls, taking vitals, fielding phone calls and questions from multiple family members visiting, calling docs with pt status changes, etc... No matter what I do on my shifts to prepare (yes, I've made a cheat sheet of how pts take their meds and even prioritized med pass based on times, type of med, etc) I continue to give 50% of meds an hour + late. I've looked back at past admin times by nurses who have been at this facility for years and they, too run into this "late time" issue on a daily basis. I have spoken to the DON about these issues and even offered solutions (like using 3 nurses on carts and splitting the units up, eliminating the "charge" position), I've talked to other nurses who have stated they've done the same however, nothing has changed nor do I have the confidence it will. This is not the type of "care" I expected to provide. Ive been a nurse for several years, but am new to this area of nursing so my glasses have lost their rose color- I don't think I'm expecting too much but this just seems ridiculous to me. Our rehospitalization rate is well above state average and now I understand why. Anyone have any suggestions? Like "run far away from this place", "hang in there it will change", "welcome to skilled nursing"?? Anything? I feel like I'm on a sinking ship- someone throw me a life buoy!

Suits?! $900?! You have to be kidding me! Are you applying for a position as a Chief Administrator or as a nurse? In my world, I wear business slacks, a sleeved blouse and a business jacket (weather dependent) and I've never been on an interview where I haven't been offered a position. It's all about selling yourself and your skills/experience, being confident in your approach, maintaining a positive attitude and a level of genuineness and not looking like you've just rolled out of bed (oh and no scrubs, please!) I work too hard for the money I make to throw it away on a suit that will sit in my closet over the years as I gain weight as a result of being a nurse at the job I landed due to my professionalism, not the $900 suit I should have never bought in the first place.

I would take it on campus. It is a difficult class to wrap your head around at first and if you have a good instructor, they will make it much easier to understand. I would suggest searching available instructors (if you have an option of choosing) on Ratemyprofessor.com where you will see reviews from previous students. I felt that Micro helped me tremendously with understanding infection control and how certain antibiotics work vs others in the nursing world as well as how to visualize the parts of a cell which will come in handy when studying Patho of diseases as a nurse or nursing student. Definitely take it on campus, even more so if you're a visual learner.

Retake them but also keep in mind that some highly competitive programs also track #of attempts and can accept another applicant over you with same GPA/one attempt. Best of luck!

That is one of the biggest concerns for me. I would also be taking a pay cut as well. I also received an offer from an ALF in NH- from what I understand we as nurses are able to do much more in this state like administer meds (not hand over hand like in other states) run diagnostic tests (UA, glucose checks, etc...) than at ALF's in other states so I would essentially be doing some of the same type of work as a LTC center but working with obviously a more independent population and a more favorable nurse to pt ratio (1:14). Any thoughts on ALF nursing?

I'm not in any way putting down LTC nurses, let me first make that clear. It's just not my cup of tea. I started out in LTC (non-nursing) and have a huge amount of respect for you guys. Here's my dilemma: I work in private duty Peds and I'm feeling pretty stagnant. I LOVE the pediatric population and know this is my niche but I need a challenge. My plan is to apply to a Children's Hospital once I transition into the RN role, however I only have home care experience and experience working at a family practice. I'm hoping the autonomy counts for something for the home care experience but my question is whether hospitals will want to see some facility experience (being able to prioritize pt care, be a part of a team, etc...) I interviewed with 3 LTC centers and received offers from all three. I am heartbroken to think of leaving my Pedis, however if it will improve my knowledge base (even though it's a different population) and look more favorable on my resume I will make the move. I feel very fortunate to have so many options and I'm not complaining by any means, just looking for guidance from anyone out there that has gone down a better path or has some good advice. Thanks in advance!

*Not preggers*, however it is possibly in my near future. Currently working in home care with a pt that receives IV chemo at clinic and oral chemo at home admin by the parents. I come in contact with oral secretions from teething but don gloves for trach suctioning (unless emergent). Would this situation be considered a hazard for a pregnant person since chemo is usually excreted through bodily fluids?

If you are looking for guidance on this forum it's best to shoot your own ideas out and ask for feedback...when you leave it open-ended without showing your effort, it seems like you're expecting others to do the work for you. Just a helpful tip...

Nothing like busting your rear and going the extra mile everyday to have families basically **** on you and act like they're owed something. Also the ones who hover as you mentioned- and plan out every minute of your day with what to work on with the patient despite your nursing judgement (ex: Please PO feed "so and so", I know they're falling asleep and vomiting through their trach but they need to learn to eat!")

This is a brilliant idea, one I wish I would have had at the time. Great investment

I worked a very similar case for almost a year so I am sensitive to your concerns, however I think you should be more concerned about your pay for working a high tech case vs how many bags you are bringing to school. Approach your agency professionally and ask them whether the state reimburses trach/vent cases at a higher rate. If they do- there is some wiggle room for them to pay the nurses more. Is this a difficult case to staff? If so- the agency should be more apt to offer a bit more per hour as well. In my state, the school districts receive the reimbursement for the hours at school and typically get a higher rate. The agency should have this info as well. Good luck to you, I hope it works out. School is fun- it breaks up the monotony of the day, you get to see your patient in a social setting and also receive help/support from Para-Educators in the classroom. Id also like to add- unless you have years of experience with trach/vent...the skills you will learn on a high tech case are invaluable especially being able to learn them on a 1:1. Don't settle for an "easier" case and close yourself off to the learning opportunity even if it seems like more work. Nursing is a lifelong learning process and it's only wise to continue to embrace it. You will be a much more valuable asset to the profession.