RATMLPN

Seeking some input, hope this is an OK place for this. I am an LPN with 10 years of experience including LTC/SNF, home health, inpatient hospice, corrections, and acute detox (inpatient). I also have 1 year of med/surg, and 2+ years of cardiac stepdown/tele (where I am now). I graduate in May with my ADN. I have a job in the ICU (literally the unit next to where I am now, where we often transfer patients to or from, depending on what's happening) available to me in July. I can also stay in the unit I am in now. The caveat? An $8-9/hr pay cut. They're trying to start me at a new grad RN rate, despite my experience in their own hospital. Roughly $14,000/year loss. It would take me 6 years to get back to my current pay rate. To be clear, there is very little difference between what the RNs can do, and what I can do on the unit I am on. My only limitations are no amio for SVT (which I've only seen once on our unit, and transiently) and the first 15 minutes of a blood transfusion (which I'm present and monitoring regardless). I take the same assignments, the same patients, the same admission diagnoses, etc. I will not be required to go through any novice nurse program after I pass my boards and accept a job (unless I move to the ICU, which all new hires to the unit have to go through for a critical care role). My end goal is medflight or CRNA. My question is this. Do I take the pay cut, pad my resume, and travel with my experience (and lose benefits, staff I know and who know me). Do I stay and go per diem and take a part time job in another nearby hospital at a higher rate (commute would be a minimum of 30 minutes, up to an hour and ten). Do I go full time with commuting and benefits? I need 2 years of critical care for CRNA. I need at least one for medalist. I'm in Massachusetts. I'll be going from SEIU to MNA. Any thoughts or advice would be appreciated.

I'm just beginning my studies pretty much, I'm an LPN now on the way to my RN. Is there any advice that you would give a nurse at the beginning of her career to keep in my mind during my studies? Useful electives, courses to really focus on, etc? I've been interested in this since I became an LPN. Thank you!

Hey ShaneTeam, Thanks for your thoughtful response. I understand my facility may be JUST on the cusp of legality & acting with the bare minimum of staff (which is not ok so far as I am concerned for patient & staff safety) but I am not willing to sit by while my coworkers are putting their careers at risk, and we have ever more increasing reportable incidents. I would never want an administrative job for just about all of the reasons you listed. That and scheduling. But unless our DON/ADON is willing to advocate for their team (which worked almost seamlessly before) Im not willing to go to bat or pick up shifts when you blatantly ignore the virtual shouts of help from your staff. I didn't meet the DON until almost 2 months into her tenure here, which I found somewhat appalling as a leader. We're going to be meeting with a couple of different union reps this week, and look into some legal angles, including meeting with a state legislator that my administrator made the mistake of mentioning by name. Good leaders are hard to come by, and if we had management that at least treated our staff like theyre actual people, I would have zero problems picking up. But until we see meaningful change, 90% of us have applications out, and Ive been on several interviews. I really do appreciate your response, and I live on Cape Cod lol.

It would tickle me in ways too obscene to say. I WISH I could have that kind of "opportunity for education" (Im sure that's how they would phrase it lol).

The change in management happened in October 2014 & it has gotten steadily worse since. Their policy HAD been to pay T1/2 for any mandated shift. It happened to me just a couple weeks ago. Now they're fighting it and they have not issued any new or updated policies that say otherwise. I was poring through the employee handbook I had signed when I was hired & they leave out any policy mention of mandated pay.

So, I am not a union employee, nor does my workplace have one. Ive never been gung-ho about unions, I guess I live in Imaginationland where my employer recognizes my value & work ethic & pays accordingly. The U word has been bandied about recently, however. I am hourly, I work a FT 32 hr week, which I did intentionally, leaving me some room to pick up if I so chose without completely screwing my week. Just a couple weeks ago, same situation, they did mandate me, and I was paid T1/2. Not sure what's different now, except now they wwant to "save money" (come to find out, the Chairman/CEO of the company decided to expand to NY, and the company has made a $246 million investment in Manhattan. Gonna build "luxury senior living", and I found out the CEO is a real estate investor with no healthcare background. Anyway, I spoke with my DON who said I was not obligated to stay because there was that second nurse there, and she was apparently expected to take both carts and all the patients. Insane. She would have refused the cart, and she would have been within her right to do so (I would have done the same). Leaving me with the option to abandon my patients, or stay... not much of an option. I looked into our policies and have filed a workplace grievance, and it was apparently their first, as they had no idea how to go about it. They have, according to their own policy, until the end of the business day on Monday to give me a written response, so we'll see how it goes. I am currently looking for other work, but I have less than a year experience as an LPN, so its slim pickins, and the places that I KNOW I could get a job at are places I would never want to be, that are worse than the place I am at now. Those are the examples my current DON (my third one now) is using as examples when she says, "That's how other places run their facility." Oi.

So I am an LPN & I work at a SNF in MA. Recently company ownership went from 1 man, 1 company to corporate (multiple states, multiple sites). VERY recently we were told "no more overtime". Not the first time Ive heard it, whatever. But not very long ago, I was mandated to stay until a nurse could come in and take the assignment I was on. Because there was no supervisor there to literally say, "Im mandating you", they're now telling me I wasn't staying, I chose to stay... despite the fact that I HAVE been mandated for this same reason before (again, not very long ago) & despite the fact that it was because of their staffing cuts that there was no supervisor on at the time (7AM). I have pointed out to them that had I left that would have been patient abandonment, and they acquiesced to that fact, but are continuing to say it was my choice to stay. I took it to my DON, she denied me the time & a half mandated pay that we have been getting for years when mandated, I then took it to the administrator, who also denied me. I then took it to a senior executive who is now fighting me on it, and today avoided a scheduled meeting (Ill give him the benefit of the doubt, he texted his secretary and said his wife was in the ER). This is the first incidence of them refusing to pay for mandated time. They are now telling me that there was another nurse on the floor... there was. We have a 32 bed unit on the unit I was on, each nurse has 16 patients. They are saying that because one of the scheduled nurses was there, she should have taken both carts and taken on all 2 patients. The unit is a rehab unit (post op, usually, hips/knees, some respiratory) and we have been seeing patients come in that have more & more acute conditions since they took over as well, increasing the workload on every nurse. I told the DON that having one nurse on the unit (with no supervisor, no other staff) was unacceptable and her response was, "Its how many other facilities run. Its perfectly acceptable." Im COMPLETELY bewildered, angry, frustrated... and soon we will be taking over some administrative duties as well as taking the floor and I doubt very much our paychecks will reflect the increase in responsibilities. I have filed what I think is their very first "workplace grievance". What else can I do about such conditions? Rarely does a day go by without a nurse doing a double or getting mandated and the aides are constantly doing doubles. Ive stopped picking up shifts completely since now they refuse to offer time & a half for picking up. Now they're offering "gift cards".