Questions to ask a new employer

[MeganMarieLPN]

I'm a new nurse. I'm currently working at an MRDD facility, have been for 8 months now. Most of the time the new orders come when our home manager is in the building and she takes care of all that ie new admits, med orders, treatments. She's always there when the doc does rounds. There was a period of time when I had to work on the nursing home side of the facility for a few hours and I learned about standing orders. But otherwise I don't think I know what I should.

Today I got hired in at a new facility that is attached to a hospital. So on top of normal nursing home residents we also have a lot of people come from the hospital with wounds. The hiring department said this facility is very fast paced and normally has 30-50 new admits a month due to the hospital. What all questions should I make sure I ask? I know to ask for the standing orders doctors have but what else do you suggest I ask for?

I feel completely lost in this area but want to learn and I'm very excited about it.

Thank you!!

[tnbutterfly - Mary, BSN]

Moved to General Nursing Discussion forum in order to generate more discussion.

[mazy]

Some things I can think of:

Length of orientation

How facility is staffed in terms of RNs, LPNs, CNAs, social services, PT, OT, etc

Typical patient load/nurse to patient ratio

CNA to patient ratio also...if the CNAs have too many patients they will be drowning and they won't be able to do their jobs either.

These numbers are indicators also of whether the facility is invested in providing high quality care or if they're just trying to maximize profits with minimal revenue output

More information about medical issues with patients, i.e. what level of complexity of wounds are you dealing with -- and is there a wound nurse/wound team that manages wound care

Also, will you be working with trach, g-tube, IV, etc. etc. issues, and what kind of support/training will you get

Is there an in-house pharmacy, how are med orders handled? Hopefully if it is affiliatd with a hospital the pharmacy will be in-house to a degree. Using an outside pharmacy makes it really hard to stay on top of patient medications.

The big concern with high admission facilities is that in a lot of facilities LPNs and RNs are responsible for doing the entire admission while working a cart and carrying a full patient load. Better facilities have a nurse, usually an RN, who comes and does the admission so that floor staff can take care of their assigned patients.

The first scenario is a nightmare, and I would head for the nearest exit; the second is pretty workable. I would also want to know how many admissions, on average, do you get per day.

So you want to ask if you are going to be doing your own admission paperwork while working a cart or if their is a staff member who comes in and handles all of that.

The same holds true for discharges.

How are supplies handled. I would ask for a tour and have them show you how supplies are ordered and distributed. You want to make sure there is a good Central Supply and that supplies are well stocked on the unit. You don't want to end up in a situation where you are trying to do patient care and at the same time running around like a lunatic looking for the supplies you need to do your job -- that can eat up precious time that should be going toward patient care.

I would also want a tour and just look at the nursing staff. Do they look at ease or do they look stressed out and unhappy.

How often do they have in-services and trainings.

I'm sure others can come up with much more.