Published Sep 3, 2011
RexRN
13 Posts
I have the opportunity to work at an LTAC hospital called Select Specialty. Has anyone ever worked there? Or any LTAC for that matter? Would you recommend it? I also have the possibility of transferring to a new department at my current place of work. I have been there for four years. Trying to decide if I should stay loyal to my current employer or just go work for the highest payer? Any advise is appreciated.
STL2008, RN
285 Posts
My classmate works for them. Last I talked to her she loves it. By the way are u talking about the one in st joes in st charles.
Neither one. There's one in Springfield that I was referring to. Looks like a nice place. The biggest worry I have is the paper charting.
rnsupreme
2 Posts
i work for them now and i do not recommend anyone work for them. there are many things about Select that i do not like. They are a for profit company, which is fine, however, they do not put patient care, safety or quality first. In addition, they do not value their employees, especially nurses. Select has a very high nurse turnover, especially the Chief Nursing Officer role. They recently mandated that nurse aides are not allowed to take blood sugars and that the nurse must take the first set of vital signs. This is all well and good, however, when you consider that you will normally have 5 very sick patients to care for, and that most Selects have paper charting and use the cheap medication dispense systems, it is impossible for a nurse to safely do their initial assessment at the start of the shift, pass meds, take vital signs, and take off orders, plan for the day, and all the other things that a nurse is responsible for, especially during that crucial first few hours of the day. The nursing leadership of Select is very far removed from actual practice. Most of them have not practiced as a nurse in some time, and many have never worked in a Select hospital. The corporate leadership is extremely profit driven. I have been on many corporate calls, with the very top executives in the company, and they spend a few minutes at most talking about safety and quality, yet they will spend hours and hours talking about marketing, expense control, and improving their profit. Also, when you work for Select, you will work for a company that actually denies care to patients if they do not think they can make a nice profit off of them. The CEO's of the hospital are actually trained and encouraged to cost out patients and if they can not make a benchmark of $7000 or so on a patient, then they will deny the patient admission into the hospital. This is called cherry picking of patients and Select actually does this. I work for them and i know. Worst part about Select is that they make a ton of money and they horde it at the top. They tell their employees that they expect the best from them each and every day yet their salaries are based on the midpoint in the area. In other words they intentionally limit what they pay their employees to the average of the market they are in but they demand their employees work at 100% each and every day. This is actual wording I have heard from the leadership of this corporation. I am not making this up. I am telling you what i have actually experienced from this company. This is all factual. I do not recommend anyone work for this company. Select needs a change in its top leadership or at least a change in its focus. Select is not driven by quality and patient care. The New York Times article that was critical of the company a year or so ago was very true for the most part. Select is a great company when it comes to making a profit, but lacks when it comes to patient care and employee satisfaction. Before you work for a Select, please find a few people that actually work for the company and ask them about the things that I have said. I am certain they will validate what i have said. Good luck.
another thing you should know as a nurse who might work for select. you will be expected to take admissions at any time of the day and night and no matter what your current staffing situation is and what your current patient load is. Select is extremely focused on accepting admissions 24-7 no matter what. do not expect to get additional support. i.e. if everyone on the floor has five patients, which is a heavy load considering the type of patient cared for in their hospitals, and a patient is ready to be admitted, then somone will be taking a sixth patient. if you refuse to take an admit, you will be in trouble. the people from select corporate office will find out about it and their will be conference calls with the CEO and CNO of that hospital. They call this an internal barrier to admission and they take this seriosuly. They do not accept that it may be dangerous or unsafe for both the patient and the nurse. they look at it as a lost day of revenue. The very top leadership of the corporation knows the census of each hospital and if one patient is denied admission, she will find out about it and will have a call with that hospital. The CEO and CNO will be put under pressure to deal with that nurse and weather or not they agree with you, they will protect their jobs and fire you before they tell corporate office that it was the right thing to do. if you interview for a job with select, ask them about taking admissions and how they handle situations where nursing staff do not feel safe taking another admission. the reply you get will include something about acuity staffing and shifting work loads, but at the end of the day, you will be expected to take an admission no matter what. the same holds true if one of your five patients gets very sick. your other patients will be handed off to another nurse, who probably already has 4 or five patients anyway because the CNO is put under so much pressure to control nursing hours, and someone will still be expected to take on admissions. to prove this, when interviewing, ask the CNO if they are allowed to have additional staff working if they are expecting to have several admissions. The answer is no! Select striclty forbids its CNO from allwoing additional staff to be on the scheduel and working in anticipation of admissions. This means that is you have 25 patients and 5 nurse sworking, each nurse will have five patients. But if three admissions come in and you cant find an additional nurse to pick up during that shfit, then three nurses will have 6 patients, no matter how sick they are. Select may tell you that they do not allow staff to have a total acuity load of more then 10, howver, they do not tell you that this is not an absolute, This is a general guideline. In other words, they will expect you to take on such a work load no matter how hard it is. All you have to do to validate this is ask the CNO these questions. If he or she tells you otherwise, then I encourage you to take very good notes of what they say and hold them to those words becuase when you work for Select, you will find that what I am telling you is the truth. Then you will have to go to that CNO and get an explanation as to why they misinformed you. My last bit of advise.....DO NOT WORK FOR SELECT.
In what capacity did you work for the? How long & where? I work in a acute care not for profit hospital - even in a not for profit organization it still comes down to $. Where I work I have anywhere from 6-8 pts ranging from 28 days to 102yrs old on med/surg. At select I'll be getting 1.5 times what I make currently. Is it possible you are wrong about them?
jammin246RN
94 Posts
I worked for Select in the St Louis region quite a few times through agency. They were one of my choices in areas to work. The staff treated each other well, the workload wasn't too difficult, and if you prioritized, it wasn't that difficult to get everything done on time. But this was a couple years ago too.
weargoodshoes
3 Posts
It is Select's goal to hire enough nurses in order to do away with agency nurses, but the high turnover won't allow it. Day shift typically has four patients, nights five. Both shifts are busy, and the time will go fast. For me personally after working my three in a row, it will take a day and one-half to recover physically. If you work nights, you will learn how to draw blood for labs, because that is one of the tasks that falls on the midnight staff. I admit that I am a new nurse, but I have seen experienced ones hustling to get it all done!
lm1991
1 Post
Agree with rnsupreme 10 yrs as a nurse @select sounds very much like my experience. In over 30 yrs of nursing i have never worked so hard or been so frustrated. Good nursing experience because pts are sick & complex. Charting is insane 8 page assessment sheet. On days nurses expected to assess all pts give meds and chart on all 4-5 pts Impossible top managers could not care for 1 pt let alone an assignment. Glad to be gone, have many good friends who left on bad terms.dont recommend select there r other places for good nurses to practice. To bad for pts who
How long were you with Select, Im 1991? I hope all is well after leaving.
zigler
I work at a Select Specialty Hospital in Texas and really enjoy it. We are transitioning to computer charting, that will help with it being so labor intensive. Education is important at Select, they offer more than any other job I have been at. There are clinical ladders they offer.The ratios are traditionally 4 and 5 to 1 unless you are working in the icu area. We have alot of nurses wanting to come work with us due to our ratios. Our host hospital has increased their ratio to 7 and 8 to one...ouch!
doro8144
27 Posts
I have worked for Select since 2004. I will tell you what I do not like about it. The paper charting is ridiculous. It is 8 pages, alot of duplicate charting and if a lawsuit were to happen, a nurse could easily hang her/himself with the charting. It is NOT charting by exception. The patients are extremely complex, think of 5 stable ICU patients. Families are allowed to run the show. Somehow, and sometimes, they are allowed to room-in with patients which can make patient care extremely stressful and difficult. We get a lot of hillbilly families at my Select and their ignorance of basic anatomy and health is comical. We get patients with complex wounds, and even though we have a wound team, they cannot get to all of them every day. Therefore the floor nurse is ultimately responsible for all wound care. Nurses draw their own labs. Most of the patients have central lines, so if they are working, this isnt so bad. However, we do not have our own lab. Blood must be couriered out to another hospital to be resulted. This can be time consuming. Because the patients are complex, med passes are a nightmare (even with only 5 patients) . Some days are spent almost exclusively passing meds. These patienst will literally have 10-12 pages of meds. NO KIDDING. No wonder they are so sick. I also don't like that the doctors won't be honest and real with the families and tell them that their loved ones WILL NOT GET BETTER. The patients are kept as long as their insurance or medicare will pay, then they are shipped to another hospital (even though their status has not changed, the docs will make up a reason) then shipped back to Select to start the cycle again until all of their Medicare days are GONE. GONE. Most of the patients will be shipped from hospital to hospital, then finally to a nursing home, where they will die a few days or weeks later. I think the families are not told they have a choice.
What I do like about it. I like my coworkers and management a lot. We are like a family and truly care about each other. We have a great team and I never feel alone. They are terrific in a code or Rapid Response situation. The physicians were great (except for what I said above) and treat the nurses with respect. I made good money and rarely had to work weekends. We had a well staffed, and well-paid weekend option program.
I only work there part-time now. I got burned out. Reading stories from other nurses about their hospitals makes me think that all places have their problems. It is just a matter of what you find you can tolerate, and having good coworkers and leadership can make anything tolerable.