Should this new grad turn down this job offer ?

mark1973 · Aug 26, 2009

They wouldn't offer you the job if they didn't think you could handle it.

NurseLoveJoy88, ASN, RN · Aug 26, 2009

I guess thats true ! Thanks.

bill4745, RN · Aug 26, 2009

I don't think is is a good idea for a new grad to be the only nurse in an LTC. Nothing personal against you, but based on my own experiences as (at one time) a new grad, it takes several months before you have the confidencce and judgement that you need. Do you really think you could handle a code?

rwbglock23 · Aug 26, 2009

Talk about a rock and a hard place! :banghead:

I am going to have to agree with Bill4745 on this one, if you don't have prior experience working in the field, and aren't confident that you can handle the worst possible situation and keep your cool, I would say pass on the offer.

Just think about this, you will be the ONLY professional in a building with 33 patients who could possible code at any given moment. You will be surrounded by under paid and under trained assistants who may or may not show up to work each day. Unfortunately this means more work for YOU!

Good luck with whatever you do! :up:

nicu4me · Aug 26, 2009

They offered you the job because you have the education and they probably liked you personally. Perhaps you are a confident person and have had prior experience prior to passing NCLEX? However, as the other posts are saying exactly who are you going to ask when you have to do something for the first time. I have been out for couple of years and ask anyone else, we all bounce things off of one another. Think of the meds you will passing.....you would have to literally look all of them up, or you should to really see if what you are giving is right. Depends upon how much training they are willing to give you also. PRN and occasional shifts only makes it worse, you will find that anyone learns best through repetition and that builds confidence and skill. You should be scared of what you don't know. Because nursing school can only teach you so much. Good luck, i know jobs are hard to find. Even in a hospital your license could be on the line, let alone with that number of pts and you're the only one with one........check out nursing home violation in your state, type it into google, it will come up under department of professional resources and see what LTC places are fined for. It's scary and there's just one of you!

BabyLady, BSN, RN · Aug 26, 2009

I don't think is is a good idea for a new grad to be the only nurse in an LTC. Nothing personal against you, but based on my own experiences as (at one time) a new grad, it takes several months before you have the confidencce and judgement that you need. Do you really think you could handle a code?

I agree with this.

As a new grad, every day, my job is getting more terrifying because I am realizing how much I don't know.

I'll be learning for the rest of my life, but my goal is to learn how to handle and recognize emergent situations right now.

It would scare me to death to have that many to be responsible for.

TransplantRN3 · Aug 26, 2009

I agree. As a new grad myself, it is so nice to have other nurses around that I can go to with any question! (And I have A LOT of them!!) I was lucky to get a position with a 3 month new grad orientation/training period where I got 1 on 1 training. I am nowhere near confident yet, but always have helpful and willing people around to help when I am unsure of something. I think this is the type of environment I thrive best in as a new grad, and would think most other new nurses would benefit as well :) Good luck with your decision! On a side note, I think it is always a good idea to go to a few interviews before you accept any offer. Are they willing to give you time to make your decision so you can see if you are a better fit at another facility?

NurseLoveJoy88, ASN, RN · Aug 26, 2009

I agree. Its not a great idea for a new grad to be alone with 33pts and aides. I'm still going to inquire more about the training and express my concerns. I'm still looking for jobs in the meantime. Even if I did get hired, he's only offering prn shifts and night shifts. I rather have day shift so that I can learn though. We'll see. I asked God to pick the right one and I know he'll give me a good intitiation on whether to accept a job or not.

Music in My Heart · Aug 26, 2009

I'd be reluctant to accept a PRN, night-shift, solo position as a new grad. The NOC thing is going to mean that you're even more out there on your own and the PRN is going to limit the rate at which you garner experience. I'm of the opinion that a new grad needs consistency and regular shifts in order to build clinical skills and judgment.

That said, I'd be sorely tempted given how scarce are nursing jobs.

Jubilayhee · Aug 26, 2009

Well, its better than no job, like most of the other new grads have. I'd take it.

jjjoy, LPN · Aug 26, 2009

Unfortunately, too many places will hire anyone with a license. I was hired as inexperienced nurse at a nursing home, appx 30-35 patients per nurse. They gave me just three days of clinical orientation; much of which was the precepting nurse giving me half of the meds to pass.

Certainly, those three days gave me the opportunity to practice passing meds with someone there to answer questions, but I had little to no opportunity to see how the experienced nurses organized their time, took care of things like uncooperative residents, working with aides, all the various paperwork. Day 4 on the floor, I was on my own with 30+ residents that I was responsible for. I wasn't completely alone; there were very busy nurses on the other hallways and the DON was often in house (though I rarely ever saw her anywhere but her office).

With 2 med passes on an 8 hour shift, that took at least half of the shift with a whopping 4 min/pt average to administer several meds (to wobbly slow elderly residents), eye drops, crush pills and mix with applesause or administer via G-tube. Of course, I was WAY late in getting them all out. I was glared at as another stepped in to help me finish.

Two weeks later I was much faster but still behind and being chastised about "not prioritizing" or "managing my time" well. I couldn't see how anyone could pass all those meds without cutting corners. I had glimpses of other nurses pocketing vitamins, signing off on meds ahead of administering them. But neither nurses nor administrators would allow to me observe anyone else's full med pass. I quit before a month was out.

I don't think it's impossible for a nursing home to be a good start for a new grad. It's not like a hospital preceptorship guarantees smooth sailing; they often pressure new grads to cut orientation short, have high acute care patient ratios, and even with other nurses available, they may not necessarily be very open to helping a newbie. And with the current economy, it may not be easy to get another offer soon.

As you make your decision, be aware of the potential problems: no on-site experienced RN to turn to for questions; perhaps no off-site support either; how comfortable you are or aren't dealing with an emergency when the buck stops with you; working PRN may mean inconsistent work and make it that much more difficult to built competency. Ask lots of questions: about any back-up for you, any extra support for you as new grad, policies on handling different emergencies, specific responsibilies as sole RN on duty, about continued training opportunties for you such as coming in during a different shift to have a chance to learn from others in your position, etc.

If you decide to take your chances and accept it, evaluate each day and if the role seems beyond you, be prepared to quit. There's no shame in that; not all "staff nursing" jobs are entry-level or appropriate for new grads (even though places will hire). It may be even be impossible for an experienced nurse to practice safely in that environment.