Soon-to-be graduate

[cracklingkraken, ASN, RN]

For those of you who I have not yet crossed paths with, I am currently enrolled in an ASN program and set to graduate in May. I currently reside in IN, but my plan is to apply to nurse residency programs and relocate outside of the Midwest (if you have lived here all of your life, you can understand my desperation to leave).

Other than working 7 months as a HHA, I am very unfamiliar with the healthcare profession. Obviously, I have my clinical experiences, but I do have a few questions for anyone who might know the answers.

1. What are red flags to be aware of?

Such as, a $10,000 bonus or offering a job immediately.

2. How do I make myself a more competitive candidate?

Since I am an ASN grad, it limited my choices of residency programs. Also, several of the programs I am looking in to prefer BSN grads over ASN grads. I am not a social butterfly, and I am not particularly good at "putting myself out there", so to speak.

3. Is it appropriate to ask how long the nurse who has worked there the longest has been at the facility? And, along the same lines, how many experienced nurses v. how many newer nurses with 1-2 years of experience work on the floor?

4. Since many of these programs require contracts to work 1-2 years upon completing the program, what are some things to be cautious of when going through the contract?

I appreciate any and all advice you guys could give me. I am really excited to graduate and hope to land a job at an awesome facility.

[Here.I.Stand, BSN, RN]

I'd highlight what your program taught you about EBP (some seem to believe the misconception that ASN programs don't teach it), and consider doing some independant study on nursing theory (which BSN programs do spend more time on.)

Things I always ask in interviews: (and yes, this may limit possibilities, but you need to expose those red flags)

1) Under what circumstances do you mandate OT? Good answer: only in natural disasters or mass casualties. Bad answer: when we can't find enough staff to fill holes.

2) What are your typical nurse-to-pt ratios? Good answer: floor: 4-5 on days or 5-7 on nocs; stepdown: 3; ICU: 1-2. Bad answer: 8-10 on the floor, 4-5 on stepdown, 3+ on ICU.

3) What have you done to increase pt satisfaction: Good answer: Staff more RNs. Add more CNAs to help with call lights and drink fetching. Show pts how they can contact the kitchen directly, rather than complain to the RN about food. Good answer #2: We show good old fashioned courtesy and compassion, but too much focus on satisfaction impedes best clinical practices. Bad answer: We strictly enforce RN-only hourly rounding (as opposed to making it a team effort with CNAs, RRTs, and rehab staff if they happen to be in the room). We give the RNs scripts, e.g. "I have the time." We write up the RN for every single pt complaint. Our RNs bake fresh cookies for the waiting room (no joke--I saw something about that here on AN. Hospital stocked frozen cookie dough, told the RNs to bake them.)

I think your question about experienced RNs is an excellent one. I might even borrow that one next time I interview!

[cracklingkraken, ASN, RN]

Thanks, Here.I.Stand! I would have never thought to ask 1 or 3. I have heard from others not to ask about nurse to pt ratio because it makes it about you, but I think it's just as important for a facility to sell itself to you as it is for you to sell yourself.

I've just noticed that filling floors with more new grads than experienced ones is becoming a pattern, so I want to make sure that my supervisor won't be someone who knows barely more than I do when I need guidance.