Special Needs Facility Job With 20 Patients

[Elven_RN, ASN, RN]

So after graduating this May, and getting registered in July, I finally had my first real interview this afternoon. I think it went well and it's likely I will be offered a job. It's at a large special needs facility. I would have about 6 weeks of training and then work 3 12 hour overnights and have 20 patients with complex medical needs. My assistance would be a nursing intern and an LPN who would come 2 hours before my shift ends. There would be no physicians around. Nursing supervisors would be on the premises, but not in the building where I would be. It sounds like A LOT for someone with very little experience to take on. I found out through someone else who knows an RN there that it really isn't a lot, that you don't actually have to do that much, but I still am unsure of what to do. I value my nursing license!! If I could get some advice, I would appreciate it so much!

[Kitiger, RN]

What is a nursing intern?

I would spend my off-time during orientation reading up on every diagnosis, and reviewing every med that I would be responsible for giving.

But there is this: Is the 6 weeks orientation in writing? Are you willing to walk away if they tell you - after a week's training - that you're so wonderful that you don't need any more orientation?

[Daisy4RN]

I think it would depend on the acuity of the patients and what your responsibilities (paper work, care etc) would entail.

On 10/24/2019 at 4:27 PM, Elven_RN said:

I found out through someone else who knows an RN there that it really isn't a lot, that you don't actually have to do that much, but I still am unsure of what to do. I value my nursing license!!

This doesn't really tell you anything. "Not having to do that much" means different things to different people, pt's with "complex medical needs" does not sound like "not that much to do". Being new is harder than someone with experience. And if you are the nurse "in charge" all the responsibility falls on you and just how available will the sup be? I would consider taking the job (if offered) and ask many questions during orientation and see just how "complex" these pts are and if you think you can handle it as a new grad. You can always bow out during orientation if it looks like too much.

Congrats on your new license and good luck with the job hunting!!

[Elven_RN, ASN, RN]

On 10/28/2019 at 10:10 AM, Kitiger said:

What is a nursing intern?

I would spend my off-time during orientation reading up on every diagnosis, and reviewing every med that I would be responsible for giving.

But there is this: Is the 6 weeks orientation in writing? Are you willing to walk away if they tell you - after a week's training - that you're so wonderful that you don't need any more orientation?

A nursing intern is a nursing student or graduate who didn't pass their boards yet.

I found out the orientation is more like 3-4 weeks. I accepted the offer and went to the office to fill out the necessary paperwork. I asked more about how long the orientation is and the answer was something like what they determine is necessary. What are your thoughts on this?

[GeminiNurse29]

Depends on acuity. Like are the patients ambulatory? Long term and stable? Tube feeds or no? What kind of meds? Aggression? And who’s training you? What about if you need orders or have to send someone out? Ask lots and lots of questions.

[mmc51264, BSN, MSN, RN]

Quote

A nursing intern is a nursing student or graduate who didn't pass their boards yet.

That's called an aide. I hope they at least have their Nurse assistant certification. If not, they are working outside of their scope.

[Nunya, BSN]

So first you think the orientation is 6 weeks, then 3-4, THEN "what they determine is necessary". Yeah, I'd say run far and run fast but looks like you've already accepted. Please keep us updated as to how long it really is and how the job is going....Good Luck!

[Elven_RN, ASN, RN]

3 hours ago, mmc51264 said:

That's called an aide. I hope they at least have their Nurse assistant certification. If not, they are working outside of their scope.

Well in this instance, they do more than a typical aid - they have to have a year of experience with the disability population and they have to OPWDD medication administration certified.

4 hours ago, GeminiNurse29 said:

Depends on acuity. Like are the patients ambulatory? Long term and stable? Tube feeds or no? What kind of meds? Aggression? And who’s training you? What about if you need orders or have to send someone out? Ask lots and lots of questions.

I believe there are tube feeds, trachs, one patient on a "breathing machine" (not an actual ventilator, but close). They are long-term and should be pretty stable; if they are in need of medical care, they get sent out I was told.

[Nunya, BSN]

15 hours ago, Elven_RN said:

Well in this instance, they do more than a typical aid - they have to have a year of experience with the disability population and they have to OPWDD medication administration certified.

I believe there are tube feeds, trachs, one patient on a "breathing machine" (not an actual ventilator, but close). They are long-term and should be pretty stable; if they are in need of medical care, they get sent out I was told.

So...what happens if two trachs come out at the same time? Or one trach and then the patient with the breathing machine starts having problems? Are the aides competent to handle both of these? Having one year experience and being so to pass meds doesn't mean they can do this.

[TriciaJ, RN]

On 11/4/2019 at 7:28 PM, Elven_RN said:

A nursing intern is a nursing student or graduate who didn't pass their boards yet.

I found out the orientation is more like 3-4 weeks. I accepted the offer and went to the office to fill out the necessary paperwork. I asked more about how long the orientation is and the answer was something like what they determine is necessary. What are your thoughts on this?

My thoughts are that you are going to be thrown in at the deep end. I predict everyone will be wonderful and caring on your first day. About 2-3 days in, someone will regretfully tell you a preceptor just isn't available, so you'll just have to wing it. But no matter! The supervisor will be instantly available if you need her! Except she won't.

Colour me jaded and cynical, but I've been around this block a few times. This whole thing smells like they're desperate for a warm body and have no real plans to provide you with an orientation.