Stay as a School Nurse or take job on Vent Unit

[lpncrest]

I figured this would be the most appropriate forum to ask this question. Since I am really starting over again.

I have been an LPN for 5 years and for all of those 5 years have been working pretty much full-time in a year round school nurse role. I am burned out at this job for multiple reasons I won't get into here. I felt as if I couldn't work anywhere else due to being "stuck here at the school". I could continue to work at this job if I wanted to.

So I applied to the local skilled nursing home down the street from where I live thinking they are not going to call me back due to lack of experience... they did and I got offered a job for 32 hours.

Background about facility: It is family owned and I even met the CEO and everyone is very welcoming and supportive. It is one of the nicest facilities in the area. I would be trained for about 3-4 weeks.

Background about the unit: It is a 35 bed vent unit with patients with ALS, MS, and any patient that is on a trach or needs respiratory care. Most patients are in wheelchairs and utilize G-tubes. Most patients are alert and oriented and and can communicate with or without an assistive device. Census is high on the unit. It is an Extended care/stay unit.

Nursing responsibilities: Besides being responsible for the obvious daily nursing care of the patient I will have to suction and trouble shoot the vents PRN and monitor the feeding pumps. Every time a patient is transferred with the CNAs I have to be in the room if they are on the vent. The unit is purposely over staffed to deal with the acuity. I would have 6-7 patients on the 3-11 shift. Repository Therapy sees the patients daily and is on call if needed.

Some facts about me:

-Pharmacy Technician at a large medical center before I Became a Nurse.

-No Nurse's Aide experience at all except when I was in Nursing school.

-I have never worked long term care or sub-acute, haven't set foot in a unit like this since I was a nursing student

- I am anxious about switching to this new position. I would be taking a pay cut but with a good budget I think I will be fine.

-I am on the fence about this job because I could just take the easy way out and stay at my current job. However, the amount of skills I would learn would be amazing and make me a stronger more employable nurse. I want the challenge. However I am so afraid to start this job.

-My nursing friends say stay where I am at now and keep the higher pay rate.

-My other nursing friends who are more encouraging say places train people for a reason.

-Biggest fear is my lack of experience as CNA and long term care and the specialty switch.

-My respiratory therapist friend says vents are not a big deal once you learn them so do other nurses I know who have dealt with them. I consider vents a big deal because well they are helping the patient breath.

Questions:

I know I can only answer yes or not to the job.

Is the patient to nurse ratio good?

Training Period adequate and long enough?

Have any of you made the jump from a desk job at a school to an actual nursing unit?

Even if you a new grad and got that first job at say the ICU or sub acute how did you cope with the anxiety of starting a new job? I mediate and pray personally.

Finally (sorry for the long winded). With my lack of experience in this nursing speciality would you take this job if it was offered to you?

[LadyFree28, BSN, LPN, RN]

What is the length of the orientation?

Honestly, people make a big deal out of vents; but once you understand how to assess the pt and the machine and the settings specific to the pt, and are comfortable with vents, you will be fine.

You could do some self-studying about vents-types of pressures, pts who need vents, as well as nursing care of vents to have some idea of what to expect.

I have been working with vent-dependent pts in all of my 10 years as a nurse, mainly in the Pediatric population.

[lpncrest]

Orientation is 3-4 weeks and this doesn't include the generic 1-3 day training all employees get when hired.

[LadyFree28, BSN, LPN, RN]

I will try to answer your questions:

Questions:

I know I can only answer yes or not to the job.

Is the patient to nurse ratio good?

Depending on how many trach/vent patients you are getting, or seems to be an acceptable ratio; my former (and now very PRN) position was in post acute and out of 6-7 pts 4 would be trach/vent, 2 would be trached and one would not, and it would be manageable.

Training Period adequate and long enough?

Could be longer, but there would be enough hours to become comfortable.

Have any of you made the jump from a desk job at a school to an actual nursing unit?

I have always had a job where there was some form of complex care going on; even at my "desk job" I still had a lot of responsibilities that transcended my nursing practice and actually helped improve my nursing practice-honing soft skills to help with anxious and challenging pts, family name members and peers.

Even if you a new grad and got that first job at say the ICU or sub acute how did you cope with the anxiety of starting a new job? I mediate and pray personally.

I am in a new specialty; what helped was self-studying what I would possibly be exposed to; it helped with my assessment skills, identify potential problems and helped me strengthen my nursing judgment.

Finally (sorry for the long winded). With my lack of experience in this nursing speciality would you take this job if it was offered to you?

Since I have taken a job in a specialty I did my have experience in, I have no issues taking a job in a new specialty, especially if I have a desire to want to grow professionally as a nurse; what I have always done is become PRN at a previous job in case I didn't want to continue into the new job or specialty; however I find myself currently enjoying my new specialty and have new moving farther from my previous employer because I am learning so much and I am committed in learning in my current specialty.-you can see if you can do the same.

Best wishes.