What's it like starting as the RN at a BRAND NEW facility the first month of opening?

[favthing, APRN]

I have a job offer of full-time day shift RN at a subacute-rehab facility. I'll be the only nurse, with the DON present, along with a CNA for the first month, and a maximum of 5 patients this first month of opening. The capacity of the facility will be >70, and it is purely rehab-subacute, not long-term care.

I have a couple years of LPN experience, but I'm a new-grad RN. I'm confident as a nurse, and excited for this opportunity, but I'm scared. Everything from fears of exactly what date the first patient will arrive so that I start work to the anticipation of State being a major presence is running through my mind.

Currently, I work in assisted living. I LOVE working directly with the residents, but professionally (and financially) its draining me. I hope to continue working there at least one day a week, mostly for personal reasons, but also the security of it (I've been there 3 years).

Any advice on what I might expect and how to prepare for being successful as a nurse at a newly opening facility would be MUCH appreciated. I feel really unsure, as everything from the date of opening to whether we will even pass State inspection to what acuity of patients I'll be having is worrying me.

[thatonemom]

Hi Favthing,

I have worked in a rehab hospital and can tell you that I prefer it over any other type of nursing. You are fortunate to work in a brand new one. You'll be able to climb the ladder fast. As far as state goes, don't even worry about them. That is the DON's job. He/she will be certain to run it accordingly. When they do come, welcome them with open arms. I perceive them as being there to help me more than to try to throw us all under the bus. If you don't know an answer about something they may ask, don't come up with something you are unsure about. Just say "I am not 100% sure, but I can most definitely find out for you." It happens all the time. Just practice the routine nursing guidelines you were practicing as an LPN ie. keeping med cabinet locked, HIPPA reg's, documentation, date everything, etc. Your DON should be able to tell you what the suspected initial bed census will be upon opening. If you've been told a max of 5 patients, I think you're going to be sitting very well meaning you will not be overloaded and can actually settle into your new positon and role. The patients will be medically stable, or should be, unlike most other hospital units that keep you running and worrying. My biggest piece of advice is to establish a routine initially that consists of priorities from a legal standpoint and a convenient methodology for you as the nurse. Look at this entire experience as a blessing rather than a blind and intimidating challenge. Relax. God will guide you, believe me. You also have your DON which can help you. Always thank your CNA, but don't try to overly assist in the beginning until you have your own flow down. If you try to do everything for everybody, you are cheating yourself out of time needed to develop your scope of practice. Once you get your job duties down and organized, then you can be much more help to others. I think it is great that you will all be learning together and can only pray others feel like you are one determined team. Hope that you get several admissions rather than hoping that none come. This will kill the anticipation factor related to new admissions and help you get the paperwork and assesments down. I'd rather learn the process sooner than later. This would help me to digest the process better and become faster at getting them in efficiently; not to mention being able to admitt without a full set of patients that you are simultaneously taking caring for. Trust me, this is a wonderful unit for you to begin your RN career on, in my opinion. I won't even wish you good luck upon my closing statements because I know you will be absolutely fine. Remember....God is with you every minute of every day in every week; especially when you are trying to do His work helping others!

Enjoy this job and do not fear it.

Thatonemom

[Quickbeam, BSN, RN]

I've opened 3 facilities. Loved the experiences. Staffing is always great and money for necessities seems to be available.

Plusd, all that new equipment!

[LVN_it1995, BSN, RN]

probably what it's like starting any new position. Good luck.

[favthing, APRN]

thatonemom: THANK YOU for your thoughtful advice and words of encouragement. Your wisdom has motivated me and helped me realize the gift of this opportunity.