Which is worse? Having non clinical RN experience or no experience at all

[tambat]

I am applying to jobs in California as a new graduate rn bsn. I have an interview for a position as an assessment and referral clinician at a local psych hospital. From what a friend who worked there stated, Basically you assess patients via phone or through walk-ins and judge if they should be admitted into the hospital or not. There are little to no clinical skills provided except vitals. The pay is $32.60/hour as a nurse in Cali which is on the lower spectrum. Should I take the job just so i can say I have some work experience or should I keep looking? Is having non-clinical RN experience better or worse than having no experience at all? Also is starting low bad long term, or it doesn't really matter?

[Davey Do]

On 6/4/2019 at 11:00 PM, tambat said:

Basically you assess patients via phone or through walk-ins and judge if they should be admitted into the hospital or not.

At the facility where I am employed, which has a psych division consisting of five separate units, there is both nursing and non-nursing staff who coordinate intakes. The intake center is housed primarily in the ED and there are a host of resources on which the intake coordinators can access.

There are strict psych assessment policies which are followed to determine the appropriateness of a candidate for admission. If there's a medical concern or question, RNs are there for consultation, but in the end, the MD, attending or ERP, calls the shot. With transfers from a medical facility, there's often a doc to doc.

Bottom line, intake coordinates the admission. They don't make the final decision.

If the facility runs like the one at which I am employed, I would recommend taking the position. It's good experience and you're not out there alone.

Good luck, tambat!

[Davey Do]

On 6/5/2019 at 9:09 AM, klone said:

So, would you be considered a QMHP?

In this area, a QMHP is a master's level social worker/therapist or an RN with two years of psych experience.

Bachelor's level or RN with less than two years experience is an MHP.

[2BS Nurse, BSN]

There are hundreds of job postings out there that would have required experience prior to the nursing shortage. I hear experienced RNs making judgemental comments like "a new grad has no business working in the ER or ICU!" Now I'm seeing new grad signing bonuses for both. If you're willing to do the homework required to get yourself up to speed... go for it!

[Workitinurfava, BSN, RN]

A great pathway to becoming a triage nurse is being an ER nurse first, however since this is a psych position, it may work.

[Monkey Nurse, ASN, RN]

I personally wouldn't take this job as a new grad. At the least it is not an ideal start, but at most puts you in a potentially risky position. I know as a new grad, I had no business in triage.

I 1000% support those that say triage is not a place for a new graduate to start. It is quite an independent position unlike starting with a preceptor and a floor full of nurses for support. Noone is on the phone with you picking up on all the non verbal and verbal cues of a situation. You have to be competent and confident enough to know you are making the right decisions on whether a person can wait, goes to the ER, or comes in to see someone at the office. You decide wrong- bad things can happen. At my first hospital, you had to have experience in the ED setting before you were allowed to take the ED triage position.

Good questions to ask is what kind of training would you have, and what sort of support do you have if you are unsure how to direct a patient. Do you have scripts or flow charts for different scenarios?

A last word from my personal experience, is that if you are in a saturated area and don't have a good network to rely on getting a job- consider moving and taking a more rural job. You can often get moving expenses. Or, if possible maybe take a longer commute for a little while if the rural community is close enough.

[2BS Nurse, BSN]

Nurses are maintaining less and less control over triage. With the implementation of Epic protocols, one simply blows the protocol into their note and follows it (unless told otherwise by management). I work in a high volume urgent care. First, we are inappropriately sent patients that should have been triaged to the ER. These patients are triaged by highly experienced RNs. They are told that all potential hospital medicare readmissions must go to UC (we send most of them straight to the ER!).

Second, in my experience, you can talk to a patient until you're blue in the face, but a patient is going to do what he/she wants to do! If you tell her to stay home and how to recover from her virus, she runs to urgent care for antibiotics anyway. If you tell him to call 911 for crushing chest pain that radiates to the arm, he comes to urgent care because he doesn't want to pay the ER bill. If you tell her to call 911 with a pulse ox of 52%, she goes to her PT appointment anyway (which results in an ambulance ride)!

From a post above: "They just want a warm body or are looking to increase census". Doesn't this pretty much apply to the profession in general? I would add "a nurse who is willing to accept the lowest salary" to that quote.