Working in Nursing home is all the same?

BricMSN · Sep 12, 2016

Workloads in most nursing homes are pretty similar. What is your exact ratio? How many techs do you have to assist you?

$28 an hour for a new grad is pretty good--my bigger concern is that you claim you are working without pay. If you're at work working, you should be getting paid for it.

A couple of things to consider: almost everyone feels overwhelmed in their first nursing job; and, the grass is not always greener elsewhere.

bigorange123 · Sep 12, 2016

It's a 8 hours shift. If I cannot get things done in my shift, then I have to use my own time to get everything finished before I leave. The ratio is 30~40 residents to 1 RN. I got 4 CNAs in the floor. But, it takes me at least 2 to 3 hours to administer medication. I do both oral and IV medications, wound change, answering the phones, giving breakfast and lunch, documentation... a lots paperwork. I would say it's no quality at all. I don't even have time to do my break, that's why I consider to try another nursing home!

TheCommuter, BSN, RN · Sep 13, 2016

Not all nursing homes are the same. Some are operated more competently than others. However, what is the nurse/resident ratio at the facility that offers the higher pay rate? Are you willing to endure a longer commute for more of the same?

$4 more per hour adds up to an additional $8,000 yearly...

bigorange123 · Sep 13, 2016

I am so torn! Additional $8,000 a year is a lot to me, but I don't like to commute that much. The facility is located in a busy area;it's not worth driving because the chance of finding a parking is pretty slim. The nursing home pay $4 per hour more is as busy as the one I am currently working with. They even have patients have ventilators...I will think about it.

Blackcat99 · Sep 13, 2016

Do not work off the clock. If you can't get all of your work done then you stay over and you make them pay you for your time. Do not "volunteer" your services period. I hate to drive so I would not want to take a job that is so far away. I think nursing homes are pretty much the same wherever you go.

Kooky Korky, BSN, RN · Sep 14, 2016

Do not work after clocking out. If you get injured, no workers' compensation. IF you harm someone else, oh boy!

Can you make the longer commute worth it by reading, sewing, studying, whatever?

How are the benefits at each facility? Comparable? Staff morale? Do people call off a lot at either one?

lifelearningrn, BSN, RN · Sep 14, 2016

I think 8k/year is worth a 30 minute commute. But I live in a city where a 30 minute commute is considered GOOD and an hour commute is the norm for many. I NY, I agree $28/hr is underpaid.

Having said all that, the workload in nursing homes is generally heavy. I'd love to find one of the gems people say are out there, the well run, well staffed ones! :)

ShelbyaStar · Sep 14, 2016

Do not clock out before your work is done. This isn't legal. I am required to be clocked in even for the dumb monthly computer trainings that my work requires. Staying an hour or two after a shift is pretty normal- I stayed later than that many times when working evening shift and now that I'm working nights I usually end up leaving about 30 minutes late by the time I give report and finish up. If it's not possible for you to get things done in your shift, they need to pay you for that extra time or hire more people so you get out on time.

Personally I would consider that commute to be too much (you're saying it's 1.5 hr, right, not half an hour?) and wouldn't want to look like a job hopper, but that's a decision that's up to you. That is a pretty big spike in pay, though I wouldn't expect the job to be better otherwise. I took the job I did because it paid a couple bucks more an hour than others and it had some generous bonuses, but it's a hot mess with staffing and everything else.

HyzenthlayLPN · Sep 14, 2016

I second and third the advice above: no matter where you work, do not work "off the clock". Ever. EVER.

Not all long term care facilities are the same. There are good ones and there are bad ones. I will say that one hint about a facility: if they are using agency/hiring through agency this often (not always) indicates that there is a problem. If you do decide to find a different job, you might want to consider not going through an agency.

I am not familiar with homes in your area but in my area (NE Oklahoma) staff:resident ratios vary. We have several private pay/SNF only facilities where the ratio much lower than other facilities (where residents are primarily Medicaid). I know of a private pay facility that has 16 residents (3 SNF/13 ICF) on a unit with a nurse, 2 CNAs and a shared (with another unit) Medication Aide. . That facility pays their nurses less (for LPNs difference is about $2/hour) than the facilities that staff 38 residents (16 SNF/22 ICF) with a nurse, 2 CNAs and a Medication Aide. (I have to mention here how grateful I am to have medication aides in Oklahoma!!!)

Not surprisingly, the facility with the lower ratio has nurses applying for jobs that aren't even open yet...and the others are chronically short staffed/needing to hire nurses.

That is not to say that every facility that has primary Medicaid residents is understaffed. I've worked at some that are well run and the workload, though challenging, is manageable. I've also worked in facilities where I refused to work there again because I felt the staffing levels were unsafe. It isn't just numbers either: 15 SNF residents could be a much heavier load than 50 ICF depending on acuity level.

Your current position doesn't sound like a good fit for you but I'm not sure the one you have been offered would be any better. I think I would explore other options if I were in your place. (((hugs))) I hope you find the right position soon!

vampiregirl, BSN, RN · Sep 14, 2016

I did my homework before I accepted a SNF job. In my state, the dept. of health conducts inspections of facilities and the results are publicly available. That is one indicator of the quality of the facility.

Another thing to consider is what resources nurses have available, this might be something to ask about at an interview. Having resources available to provide quality care was very important to me.

Every job has it's benefits and burdens, it's each individual who has to figure out what is the right job for them at the current time in their life - depending upon personal goals.

bigorange123 · Sep 15, 2016

The resident care ratio in my current place I work with is 1 RN : 40 residents with 2 CNAs. The facility has 280 beds.There are so many IV and oral medications and paperworks to be done in every shift. Sometimes I have to write an accident report when the accident falls or behavior changes. Basically, it's impossible for me to get everything done on time if I want do all the procedures in the RIGHT way. I find it's very dangerous to work there because they are understaff, that's why I consider to quit. Although all nursing mangers there are encouraging me to stay. Another nursing home I consider to work has 330 beds and have 12 beds residents with ventilators. I don't know if this one would get a bit better. I am so torn to make my own decision!