Would YOU accept this position?

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I was recently offered my first position as an RN in a LTC/SNF in northeast FL. I completed orientation and was scheduled for nights (7p-7a). The thing is, when I looked at the schedule, I noticed that I am the only RN with 3 LPNs and several CNAs. I tried to ask the ADON who would be in charge in that situation and all she told me is that the company expects all of their RNs to oversee everything and that if there were a code I would have to run it... I've never even been in one! I asked her a couple more times in different ways thinking maybe I wasn't very clear in what I was asking and she seemed to be dodging my question. My intuition is telling me this is a potentially unsafe situation (there are 100 residents and I would be the only RN in the building). I'm going to call again today and have a conversation with the ADON and try to get some straight answers. I'm scheduled for Saturday, but I really don't want to put myself in a situation that jeopardizes any residents/employees or my license.

I just wanted to see what others thought about this situation. I tried to ask the ADON who would be liable if anything went wrong (legally, I am sure it would be me), but again, she dodged me (at least it seemed like it). The pay is great for starting, but when I was hired I honestly felt that the reason I got hired is b/c I have a pulse and a license. There was NO competition for the job at all (which is FAR from the norm in my area)... I'll update later after I've spoken to her again, but I would like to hear other people's thoughts on this.

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Forgot to add one critical piece of information... I am newly licensed and just graduated in May... and I'm NOT ACLS.

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I think the norm for LTCs is to have a load of up to 30 or so pts, so with you have a bit less than that, maybe it's not so bad? You will have 3 other nurses on your team and several CNAs so you won't be alone. How long was your orientation? Have you seen any codes during your orientation? Are there doctors in house to come running if there is one? I haven't seen one yet, but I don't work on a unit where they often happen, if ever. What acuity are the patients on your unit? Are they all bedridden or are they up and about? What was your impression of the support staff during your orientation?

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Specializes in NeuroICU/SICU/MICU.
I think the norm for LTCs is to have a load of up to 30 or so pts, so with you have a bit less than that, maybe it's not so bad? You will have 3 other nurses on your team and several CNAs so you won't be alone. How long was your orientation? Have you seen any codes during your orientation? Are there doctors in house to come running if there is one? I haven't seen one yet, but I don't work on a unit where they often happen, if ever. What acuity are the patients on your unit? Are they all bedridden or are they up and about? What was your impression of the support staff during your orientation?

My understanding of what the OP is saying is that there wasn't an orientation. It sounds like the OP's first shift is Saturday, and s/he will be the only RN in the building, in charge of 3 LPNs and several CNAs. Not to mention, this is a long-term care facility. There will be no physicians in house, except maybe once a week for a couple hours to write orders. OP, if this is in fact the situation, you should listen to your gut and run away quickly. It's not worth losing your brand-new license.

PS: I just noticed you said there was an orientation, so ignore that part. My point still stands, though - if you have a bad feeling about this place, run, don't walk.

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I was recently offered my first position as an RN in a LTC/SNF in northeast FL. I completed orientation and was scheduled for nights (7p-7a).

The op states in her second sentence that she completed orientation.

It kind of sounds like the op accepted a night charge position without really knowing what it entails.

The staffing doesn't sound unusual for LTC at night (1:25 is actually pretty darn good) and if it's typical LTC one RN is sufficient with experienced LPNs.

Having the ACLS is unnecessary, you won't have access to the drugs, equipment or doc if someone codes, you'll call 911 and perform CPR until EMS arrives.

Unless you are the designated supervisor and are delegating tasks to the LPNs they are working under their own licenses not yours.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

It sounds like what you are worried about is a coding patient. You have CRP training right? If a patient codes call an ambulance and do CPR unti it gets there. No big deal.

Unless there is some other problem you haven't mentioned I would take the job.

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My understanding of what the OP is saying is that there wasn't an orientation. It sounds like the OP's first shift is Saturday, and s/he will be the only RN in the building, in charge of 3 LPNs and several CNAs. Not to mention, this is a long-term care facility. There will be no physicians in house, except maybe once a week for a couple hours to write orders. OP, if this is in fact the situation, you should listen to your gut and run away quickly. It's not worth losing your brand-new license.

PS: I just noticed you said there was an orientation, so ignore that part. My point still stands, though - if you have a bad feeling about this place, run, don't walk.

This is an accurate description of what is going on. There was a facility orientation that was 2 days long and consisted of me sitting in a room watching videos. As for unit orientation. I'm being told that I will have three days of mentoring and after that I'm flying solo. I had to ask the ADON five times before I got a straight answer out of her as far as liability issues with me being the only RN in the building. She told me that I won't be liable which helps a bit, nor is anyone on the floor at night "in charge". We all care for our own patients/residents. I am still not completely comfortable with this situation, but I am comfortable enough to give it a chance and see how it goes...

Thank you for your response!

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The op states in her second sentence that she completed orientation.

It kind of sounds like the op accepted a night charge position without really knowing what it entails.

The staffing doesn't sound unusual for LTC at night (1:25 is actually pretty darn good) and if it's typical LTC one RN is sufficient with experienced LPNs.

Having the ACLS is unnecessary, you won't have access to the drugs, equipment or doc if someone codes, you'll call 911 and perform CPR until EMS arrives.

Unless you are the designated supervisor and are delegating tasks to the LPNs they are working under their own licenses not yours.

I asked so many questions that I think people were getting irritated with me, but I felt as though they were trying to dodge my questions... I made it very clear that I am a newly licensed grad and never once was "charge nurse" mentioned when I spoke to these people. This is a position that I would really rather not take, but there really are no other options in my area for new nurses. People with experience would do very well finding a position down here though.

Thanks everyone for your thoughts.

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RUN!!!

If you are the only RN over seeing 3 LPNs and they say you are not the one liable for the decisions you make they are not being honest with you. If you are uncomfortable with the situation then turn it down.

The only way these places will change is if people start telling them no.

The bottom line is you are the charge nurse of the shift. You will be liable for the actions of EVERYBODY in your charge. Get used to that, it is part of the job you have chosen as a career and almost all RNs are going to be in charge at some point.

But if you are not comfortable with it right now you need to find another job that gives you more time to grow into your RN role.

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Thank you very much for your input. I am taking everyone's comments very seriously and am weighing my options. The most difficult part of this entire situation is that my DH just retired from the military and we have lost half of our income. We really need the income right now, so I have a lot of things to consider. Thank you again!

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I know you're overwhelmed! I think that you should strongly reiterate to the DON that you are uncomfortable with being the primary charge nurse on the floor. If she could alert some of the more experienced nurses on another unit or on another floor to be mindful to being available to answer some of your questions, then atleast you would get some kind of support. When I worked as charge nurse, I would walk across the hall to another unit where a more experienced nurse was and ask her questions as they arose for me. She was nice and helped me out with paperwork and supplies at times. Its so much easier to walk away from a job that feels as though it's going to swallow you up, but you don't have to let the situation sink you!

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Specializes in Mental Health Nursing.

I'm a new grad as well. I'm charge nurse on the floor with 3 CNAs and 40 residents. I have to do all med passes, wound care, documentation, etc. I'm still fairly new, but the more you do it, the more it becomes natural.. kinda like riding a bike. Idk about your LTC facility, but mine provides the nurses with ACLS and IV training and certifications. Ask if your facility provides training.

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