My First RN Job!

My first job was not at an acute hospital like I mentioned in my prior post here. I worked at a skilled nursing facility (SNF) near my hometown. I got my license in July 2019 and started my first RN job in November 2019. In between those months, I was working at AMC part time. With my RN license I was way over qualified for the job but I could not land any new grad job yet.

I was still on the hunt for a new grad job while I was working at AMC since I had less than 1 year experience. However, my parents were constantly berating me about getting a nursing job. My parents were really harsh on me about it; I know they just wanted the best for me but it’s not like I wasn’t actively looking. I was going through a lot of issues mentally and I wanted to aim high for a hospital position.

How I got the job: 

My dad ran into one of my old middle school friend’s mom at a Filipino market who is also an RN. They got to talking and she mentioned to my dad that I could work at her facility. Of course my parents pushed me to do it, and wouldn’t stop until I tried it. I drove to the facility to fill out an application. While I was filling out the application, the director of nursing (DON) came back from her lunch and offered to do an interview right then and there. Luckily, since I had already met the assistant DON, supervisor of the facility, and another RN, I was ready to go with four portfolios.

Although I lacked RN experience, they were very excited to have me be an RN at their facility. The DON complimented me and thought I would be a great fit. I obviously accepted because if I didn’t I knew my parents were going to rain havoc onto me. I also knew that this would be a good opportunity for me to see what else there is other than bedside nursing, and help me get my feet wet into the nursing world.

At the SNF, I was a RN supervisor. Let me repeat that. A supervisor to my LVNs. Just graduated, no experience, but a supervisor because I had the RN license. 

The amount of stress and responsibility I felt overwhelmed me. It was a completely new facility that consisted of subacute and long term patients. I was in charge of the long term patients so I overlooked about 35 patients along with my LVNs every time I came in. Did I mention it was all paper charting? PAPER CHARTING. It was hell when the doctors visited. Busted out all the charts and had to write, “Dr. ___ saw and assessed patient. No s/sx of distress noted at time of visit. No new orders. - RC, RN.” I knew that I knew nothing so I really relied on my LVNs since they had been there longer. I wasn’t gonna come into the place acting all high and mighty. Hell no, that’s a great way to get people to not like you lol. Be humble y’all. You’re learning. Just because you have the RN title, it does not mean you can't ask for help from your LVNs and other colleagues. Always remember that. My LVNs were absolutely amazing and they guided me through a lot of the processes that I was not familiar with at all.

It was honestly super difficult. I did receive some orientation shifts where I was with another nurse and they watched over me and taught me how to do things before I was on my own. It was kind of crazy and I was not used to the way they did things over there. 

I’m about to be super honest about my time at the SNF so here’s a reminder that my experience is my experience. I do not want to discourage anyone from pursuing a position at a SNF if you want to do so. Maybe what I say will give you red flags to watch out for but I don’t want to say that all SNFs are bad. I just did not like the way things were run at the one I worked at.

First off, the environment was very toxic. I had great LVNs that I still talk to today but there was always a sprinkle of those that ate their young and  were extremely mean and belittling. They made me cry so many times especially because I was new as an RN. I relied on my LVNs so whenever I asked questions she would say comments like, “Aren’t you an RN? Shouldn’t you know this? Why are you asking us?” I was terrified of talking back and couldn’t stand up for myself. I wasn’t incompetent, it was me asking my resources for help and solutions of what I should do next. Just because I was an RN, it doesn't mean I shouldn’t also ask for help when I know I need it.

One LVN in particular would question a lot of my work and how I wrote orders. I wanted to learn so I took the criticisms, but the way she relayed her message was very rude. Some of the orders I only wrote in the way I did because another nurse who had been there a while told me to do it like that. So  when I explained that she would say, “Don’t you have your own brain?” It was just not a good environment and had a lot of horizontal violence. 

The DON wasn’t always the best resource either. When you look for a new job, you should see what kind of vibe your supervisor or manager gives you. You want someone that will advocate for you and push you to be better. No manager should ever stop you from progressing. You need a safe space to grow. Look for someone who is understanding and willing to help out their team when they are in need of it. Meanwhile, my DON was negative and held grudges against her staff.

As the new RN with no experience, I did everything I could to have her like me. I received the SNF position with 8 hours shift, 4 days a week which was considered full time. My hours ranged from 0700-1500 or 1500-2300. Then one of the RNs had to be on leave and she was the night shift RN. I was placed on night shift and the hours changed from 8 hours to 12 hours shifts. Little o’l me unable to say no and wanted to be known as a good team player did 4-5 12 hours shifts with rotating shifts of nights and day shifts. 

At some point I got a really bad throat infection. I was unable to eat, drink, or speak because my throat was so swollen and had so much pain that I had to call off. I called off a day ahead because I knew I wasn’t coming in with a doctor’s note. My DON was pissed with me. After all those hours worked with the inconsistent schedules, it was nothing to her. No appreciation or understanding from her. Once you did something she didn’t like, you were always on her bad side. The staff I spoke to agreed that she can be unprofessional and hold a grudge. 

Luckily I soon landed a new grad job at the hospital and immediately left. The DON was not happy that I left but everyone else that I worked with was very happy for me.

I didn’t know this until I was well into working at the SNF, but it had a high turnover rate. The LVNs who have been there have seen plenty of RNs that came and left. I was only there about 5 months and saw why. The amount of stress you’re put under, the paper charting, a toxic environment caused by specific staff members, and the DON that will purposely give you a hard time because you did something that inconvenienced her.

Since I was a supervisor, I didn’t have direct patient care. No medication passes, only assessed residents when needed to, and did more paperwork than I liked. It was more of overseeing the entire facility and handling all the paperwork than patient care.

I eventually got better at my position after spending some time getting to know the patients, staff, and policies and procedures. I enjoyed my residents and got close to them. The majority of the staff I really liked because there was a team foundation and we talked about life and bonded over certain things.

I don’t regret working at the SNF at all. It was a great stepping stone and gave me more of an appreciation of direct patient care and hospitals, especially electronic charting. I missed patient care and I felt like I wasn’t helping the residents as much as I wanted to. I became confident and learned a lot but I knew I wanted a hospital. Once I was given the opportunity to change, I took it.

Don’t ever be afraid to leave a position that you don’t feel safe or happy in, regardless of how much experience you do or don’t have. Your first job does not mean you have to stay there forever. Always look for growth and take care of your mental health and license. Everything you experience is just a stepping stone into you becoming the best nurse that you can be that is always evolving. I enjoy where I am at now, but it doesn't mean I’ll stay there forever. Change can be good. You gotta take it, see it as a challenge, and run with it. It’ll teach you lessons as a nurse and as a person. Become the best version of yourself. 

<3 Mags

Thanks thanks best friend.