Info about Harlingen, Mcallen and Brownsville, nurse worried to work there.

[ValleyCat]

I'm a new RN just moved to Brownsville, TX. I work at Valley Regional Medical Center (VRMC) in Brownsville, in med-surg, my first nursing job. To say it is "hard" is an understatement. I can't imagine ever getting comfortable in the job, because it is extremely demanding. They have an excellent nurse internship education department, but it cannot fill the gap, in my opinion. The patient-to-nurse ratio is about 6:1 -- 8:1. Pts are high acuity because there is a shortage of ICU beds, so they get stuck in med-surg. Similarly, there is always a backlog of ED holds, because beds are not available in the various appropriate areas.

Travel nurses are generally the most congenial and helpful, but several of them have warned me that VR is not a realistic place to continue on as an RN, at least not in med-surg. All said they were leaving and would never return, at least not to VR.

VRMC did not offer a sign-on bonus, and I didn't ask for one. Originally, I spoke to HR at Valley Baptist in Brownsville (VBMC)--owned by Tenet Healthcare. They offered a $5000 sign-on contract, but I chose VR after hearing that VB was much harder, at least for med-surg. Later, I heard that VB in Harlingen--sister to VB in Brownsville--was a pretty nice place, generally speaking, and they use an EHR software called Cerner which is pretty good (comparable to Epic, which I know is user friendly). At VR (and all HCA hospitals), they use an EHR software called Meditech, and this is loathed by everyone I've ever talked to, including administrators and MDs. There are different versions of Meditech. VR uses 5.66, but the latest is 6.0 or something like that, and from what i've been told, it isn't much improvement. I recommend avoiding any employer that uses Meditech, unless you're already used to it. It's horrible!

A few questions for those who know:

1) Will hospice centers or rehab hospitals consider anyone without med-surg experience? I've heard some do and some don't, and I plan to call around soon to find out. Obviously, an RN with med-surg would be their first choice.

2) Word is that nursing homes will work an RN pretty hard, because you have to supervise several CNAs, techs, etc. They might only hire one RN for the whole shift. Is this true? Will they even consider a new RN without med-surg experience?

3) Does anyone have experience to share about any of the employers (for RNs) in the Brownsville/ Harlingen/ McAllen area? Can you recommend any hospital or dept therein? Other facilities for RNs?

4) Some say that Renaissance Doctor's Hospital (and the whole Renaissance complex, including hospice, oncology, women's, etc.) in McAllen is very good for RNs. Any words from the wise on that?

5) What about HHAs for a new RN? Some will offer orientation/ training, but would it still be too much for a new RN? I speak some Spanish and am learning more all the time. I suppose there is phone translation available, and I have Google Translator app. The immersion of HHA work might teach me a lot. :-) But I wouldn't want to be overly frustrated nor a disappointment to patients. Any thoughts on the HHA idea?

6) One person said to check out RN jobs with TX state public health. Any suggestions on that?

Thanks to any and all who might have ideas or input. Sincerely, ValleyCat

[ChristieP]

I'm a hospital HR manager who hires RNs. I don't know about the Valley, but I can tell you in general about hiring practices, etc.

You have to WANT to do hospice. Most nurses will not work in that field because they do not want to watch people die. If you truly want to do it, then yes, they are always looking for RNs.

Rehab centers and nursing homes are also always looking for RNs, even without experience, but it is a tough job. You will likely be the only RN on the shift, and you will be supervising CNAs and LVNs. Only a RN can pronounce a death, so there has to be one in the building 24/7.

If you could work for a GOOD home health company, it can be a good job. But many companies are small, and they are notorious for not paying properly, and skirting the rules. I've had too many nurses say they had "had enough" of home health and come back to the hospitals. Going into people's filthy and cluttered homes can be gross! Also, home health cannot guarantee hours if their patient census drops, so your income could be affected. If you are not fluent in Spanish, that might not be a good place for you.

Good luck with your decision!

[hellpaso]

You're not likely to get anything without a minimum of a years' experience.

And with all respect to ChristieP, there are very few facilities that are "always looking for RNs". And while allowed by the Texas Board of Nursing, RNs can only pronounce death if in accordance with a particular facilities written policy.

I spent 7 years in the RGV, and have first hand knowledge of the facilities you mentioned. My recommendation would be to finish out a year there if you can, but start taking steps to relocate to another area. It's just very doubtful you can find anything like a home health, hospice, rehab, or nursing home position without a year of experience. And honestly, it wouldn't be fair to the patients or yourself to take one of those positions without minimum experience. And a "year experience" is laughable, but it's better than none.

[ChristieP]

Nursing homes are willing to hire RNs without experience/straight out of school. And yes, most nursing homes are always looking for a RN. I was the HR Manager at one for 3 years.

[hellpaso]

Originally Posted by ChristieP

Nursing homes are willing to hire RNs without experience/straight out of school. And yes, most nursing homes are always looking for a RN. I was the HR Manager at one for 3 years.

Actually, it depends on the location.

[ValleyCat]

Thank you to ChristieP and Hellpaso! I really appreciate any insights.

[ValleyCat]

I shouldn't neglect to say that it is very compassionate of you, ChristieP, to be supportive of a stranger just starting out. As we all learn sooner or later, nursing is a tough realm, and kindness goes a long way.

Hellpaso, your candid, informative tips were also very helpful. But I think you should choose your inflection more thoughtfully. If I were thin skinned, I might feel discouraged by your contemptuous tone. Since I've been around, it doesn't get to me, but it could hurt other newbies to hear a year's experience is laughable. This could as easily be said, Even a year's experience doesn't get you far. When people lack experience they already know this, after all. No need to be snooty, unless it's what you had in mind.

Info is info, true enough, but what comes through the words can matter even more. Nonetheless, thanks again.

[hellpaso]

Funny!

[JoninATX]

I wouldn't worry about prejudice people. They don't contribute to anything positive so let them live in their own world. I mean I'm white and love diversity.