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Select Specialty Hospital

A for profit hospital with minimal staffing for critically ill and high acuity patients. A fast paced climate and no time to become bored. Patients constantly complain of call bell response time. Hospital is for critically ill recovery patients and they do a good job of preparing patients for discharge to rehab, SNF or home. It is rewarding to see progress patients make towards discharge. Hospital aggressively weans airway patients from ventilators and to de-cannulation. Most of the shift is 1 RT on the floor with 2 RTs on the floor during the first 4 hours of the shift. Unfortunately, no time during the shift to visit or chat with patients because you must keep moving onto to next task or answer the constant barrage of alarms and call bells. RNs usually 4:1 or 5:1 patient ratio. RNs can sharpen their airway management skills.  Good time management and organizational skills a must for all staff. Patients are to be OOB twice daily. You need to be a team player (CNAs, RNsand RTs are extremely busy) PT/OT will help with bathing and mobility of patients during their therapy sessions. Charge RNs go out onto the floor to help out when necessary. CNO will offer to help on the floor at times. Staff entitled only to a 30 minute lunch break (staff was told we aren't entitled to any additional 15 minute breaks; only break we get is what "by law the PA Dept of L&I requires"). Training is required via online through company website however, none of those classes can be used for RN or RT CEUs to maintain license. This hospital exposes clinical staff to various critical situations where knowledge and experience can be gained. Unfortunately, they don't always seem to have the latest equipment available for use (eg. outdated BiPAP machines). They used paper charts until a little more than a year ago, now they chart electronically. Their mobile workstations with computers work great and they include nice laptops. The materials in the supply rooms are adequately staffed.  Hospital appears to use the least expensive materials and equipment at times. When equipment breaks some staff do not always take the time to tag out the item and instead leave it for their coworkers to deal with. There is a staff huddle about 2 hours into the shift which is beneficial. Everyone knows their part during a code situation.  A great place for new RNs fresh out of school to go through orientation and fulfill a 2 year commitment at Select and change to an acute hospital to further their career.  There has a been a lot of staff turnover in both management and clinical side.  However, the staff are nice to work with and most are more than happy to help other staff when asked. Nice activities planned for staff within hospital. Company benefits are decent.  Most co-workers are happy to share their clinical knowledge with you when asked. It is rewarding to see patient successes and hear from grateful patient families.

Select speaciaty is a very nasty filthy hospital . The nurses and respiratory therapist leaves supplies everywhere from needles down to the suction's .  You will always find more than enough supplies in each room because they are to lazy to walk back and forth to get the supplies they need so the shelves are full of very supply you could possibly name.They run every Nursing Assitant away by spending their time running after the CNAs  looking for things to complain about instead of actually doing their jobs. The charge nurse makes the CNAs clean up the rooms and actually have to set the room up room moving mattresses transporting them to the 11th floor. I feel like if you have a house keeper and maintenance man you might as well use them to actually do things in their job description. Cna's do patent care which does not require you to move furniture around. They will require you to get the patients up twice a day but keep and mind you will always be under staffed so that makes it impossible. You will work with at least 3 to 4 different nurses who will all think you can be one place at one time all while juggling about 8-14 patients. They're supposed to have about 5 CNA's but always have 4 or less working the floor. The turn over rate is very high. They never keep anyone and they took the self scheduling away making it harder for people to juggle 12 hour shifts and also keep your personal life in order.No one there is happy everyone is always talking negative because no one is happy with their job. You also have a lazy wound care nurse who does rounds when she feels like it pushing her work over on the RNs to do their rounds plus wound care. They never have all the supplies you need and all beds and chairs are all broken and out of date which makes it harder on you. The charge nurses are not much of a charge nurse and then you have . I think it's ooor management because because that place should not look like a dump. Most of everyone is of color and no one really cares about anything . Nurses are not appreciated at all.All money is not good money. Don't run after every top dollar your happiness is way more important .The patient overload will kill you daily. They give you 23 points and every day you miss it's 3 points , late call in 6 points so if you're in the hospital or your phone is off  you better get to the nearest phone , 6 points if you call in on the holidays , 1 point if you forget to clock out , 2 points if you leave early. They don't take Dr excuse if you're sick you just point out . As high as a turn over they have you would think they would take the point system away. Also they give nurses a bounus if they refer another RN and if they come in on an off day up to like 500 per day not including what you already make . I'm sorry CNAs they offer you nothing at all no bonus and no extra money for coming in except probably time in a half. You don't get money for referring a CNA either which sucks.You also have CNAs who are just lazy and have no team work at all.

nurses are over burdened overworked and too many duties and tasks to be completed .REPETITIVE COMPUTER CHARTING WHICH IS BEYOND EXCESSIVE AND REDUNDANT. yOUR mOST TIME AT WORK IS ON THE COMPUTER DOUBLE AND TRIPLE CHARTING, IF YOUR PRIORITY IS YOUR PATIENT CARE COMFORT AND MEDICATION ADMINISTRATION AND FULL PROPER ASSESSMENT...YOU WILL BE STAYING LATE FOR HOURS TO COMPLETE YOUR CHARTING AND IF YOU HAVE ANY CODES OR INCIDENT AND AN ADMISSION WITH YOUR 6 PT WORK LOAD YOU WILL BE FORCED TO STAY AT LEAST 3 HOURS AFTER SHIFT TO COMPLETE ALL DUTIES,TASKS,AND NEW ADMISSION CH..ALONG WITH ANY DRIPS THAT MUST BE TITRATED AND COMPUTER DOCUMENTED IN REAL TIME...cna ONLY HOLD patient while you wash them and complete would care you will clean all patients for Incontinence of bladder and bowels...many C Diff patients..the RN cleans all incontinent patients on her assignment, RN take all Vitals q 4 , and perform all QC contol testing and Provide all Blood glucose testings on her patients and must also administer all insulin in the time frame provided and chart in real time, CNA are not allowed to take vitals, or Control testing for QC on BGM machines nor are they allowed to do your blood sugar/fingersticks and report the reading to you also during this time frame you are to get all pt out to chair at 6am on ventilator/covid pt..the do all your order bloodwork/lab draws on all your patients which most are dialysis patients with many specimens to draw and extremely difficult sticks..and label print labslips and bag to lab..also 6am meds due at this time alsomany IV ABT, peg/gt medication administration,,,all tube feeds must be taken down and New bottles tubing flush bag and irrigation set timed dated and initialed along with all IVF and IVPB..no cafeteria...no coffeemakers allowed on unit due to covid, must be knowledgeable in telemetry almost all patients on monitor with heart disease,bypass,valve replacement etc..all patients vented must be proficient in lung ausculation and lung sounds, how to care prooperly and cccuratley monitor and document chest tube drainage, must be familiar with KCI would vac...working properly or apply new foam dressing and insure proper seal and correct + suction, placement to ensure no additional skin damage, coworkers are nice but you will be to busy to chit chat or take a meal break it will take time away from charting and you will be charting after shift and having to return for consecutive shift 6 out of 7 day block schedules for RN..then 1 week off...some love it...some do not...you will see if its a good fit for you..everyone is different

At the beginning of your select career management is over the top with saying their door is always open if you need to talk, they have and amazing work culture,  and there is a multitude of avenues for career advancement. However this is not the case. When you have worked their for a while, none of management cares about you. Unless you are a brown noser, follow everything they say to a T, and don't bring up anything that could be a concern about safety or patient care, they could care less about you. If the CEO doesn't like you, he'll find any little thing that he could use to get rid of you. The only time they'll talk to you is if you messed something up and you need to fix it. All of the staff meetings consist of berating the staff about how bad they are doing and how we need to improve. Staff could be drowning in work and short staffed but they still won't come out of there offices to help out, plus they'll continue to add more stuff for you to do on top everything else you are already doing. The CNO and DQM only follow nursing protocols when it suits them. They almost routinely put staff in situations where one could lose their license.  The admissions team is clueless and has no clue how to properly clinically assess a possible admission. The DBD and admissions team only cares about filling beds to meet monetary quotas. They'll continue to bring in admissions even when the hospital is short staffed, the floor doesn't have the equipment to take care of the patient, and it overall generally unsafe to bring them to this hospital. The therapy team is a joke. They expect the staff to do all of the mobility for all of the patients, (this hospital is nuts about mobility, almost like it's the only thing the care about, other than money) and yet take all of the credit. Very few of the PT or OT actually do their jobs that they get paid to do. Lastly, pharmacy is a joke. Most hospitals have a pharmacist in the building 24/7, if not on call that'll come in to mix medications and restock meds when they are out of stock. This pharmacy works 8-5, sometimes. It's not uncommon to run out of routine meds, such as Tylenol. If you have a patient on a drip and there is none left in stock they tell you to go down to the host hospital pharmacy so that way they can stay home and not have to come in. This hospital causes so much extra stress to an already stressful job as a nurse. If you value your mental health and license, DO NOT WORK HERE.

This was an ok place to work. The co-workers were for the most part great to work with. The experience and knowledge you acquire is by far great. However, management does not care about you they Re only worried about the numbers and filling the beds despite whether their employees are overloaded. RN's usually alwaysaxed out with 4 to 6 critical recovery pts. While CNA's had anywhere from 10-12 pts a shift. Pts not getting proper care due to nursing overloaded with responsibilities that took priority. Often you would not have enough CNA's to even cover and RN' s would have 3 pts and do primary care while 1 CNA would float the entire floor to help when they could. Nurse managers and shift supervisors worked the floor when needed and helped often but anyone higher could careless what was happening and the stress the floor nurses and CNA'S were going through.  My heart went out to the coherent pts that didn't get peopwr care on a daily basis due to the shortage. Pts would go without baths for days up to weeks sometimes. Call lights unanswered for hours. Communication between RN and CNA was limited instead of teamwork. All around frustrating but it was a great learning experience. Most of the pts were pleasant and very appreciative. Just wish management would have noticed low morale and cared enough to help fix it. CNA's were always an after thought and it showed. Therefore giving the impression to other employees they weren't worth the time or day. The amount of work a CNA was expected to do on a shift far outweighed the pay that was given. If you did your job and gave 150% you went home dead after a 12 or 13hr shift and still felt like you didn't everything done! And as for the pay u start at $16/hr when you did the work most of the time of 2 or 3 CNA's by yourself! Time off was difficult and if you did not request it off 3 or 4 months in advanced u didn't get it and the points system was ridiculous. You could not have more than 20 pts in a year. But the points were counted from when you got them. So it was a year from each point u got unril it dropped off. You received 3 points for call outs even if u gave days notice, 5pts if u called out on a weekend, 1 - 2 pts if u clocked in early or late, 2 pts if u missed a swipe in or out for any reason even if it was the time machine malfunction, 1 pt for not having your badge. So the frustration and stress here was undoubtedly high. 

Very Hard work that is not acknowledged by the corporation or management. Our patients are very sick and the families are very frustrated and take it out on the nurses/aides. Instead of management supporting their staff they would rather write them up, suspend them or ignore the situation. The pay is terrible for the work that we do. Our patients are critical and we have a patient load of 5/days 6/nights. When we voice our concern that the work load is too heavy the response that we get is Med-Surg nurses have any where from 6-8 patients day 7-9 patients nights. However med-surg nurses do not have Vent patients, Cardiac drips, Septic patients, or critical tele patients so that is a poor comparison on their part. Our coworkers are wonderful and for the most part we are a family. The CNA's do not have to do blood pressures, accuchecks. they are responsible for turning, cleaning (bathing) and feeding patients.Ours CNA's run the facility, they have anywhere from 5-8 patients and still complain that they do too much usually it is the nurse that is cleaning, supplying the ice water. I would rather do total patient care and omit the CNA's all together however the company says that is not cost effective. When we are short nurses they cusion our staff with an extra aide, as if that makes a difference. The company bends over backwards for families but do nothing for the employees sadly the patients are rarely complainers. The turn over is ridiculous. You do get to learn a lot and see a lot at Select. Any complaints that you take to management is usually responded by a "You know where the door is" response. Your yearly raise is pennies nickels if your top notch. Admissions come regardless of staffing. Management makes up policies as the go usually saying "corporate says...." then a few weeks later they change the policy again. There is no consistency there, because the people who make the policy's are so far from the actual nursing care that they are in a dream world. I have been with the company for years and am about to retire so their is no need to go anywhere else for me, but for any new nurse bypass this company it will suck the life out of you and make you question the reason you became a nurse.

Select has such a wide variety of patient population that you truly get to see everything. It’s a great place to start as a new graduate. A lot of downfalls of this place, if you have depression & anxiety- you will either get it working here or have your prior mental health become worse. Management is horrible and does nothing to help the staff. Management is not available like they promise you in the beginning. Poor staff who does not show up or do not do their job, do not get fired. It really puts a damper on the people who are there to care for the patients. Some coworkers are amazing and are willing to help show you everything. Other coworkers do absolutely nothing. There are several bullies who work there both day and night shift. Management does nothing to control their behaviors because they are so short staffed they can’t afford to fire anyone. 
Nurses- you pretty much do EVERYTHING. And I mean everything. Vital signs, blood sugars, wound care, meds, blood draws, IV sticks. Etc. You will feel really overwhelmed like 80% of your shift. The CNA’s do baths and even then they make you HELP them. I’m not one to complain but some of them work together and do their patients together which is fantastic! I don’t mind helping the CNA’s at all however, if they lady is 90 lbs you most certainly do not need my help! 

The patient to staff ratio use to be 4-5 patients per nurse when I first started. The new normal is having 6-7 patients which is RIDICULOUS. It’s completely unsafe because we take care of CRITICAL PATIENTS. Fresh from the ICU- and some patients come to us and die or code within the first 72 hours of being here. 

Charge nurses- There is only two appropriately trained charge nurses and they both work dayshift. The other charge nurses are “fill ins” who weren’t shown how to do anything. Half the time charge has patients also and cannot help the nurses on the floor appropriately. 

Overall, select has helped me to become an amazing nurse because the passion some nurses had when I first started here. I have watched this place decline so rapidly and truly, not sure how they are going to turn this around. Anyone who starts there now will not last because they see how insane it is to work here. Is unsafe conditions that is going to get RN licenses pulled. 
Be cautious!!!

What is the best part of working at the company?
Fellow co-workers, working with like minded peers to ensure safe and quality patient care. 

What is the most stressful part about working at the company?
Unrealistic expectations, you do not have a free minute in your day. Ever changing job expectations, a definite decision or answer does not exist. Company prides itself on structure yet upper leadership operates their respective divisions independently deciding what’s most important to them following their own personal business model. You are talked to about meeting the Business Plan but never actually shown what that is. Preach transparency yet you cannot even see the patient census count of a partner facility. If you work hard and produce quality work they will throw more and more on top of you. False promises! If you think there is loyalty and trust in your leaders and turn down a job offer that is more money, they will promise to address just give them until after the new year and then they act like they have no idea what you are talking about. Money is valued, employees are dispensable regardless on contribution. 

What is the work environment and culture like at the company?
The Select Medical Way is truly to get as much work out of one employee as you can regardless of overwhelming them and stressing them out. Most employees are on anxiety meds within 6 months of working there and clinical staff is expected to take a patient load that is nearly impossible. Staffing like a short term acute care hospital but functioning as a long term acute care hospital. Claim level of care is med/surg when it is truly more relatable to an ICU setting. 

What is a typical day like for you at the company?
Stressed. Meetings fill your calendar and time to get your work done is usually after 5pm or on weekends so you don’t get interrupted or pulled and distracted all day long because corporate needs to have a call, about a call, about a call and roll out new initiatives every single month. But you better get your assigned job functions done at the same time. Everyday feels like you are being set up to fail. If you share your troubles or obstacles they will listen and then tell you why you are going to do it. There are no passes, no understanding, no help.

Charge nurses and coworkers were wonderful...we were family and a team that worked together on the nightshift..my charge nurses were approachable and always answered my questions regarding protocol if I was unsure..RT<RN<CNA worked together as team and worked well together..i was a different race than the entire shift...never treated any different that any other worker,,until new Corporate CNO arrived ...harassed me gave me most difficult assignments because of my race was different then hers...and coworkers picked up on this before i even did,,,and bought it to my attention,,that was the hardest part of the job..to be viewed as something less due to skincolor..i made some lifelong associates and friends...many excellent disciplines and most are very unhappy especially nurses our workload has increased tenfold with no help...we do everything,labdraws,vsQ4,bs/fs,QCtesting,insulin admin with verified cosigner which takes a lot of time to find...so many tasks added at 6am it is impossible to complete or do well, and has created burnout among the nurses..hardest part to be stuck on Covid side for months with 6 or more patients and inappropriate PPE..broken hard stiff ergonomically deficit caising neck spasms and pinched nurves frm the wrist up to the neck...chairs to low computer cant swivel for proper viewing without straining neck or back...causing pain and severe discomfort while working on inappropriate chair height no lumber support causing pain to hip and knee joints..those plastic chairs are made for elementary sized children , not adults,but i stayed because of the great team I worked with and was hoping for change but all I received was harassment due to the color of my skin..i would have stayed there until I retired if my skin was of similar color...makes me sad

This is a poorly run facility. The CEO is blind most of the important issues like quality, excellent patient care, and staffing to meet demands. There is too much focus on filling the beds and minimal work is done on recruiting. The CEO wants to be everyone's "friend" mainly because he is an incredibly inept leader. Most of the leadership team makes fun of his bumbling style and his blindness to what is happening in his facility. 
The nursing staff is made up of just associates degree RN's with minimal staff having their BSN. The CNO doesn't even have a BSN! Where does this ever happen? It should make anyone question the quality of care delivered. They bend their own rules and allow an LPN to function as a clinical liaison when most facilities have BSN's. They even hired a CEO in another location with only a Bachelors and the job descriptions says "Masters required"! Again, you have to question the companies direction and the quality of the staff when rules are bent like this. Turnover of CNA's is at least 50% and nursing is understaffed. The facility cant hire quality staff because of the poor reputation in Omaha, even when they offered a sign on bonus no one applied! HR is most of the problem due to lack of experience and an inability to focus and get anything done. 
Incompetent people do well at this facility. They are given superior ratings and allowed to attempt doing there jobs without question. The CEO surrounds himself that are incompetent employees that have been his friends for years. Anyone with any sign of being good at what they do or who tries to fix this broken facility either leaves or is asked to leave. They are happy functioning at a level of dysfunction that most people would see as abnormal. 
There are too many facilities that are run in an excellent manner to make a mistake working at Select. Its been this way for years; its not changing.  Put your shoes on and run!

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