registered nurse

patient care technician

Texas NeuroRehab Center

The reason why I left this company was because of the management's lack of willingness to set boundaries with difficult family members. I worked the overnight shift on the medical unit as a tech. Some of the families were friendly and sometimes even helpful, assisting with simple care tasks like positioning the patient. However, this hospital basically allows family members to move into the patients' rooms which interferes with care. They set up cots, which get in the way of the staff and the medical equipment and when we check on the patients overnight to provide care and safety they will sometimes abuse the staff for waking them up, the family member, not the patient. Some of them can be totally overbearing and just directly insulting. This group of people were why I walked off the floor on my last shift and quit without notice. The other most stressful thing I dealt with were the anxious patients who would often call several times per hour. This would not have been an issue if management had assigned a lower staff ratio to high needs patients. It was totally overwhelming and many nights I would cry in the bathroom. I even started smoking again.

The nurses I worked with were very diverse in their level of helpfulness. Some were wonderful. Some would back me up without me even having to ask, they would counsel me and teach me new skills. These nurses inspired me to go to school and get my nursing license. Others would play on their phones while I was clearly overwhelmed and required constant nagging to help me. Some nurses were totally overbearing and overly critical and never appreciated all of the good work I did and all of the effort I contributed. I enjoyed the nights that I had the good ones and hated my job when I got a bad one.

I learned many new skills! I believe I will be an effective nurse because of my experience working here but in the end it was way to stressful for me to stay. One night, I walked nine miles in a shift but the physical effort was worth it to help the patients. I would work here again if family members were not allowed to move in, I had a good, appreciative charge nurse and the staffing ratios were based on the patient's level of need. Seriously, some of these folks needed a 1:1 ratio but always had about 8 or 9.

Also, getting time off is hard. I once gave adequate notice and found not one but two techs willing to cover for me on my own and management still ruined my vacation by making me work overnight the day before my trip.

As someone who also worked as a clinician at Texas NeuroRehab Center, I want to offer a contrasting perspective to the overly polished review that was shared. In fact, that kind of targeted, passive-aggressive language — masked as "balanced perspective" — is exactly the tone you can expect from leadership here. It presents a narrative of reflective professionalism while subtly dismissing valid concerns, which mirrors the organizational culture itself.

The reality is that support is sorely lacking. Despite the language around trauma-informed care and neurodiversity-affirming practice, the system does not walk the talk. Leadership picks and chooses which staff and patients they care about. Children are often treated as billing codes rather than people, and decisions are made with finances in mind far more than clinical integrity or individual wellbeing.

A major red flag: nearly half of the clinical team left in a mass exodus — not because they were “negative,” as it was framed by leadership, but because the environment was unsustainable and toxic. Those therapists cared deeply, worked hard, and advocated for real systemic improvements. Instead of being heard, they were dismissed and scapegoated for pointing out serious flaws in the system.

If you're someone who values integrity, transparency, and actual therapeutic support — both for clients and clinicians — I’d urge you to ask very specific questions during your interview and speak directly to former employees if you can. This may be the “hardest job you’ll ever do,” but not because of the clients — it’s because of the systemic failures and performative leadership you’ll be expected to endure.

Approach with caution, and know your limits. Passion for patients should never be exploited.

Depends on the shift your working & if you have ever done any kind of work w/ psychiatric patients of the adolescent population. It’s residential treatment for kids basically. Austin oaks and the San Marcos treatment center are sister facilities. That should tell you a lot right there.
 On the plus side, TNC is the mild version of the sister hospitals bc it’s not Acute Psych but equally difficult bc it’s residential. -Acte psych= AUSTIN OAKS= Behavioral & medical(possible) Coding patients all shift/ night. While; Admissions galore are going on while coding. Unsafe ratios often-32patient to do Q15min  rounds on to 1 yes I said ONE…MHT/PCT it’s  Skid row type patients/ Criminally Insane Inmates on the adult sides. The kid side is not any better. Beware of all of that if you’re a female!! So w/ that said —-Residential psych= A little less codes usually once rep-or is developed w/ the kids. No adult psych here anymore. & the adults they do have are on the LTAC/SNF. So if you like medical it’s there for you as well. I’ve had many shifts w/ no codes at all. Full weekends with no behavioral codes or restraints. Ranging from 6yo-16. I don’t think I’ve ever cared for a kid that was 17 unless they were aging out of us and going to TYC or getting adopted/ returning to family members, etc. 
    
    Overall not a bad place to start or finish your career if you don’t mind team work and  can be a hard worker. They do good things for a lot of patients and have for a very long time. They also have taught me a lot about the Neurological aspect of health. 

I spent 2+ years here part-time (only reason I stayed was because of how flexible the schedule was for part timers which is great for school) and I would NOT recommend this job to anyone. Management likes to play favorites and if you get on their bad side you can bet you won’t get scheduled the hours you want (even as a full-time as well). Had to call in one day for a family emergency and I got taken off the schedule for the next 3 days because of it. As for the culture this place is toxic. A lot of division between clicks that lead to patients being hurt in the long run because more emphasis is placed on pettiness between people than on the patients. To top it all off this is a VERY stressful job that can be very dangerous if not properly trained (my instructor during orientation week cut down our training from 40 hours to 30 because she thought “oh I know you guys don’t want to be here let’s do this quickly”). Pay is great for part time and as a part timer you can make your schedule every week however you want but just because you schedule yourself certain days does not guarantee you’ll get them especially if others schedule themselves those days as well and they become overstaffed which will lead to them telling you that you’re not needed that day. On a side note if you’re a full timer and you have to miss work because of an accident or emergency management will pressure you to comeback before you’re ready. I left as soon as I graduated, look somewhere else.

For fourteen years, I worked the 32 hour weekend shift at Texas Neuro, on the adolescent psych/behavioral unit. During that time, I also worked extra shifts during the week on other units, such as children's or RTC. I learned expertise in milieu management and how to integrate the treatment plan into day to day activities. My co-workers and I called ourselves the "Weekend Warriors," as we worked long hours on the least desirable shift (most people want Mon-Fri). I had the same team for almost the entire time I was there, with a few changes periodically.

Management has gone through several changes (and corporate buy-outs) during the time I have been here, but we veterans have weathered the storm. Our first priorities are the patients, who come from all different walks of life, all over the globe. Most have complex diagnoses, such as autism with Pervasive Developmental Disorder and ADHD, including a problem with aggression. The hardest part of the job is also the most enjoyable--that is, helping a patient navigate a challenging world. Even if it is just helping them tie their shoes or to use appropriate coping skills, or teaching them to communicate in the best way to get their meeds met, is an accomplishment for both the patient and the staff.

Assignments were not balanced according to acuity of patients. Nurse may be required to care for a minimum of 5 or more extremely acutely ill patients.Overall organization of the unit medication sytem was extremely poor, takes 1-2 1/2 hours to just gather medications to administer to patients. Company failed to have policy and procedures established prior to acceptance of patients with special needs.ofpatients with Preceptor was knowledgeable regarding patient care but not in student/preceptor interactions. Preceptor had poor ability to allow independent growth of employee. Poor communicatioin of senior management with staff...poor management/staff interaction except with charge nurses and supervisors. Management failed to identify required needs to meet requirements for permanent employment while in orientation and refused to identify any deficiency or allow time to meet their expectations or allow employees to correct deficiencies.

While working at TNC I was promised a lot of improvements to come with the hiring process, cameras on units, security, and quality of care given to the patients. When I left there was an influx of therapists leaving, a turn over of recently hired techs, and cameras on only 2 out of the 4 units. It is an open campus and people go for walks where there are patients all the time. There are patients that are kept even if their insurance has been denied because the higher ups see them as numbers and not kids. The kids make progress then regress because they aren’t able to be placed somewhere else when showing progress. 

It's hard to maintain a positive attitude when most of the other staff are almost always in a bad mood. Some of the patients and families are lovely and make excellent progress which is very rewarding. However, they are all grieving and sometimes family members can express that grief inappropriately and be cruel to the staff and micromanage care. Since this is a long term care facility, it can be emotionally difficult to know how long some families have been in the hospital (sometimes several months and a few more than a year) and some patients don't seem to make progress. It is noble work but burn out is common and obvious.

If you work night shift, know that many patients' families stay in their room with them and become very angry when awakened even though staff are REQUIRED to check on the patients once and hour.

TNC hires young and inexperienced staff to save on money and then teach them incorrectly to benefit their unethical structure. The job and company is talked up in the interview process, just to see what they described and/or promised is not true. This company has a “just get it done by whatever means” mindset without additional support or compensation. Extremely high turnover in all positions. Any reports of staff abuse are overlooked and justified by just moving staff to another unit temporarily. This company will save any cent they can regardless if it is unethical or immoral. The patients are the ones who suffer in the long run. The only benefit of this job is the relationships built with coworkers; built from trauma bonding. PTO and benefits are decent. 

I worked the 18:00-06:30 shift, Tuesday, Wednesday and Thursday
every week.
I had a great opportunity to learn and care for patients with
neural, as well as other co-morbidities.
This presented a great challenge in both learning and caring for
these patients.
Our goal was, when possible, to wean patients from 
ventilator support, oxygen dependence, and ultimately all respiratory
care.
In addition, many times, family members needed to be educated on
the situation their loved ones were dealing with.
They had many questions and concerns that needed to be 
addressed.
It taught me how to become well rounded, and best accomplish my goals as both an RT, as well as helping families understand the
overall situation.
These fore-mentioned situations were what made the job difficult,
but also the most enjoyable.

Top Job Titles	Average Salary
Registered nurse 8 salaries reported	$39.75 per hour
Patient care technician 3 salaries reported	$18.00 per hour

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