Any advice on how to transition from LTC to acute care/ICU?

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    Long story short, I graduated May 2012 with my ADN. I was licensed last September. After almost 8 months of applying to hundreds of hospital positions, I gave up and decided to branch out to local LTC facilities. I was able to land a job last month in LTC.

    So far, my experience has been pretty HORRIBLE. Critical supplies (alcohol pads, med cups, blood pressure cuffs) are always in short supply or just nonexistent. I work 11p-7a part time so I'm responsible for medicating, documentation, treatments, etc... For almost 50 residents. There are at least 8 PEGs and accu checks. Everything is still paper, the environment and culture is very punitive as well. Even tho there are other nurses in the building, I'm usually the only other RN besides the supervisor. I feel like every shift I walk into this place, I'm risking my license.

    Although my experience is bad, I have picked up valuable skills during this timeframe. I have always wanted to do ICU nursing since I started nursing school. I did work in a hospital for about a year as a tech on a ICU/PCU floor but when they hired new nurses, I was not chosen. At the time that resigned (because I found employment as an RN), I was told I was eligible for rehire. I've revamped my résumé to include the skills I've learned from working this job.

    Is there any other advice you guys can give me to help me in my situation? I want to get out of this facility so badly, but unfortunately, it's my only source of income. Questions and comments appreciated.
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  4. 10 Comments so far...

  5. 0
    When I graduated with my LPN, I went to work in LTC. Initially I worked in the skilled wing, but due to low census, management told me in order get hours, I'd have to be willing to work the nursing home side too. It.was.terrifying. I had little confidence in my new nursing skills, and the workload of 30+ residents and supervising CNAs, I was ready to run. I can honestly say i cried in my car on way home most days the first three months, and I prayed that I would survive. The more I worked, the more I was able to develop a plan of action, which made this go smoother. Sure there were plenty of sh-tty days, but I learned a hell of a lot. It got easier too once I got to know the residents and their routine.

    I say give it 90 days, but look into other options, not all LTCs are the same. Maybe a different shift would work better for you. Hang in there.
  6. 0
    Trying my best to do that. I forgot to mention that I'm currently enrolled in an RN-BSN program as well.
  7. 1
    If you're interested in ICU, you should look for acute care or med surg positions and then take a critical care nursing course along with ACLS and PALS.
    MsDiva812 likes this.
  8. 0
    Quote from joanna73
    If you're interested in ICU, you should look for acute care or med surg positions and then take a critical care nursing course along with ACLS and PALS.
    I am interested in these courses, but they also cost hundreds of dollars as well. Since I work part time, it would be very hard to pay for these courses along with the rest of my expenses, but I see what you're trying to say.
  9. 0
    I sorta doubt that you would get hired right out of LTC into ICU, but the hospital I work at hires people into med surg/tele after they have a year of LTC. The ICU asks that you have strong med-surg/tele experience. I'd advise going for one of those types of positions first - they can teach you a lot plus it sounds like you already have a lot on your plate!
  10. 0
    I think that LTC/skilled nursing is very valuable experience. I started as an LPN in the facility I worked in as a CNA as the only nurse in a 60 bed facility on nights full time and it was terrifying. When I got my RN I worked in subacute rehab doing weekend option for a year, then started in a hospital on medsurg/Ortho for a year. Then I was hired into critical care at the same hospital, which is where I am now. Don't give up.
  11. 0
    I have to add that since leaving the subacute rehab setting, each job has been progressively easier. More resources, more support.
  12. 0
    That's one of the main reasons I want to leave this particular facility and LTC. I know a hospital environment would suit me better cause there's more support and resources needed to do your job as well as the infrastructure to develop you personally and professionally. That doesn't exist in the facility I work at. If anything, I believe I'll stagnate very soon.
  13. 1
    Unfortunately life in the LTC setting is just like that. I work short staffed with a lack of equipment every day. Stick it out though. I bet in three months you'll be way more comfortable in your position. It is extremely hard to get into the acute setting with out experience, at least in California. If you really want to get in to acute nursing, consider getting a license in a compact state. I have friends who moved to TX and AZ right after school and were picked up by hospitals.

    Good luck.
    MsDiva812 likes this.


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