Hospitals vs LTC - Same dynamics?

[Scottishtape]

Hey all

As an LPN, I've spent the majority of my career in LTC. Now that I'm about to graduate and embark upon hospital work, I'm left wondering if I'll run into the same issues.

In the LTC places I've worked, they have been ....not above board .. when it comes to rules. Example: covering up wounds so they won't get tags, trying to get nurses to false document for billing purposes, convincing residents to not report abuse incidents, etc. (Yes, I have actually reported a few of these - I reported the abuse and the wounds).

I can't handle that, which is why I ended up leaving that area. Do hospitals do the same thing? I'm so excited to move onto hospital nursing, but I'm worried I'll run into the same thing and have to leave.

In your experience, how often do hospitals do skeezy things? And, when they do happen, is it more of a small hospital issue, rather than a large hospital issue?

Any insight is appreciated!

[mmc51264, BSN, MSN, RN]

Not that I have seen. I too worked in LTC and was forever going to QC for finding stuff. I was not so very popular.

I may be naive, but where I am, we actually look for ways to avoid the bad stuff, not hide it. I am sure stuff goes on, but I don't think at the level that it can at a LTC.

[Scottishtape]

Thank you for your reply.

I'm ready to try and find my nursing "forever home", if you will, and pray I'm finally going to get athrough at from th skeeze. I'm sure not all LTCs are like that, but sadly, every one I've worked at has had that to some degree.

What kind of issues are common for staff nurses in the hospital environment?

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Most all hospitals are electronic, from medications to documentation. It's very hard if not impossible to cover up anything. The culture of the hospital will be a major factor in your happiness or success in acute care.

The hospital I work in knows that mistakes happen because humans are involved. But the focus is on how did it happen and what needs to be done to prevent future occurrences. There has to be blatant negligence and abuse going on in order for punitive actions to occur. But you can be let go if it is determined for other reasons that you're just not a good fit...such as attitude, unprofessional behavior, etc..

Staffing is the biggest problem at our hospital, just like most places; but it's not our only problem...just like most places. However, in LTC, there is just too much complacency and territorialism.

Acute care nurses do not have the same issues as nurses transitioning into acute care...although we all did at one point. You'll be learning acute care and trying to get the feel for a new environment and colleagues. What I do when floating to unfamiliar units is to always start my countdown announcement when I arrive just to break the ice: "Hey guys! In 12 hours and 15 minutes, we are outta here! Who's with me?" Works every time. After that announcement, I go off to do my job, only talking to them if either of us needs something...can't help it; I'm an introvert by nature. But, at least I've let them know that I'm approachable and will be approaching them at some point before I get off.

Ask for help when you need it, and offer it in return where you can especially if there are elderly patients (your familiar territory) on the floor. Trade-outs work wonders if it's not used to 'get out' of doing something.

[Scottishtape]

Thanks for your input BSN, it definitely puts me more at ease, and increases my excitement in switching areas.

I'll be looking into the new grad residency programs at the two main hospital systems here and hoping for the best!