Is LTC a predictor of the kind of nurse you will be in a hospital setting?

[SaltySarcasticSally, LPN, RN]

I am a LPN with 8 years experience, soon to be graduating from RN school in April. Most of my LPN experience has been spent in a variety of clinical settings where, without sounding cocky I hope, I have gotten quite good and excelled at a variety of tasks and abilities, I now make a good wage per hour for a clinic job in my area due to that experience.

I have recently returned to the clinic world after spending a year or so in LTC. I worked 2 years as an aide in LTC, 6 months in my first LPN job, then went to clinics after that.

I went back last year A) for the flexible/PRN and B) to strengthen my skills/critical thinking to hopefully make my transition to a hospital environment more seamless when I hopefully pass NCELX-RN in the summer.

I had gained a lot of confidence with excelling in the clinic world, LTC knocked me right back to new grad level confidence. Granted, I was PRN so I wasn't there more than a few times a month so I never got a firm daily routine down but I feel like with 8 years of experience I should have took off running.

I didn't make any mistakes, good reviews from my DON, no patient complaints, co-workers seemed to like me, but I really struggled with the patient load which makes me nervous I will not excel in the hospital environment.

We were a two nurse/shift facility so your on your own mostly but I often left feeling like I was overwhelmed, not doing enough, and only had enough time to get all the essentials done - it made me feel like crap quite frankly. I had 18 LTC beds and 7 rehab beds. The rehab beds were not what they were like 8 years ago, they are now PICC lines, g tubes, IVs, wounds, and full codes our facility was not equipped to handle. I am confident in doing the skills those patients needed but everything together was just purely a task in doing the most in the fastest/safest way you could.

I don't want to leave my current clinic job, where I can advance on as an RN, for a hospital because if I don't feel like I can "make it" in LTC, how will I possibly make it in a hospital? I do have clinical in the hospital of course but you only know/experience so much as a student. I definitely want to work in a hospital but just trying to evaluate if I would be a good fit.

Any thoughts or experiences from those who have gone from LTC to the hospital?

[LoveMyBugs, BSN, CNA, RN]

I went from a SNF to now working pediatric ED. SNF/LTC nursing is so much different than acute and critical care.

There is much more resources and people to back you up in a hospital than LTC.

Like you said LTC you are it and on your own. Hospitals there is more of a team environment.

[caliotter3]

On the surface, I agree with what you say in your post OP. However, I think that you are selling yourself short on your appraisal of your abilities because you have not really given yourself enough leeway for the fact that you have been PRN at the facility. If you had been employed there on a full time basis, your outlook would be different.

[ED_Murse]

Agree with what was said in the first post. Don't sell yourself short - your current workload sounds very streasful! In acute setting you will have more support, both nursing and medical.

[purplegal]

On the flipside, I've gone from a hospital job to working in a SNF. I'm doing much better at my second job. In my experience, I found that my coworkers at my SNF are more supportive, more willing to help out and less critical. So, some of it depends on which facility and which hospital unit you work on. Therefore, I don't really think you can base your performance at one job to what it will be at another job. You may very well do well in acute care.

[VANurse2010]

The workload in a hospital is typically much less than in LTC. Your material and human resources will also be much more abundant.

[HeySis, BSN, RN]

I don't believe that your part time LTC stint is a good predictor of how well you'll do somewhere else. The first several months, even up to a year, in an acute care setting can be a bit overwhelming. And that is working full time. If you work less it'll take longer. I wouldn't give up on what you want to do, just keep plowing ahead and take time after each shift to see the small improvements. One day you'll look back and wonder why you ever doubted yourself.

[SaltySarcasticSally, LPN, RN]

Thank you for the comments, useful experiences to hear. I do get to do a one on one capstone of sorts with a hospital nurse at the end of my program so I am hoping that will shed some more light on whether or not I can survive AND thrive in a hospital setting.