LTC? or Hospital?

Nurses General Nursing

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Specializes in LTC, Med/Surg, Home Health.

I've had my RN now for a little over a year. Prior to that I was an LPN for seven years. I have only worked in LTC and have always wanted to try out the hospital. Which was one of my primary reasons for going back and getting my RN. Problem is I am thinking and currently :redbeathetrying to get job in hospital. I am burnt out in LTC. I am tired of seeing little elderly patients being pushed past the point of mother nature. The dynamics of the LTC has really burnt me out. Case scenario :you have a little old man who is in his last days and family members who want DADDY to live and be stuck like a pin cushion such as going to dialysis Three times weekly and who also has a stage 3 on his coccyx and wound vac to boot. Poor man! Then you have your boss breathing down your neck d/t the same patient not eating and your boss wanting you to call the family to ask do they want a GI referal for a G-tube placement. Not to mention you get pulled to work a med cart while you are also expected to play charge nurse simultaneously for 100 patients. :nurse:I have spoken with some nurses who work at hospital who say it is much different that you actually get to take care of patient. So any input from hospital nurses or nurses who have crossed from LTC to Hospital nursing and honest opinions/experiences! Would be greatly appreciated!

I left LTC after 5 years when I went from LPN to RN. I now work on an acute stroke unit, but we get a lot of medical patients too. I found that I had an advantage because I had great organizational skills from LTC - and lets not forget the heavy med pass. The biggest learning issues for me were IV skills and learning that I was the RN and had to take charge of issues. I love my job and find it much easier than where I came from.

Specializes in Psych (25 years), Medical (15 years).

msrosebud28:

It's easy to empathisize with you. Pushing lives past Mother nature's expiration date can be difficult. Doing things one doesn't believe in can be taxing. Too bad they don't pay us for following our beliefs.

But they don't. As Nurses, we provide our services according to our professional guidelines, the tenets of the institution, our culture and society, or those who are in control of the destiny of the individual. We don't have to like it. We only have to do it.

Whether Hospital or LTC, there always may be some stipulation we may not agree with. However, we are always free to change our perception.

Dave

I'm also burnt out with LTC, and I'm really interested of being in an acute care setting..looking forward for more inputs.. :)

I have been both a DON in SNFs and a Nurse Manager in hospitals (Med/Surg/Tele, Rehab, and Adult Psych). I have always said you could take a LTC nurse and place her / him in a hospital setting and they will survive. The reverse is not always true. LTC nurses are now hanging IVs (not blood) with IV certifications for LPNs under RN supervision, doing wound care, passing meds but for 20 instead of 6 - 8, working with wound vacs, chest tubes, trachs, vents depending on the facility, etc. Hospital nurses, while doing the same, have less patients ~ they are more critical when they have them though. HOWEVER, they are also doing more prep work for testing, post surgical patients just after the procedure instead of a week later, and need to cope with the doc's making rounds all of the time. LTC doctors come to the facility less frequently (it's usually a PA or ARNP) but the burden of decision to call or don't call a doc at 2 a.m. is on the nurse because there are no doctors hanging out (when in doubt, for heaven's sake CALL ~ who cares if they knock your head off as long as the patient is safe?). Either way it is a catch 22....hospistals offer more opportunity for change if you get burned out in one area and you are able to transfer to another area. LTC stays much the same facility to facility, floor to floor. No matter what you do, it takes an enormous amount of courage to just get out of bed and go to work, the responsibility placed on us as professionals is much greater than we will ever be given credit for. After all, the doctor is the one who does everything, right?

Specializes in LTC, Med-SURG,STICU.

I have been a staff nurse in a LTC for the past three years. Your story sounds very much like my own. I was completly burnt out from the whole LTC thing. Keeping someone's love one alive well past the time that the resident was ready to pass away. The whole med passes from heck. Really I must ask when is a 92 year old dementia resident that can no longer remember anyone or anything still on 3 multivitamins and 15 other pills just in the morning alone. Sorry if it seems judgemental to you all, but this person has no quaility of life what so ever. However the family insist that everything must be done to keep this person alive for the next however many years. Sad thing to see.

I recently obtained a hospital position and I LOVE IT. You still see the 92 year old dementia pt that should have been allowed to go years ago, but not as often. I feel like a real nurse again, not the messager for the family. I now enjoy being a nurse again.

As far as the work load it is great. There are a few things that I have to brush up on, but all in all it is great. I feel that I am adjusting very well. I do stay just as busy with my pt load in a hospital as I do with my LTC load.

If you have any questions feel free to contact me and I will help you anyway that I am able. Good luck with the job search and do not give up.

Specializes in LTC, Med/Surg, Home Health.

Thanks everyone! Dave you are right, but in LTC you become more aquainted with the patients which causes some emotional attachment. I do not think it would be the same in a hospital setting. And as nurses we are also patient advocates. Either way I do not believe that I will be satisfied until I gain Hospital employment. I have given case manager a thought in my future and all of those jobs require hospital or home health experience. But thank you everyone for your input!8+)

Specializes in LTC, Med/Surg, Home Health.

Got a job offer for a med-surge floor ! It's 3rd shift but ya gotta start somewhere! Even though I am not a brand new grad I am new to the hospital. So they are giving me a 10 week orientation!WOO HOO! Hope I am making the right decision!

Of course you made the right decision ~ you've got a job!!! WAHOO and good for you! Congrats and good luck. Midnight's aren't that bad really, it's how I got started and it's kind of nice to have the pace slow down (a little but not a lot), especially when you're learning the ropes. Have fun not having the doc's hang around all day long (you'll still be there for the a.m. rounds but you'll hardly notice 'em!). Let us know how it goes!

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