Most challenging nursing department

Here.I.Stand, BSN, RN · Jul 1, 2014

LTAC=long term ACUTE care (hospital care); LTC=long term care...did you mean long term care? I agree! One of my grandpas lived in skilled/LTC for the last two years of his life. Those nurses saved his life several times. He'd been incredibly healthy but at age 102 fell and got some compression fractures, and he never really recovered. He had several bouts of pneumonia and acute renal failure, and those nurses knew him so well that they were able to spot immediately when something was wrong. My mom is the type to downplay everything, so I believe that had he been in his own home those subtle cues would have been missed until it was too late. But his nurses got him transferred quickly, and then cared for him again when he was released from the hospital. We were amazed how many times he recovered, and ended up living another 2 years of quality life. He'd become confused but enjoyed life, enjoyed his great-grandkids and even lived to meet the then-youngest one. My 3rd child remembers him, and my 4th has pictures of him holding her has a newborn. My older 3 kids got to play catch with him, read to him, and enjoy his famous hugs. :inlove:

My hat's off to geriatric nurses!! :nurse:

But, as an observer, I have the highest admiration for the nurses in the SNF, LTAC or homes (if those acronyms are correctly used in that context).

invisiblewounds · Jul 1, 2014

I'm currently at an LTAC facility for a clinical rotation and I HATE it. By far my least favorite clinical site. Kudos to the staff who go in day after day after day...

For me, by FAR the hardest I've ever worked--mentally and physically--in 5 yrs as a CNA, nursing school, and 11 yrs as an RN combined, was LTAC. Long-term acute care. It's the challenges of med-surg, ICU, and psych on steroids (and subsequently developing new onset Type 2 DM.)
Picture 3 ICU patients with drips and on vents, even the occasional LVAD. Floor pts on vents and tele. Dressing changes that could take upwards of 2 hours, which are done by yourself unless they happen to be on the WOCN's schedule that day. To illustrate, my current hospital has a burn unit in which all dressing changes are done by an RN/LPN/CNA team. That same pt, when typical hospital covered days ran out, would be transferred to my former LTACH. Now, his/her same burns are cared for and dressed by the RN alone. New DM, sepsis, delirium. Pts and families who were completely mentally worn out from months-long hospitalizations.
I've worked med-surg, worked with peds pulmonary pts who had aged out of peds (think CF, PPH) neuro, SICU/CVICU with fresh heart/lung/liver transplants and all manner of brain surgery, now I work SICU with all manner of trauma and neuro (although more TBI and hypertensive bleeds than my old one which had more tumor excisions), I've worked the rehab floor in an SNF, LTC as a CNA...
I have never in my life worked like I did in LTACH. But I'll tell you, when I had a good day it was a GREAT day!! When that pt was FINALLY well enough to leave and go to a SNF or even home, that was a GREAT day. When we saw their wounds healing, and they expressed gratitude for our care, it was a GREAT day. When a pt was able to come off the vent for the first time in months, it was a GREAT day. :)

"I've saved some sunlight if you should ever need a place away from darkness where your mind can feed." - Rod McKuen

ClearBlueOctoberSky · Jul 1, 2014

Hmm. I work LTC. I started on the Secured a Neighborhood, first as PT Nights, then as a Day Charge. I then moved to Restorative a Nursing, I am now UM and SDC. I literally shake in my boots when I have to cover the LTC Neighborhoods. I would rather be back on the a secured a Neighborhood. Same number of patients, different dynamics, and I get discombobulated!

eagle78 · Jul 1, 2014

LTAC=long term ACUTE care (hospital care); LTC=long term care...did you mean long term care?

Yes I did, thank you for clarifying for me. The acronyms always, always through me... :facepalm: