Offered "ADON2" if I'll stay...what do I do?

Nurses General Nursing

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I recently posted about my plight about leaving the nursing home and going to work at an extended care hospital.

The idea was that I would get hospital experience (which I've never had) but I've been told by some that LTAC will not be hospital experience even if they call themselves a hospital (???)

The nursing home has been trying to get me to stay, and I was recently told the ADON wanted to cut her hours and they would like to put me in her position when she is not there (a couple of days a week.) I went in today and she showed me some of the ropes and all, but I still don't feel very useful, though I don't know if that would improve as I learned more about what she does. I don't want to just be there shuffling papers so I can have a job. I still am not quite sure about what the future would hold for me at the nursing home. I'm planning to start a FNP program soon and the DON (who is planning to go through the same program) keeps telling me I have a much better opportunity there and they will work with me while I'm in school which is something "that hospital" won't do (but how do they know?)

Anyway, it has come down to the wire. I am supposed to start orientation at the hospital Monday, but if I'm going to stay at the nursing home...anyway, I need to make a decision soon. I understand I won't need hospital experience to become a FNP (I'm thinking I would like to start out with primary care, maybe stay doing that for my whole career).

I need your help. The anxiety is eating my brain.

Nursing home pros:

It's a familiar environment

I like the people I work with, I love the patients

They (right now) are willing to be flexible with my schedule

slow pace (much of the time)

NH cons:

four 8 hr shifts a week (instead of 3 12's like at the hospital)

working the floor is boring

afraid I'll be a pencil pusher

pace is too slow (much of the time)

LTAC hospital: I don't know what the sam hill to expect...

Specializes in Education, FP, LNC, Forensics, ED, OB.

Have a safe trip. Be careful.

Specializes in ICU.
Not sure where they've gotten their LTAC experience from, or how old the experience is. But I've worked in three different LTAC's in Houston TX, and each of them I worked in the ICU. The ONLY time we transferred someone out of this ICU is when they needed surgery.

They can be critical and knocking on death's door, but if they don't need surgery, they are not going anywhere. Even when they do have the surgery, the patient is brought back in less than 24 hours. This is because of billing and money of course. If the patient stays more than 24 hours at another hospital, money is lost by the LTAC.

I don't know what else to say, other than,,, maybe they have worked at a *different* kind of ltac.. lol ...

edit: when I say surgery, I mean major surgery. Bronch's, peg insertions, trach's, wound care debredment, and procedures like these are performed at the bedside, with the surgeon and ICU nurse of course.

I just have to add a little more.... Patients in LTAC ICU's can be very unstable. I have managed several critical care drips on a patient being ventilated, on dialysis, upper and lower GI bleeding, all at the same time... It happens. The LTAC's that I've worked at will do whatever they can to keep the patient there,, they do not like to transfer the patient's out. It has to be a severe or extreme circumstance. When transferred for surgery, like I said, they will come back within 24 hours, unless there is a major conflict with the doctors, or the patient dies before coming back.

I can remember twice that a patient was transferred out and didn't come back within 24 hours. Once was a 40 year old woman who had severe abd bleeding,, she went out for an exploratory lap to figure out where the bleed was and fix it,,, she expired during surgery. The other one was transferred to the VA medical center,, well, because he was a veteran and the family requested it. All of the other transfers were NOT because the patient became critical, but because it was their time to go.. go wherever they're suppose to be going after they're done with ltac. :)

Specializes in ICU.

It is true, you won't get any pediatric experience in an ltac. If that's what you're looking for... don't go to ltac.

I know it's hard. Believe me.

You just have to weigh the short-term and long-term pros and cons. Write them down. Study them for a little while. What is it you are wanting to do in the long run? As an FNP........future goals contemplating CRNA?

Love the Bob Seger song quote. You truly have a fire inside, don't you??

I sure wish I had more time to think about it. I've got to go!

I thought that Bob Seger quote would add levity but when you think about the words they're really sad...

oh well, you can see me in my little spud-mobile passing through Memphis about 5:30am, I guess...just don't step on my blue suede crocs.

It is true, you won't get any pediatric experience in an ltac. If that's what you're looking for... don't go to ltac.

I love children but seeing sick ones is so painful. I can deal with death in older people, but not little ones. The program I am in the process of getting into only has the FNP concentration.

Specializes in Education, FP, LNC, Forensics, ED, OB.

oh well, you can see me in my little spud-mobile passing through Memphis about 5:30am, I guess...just don't step on my blue suede crocs.

hhahahaha

Be careful there now.

Specializes in ICU.

Jo,

Try this. It works for me. Take out a coin. Heads you go, tails you stay. Flip said coin. Is it heads or tails?

Now is the important part: What was your immediate emotional reaction? Were you disappointed by the result? Excited? Wanted to flip again? Wanted best 2 out of 3?

It doesn't really help you weigh the merits of the choices, but it might help you sort out your feelings.

Best of luck deciding.

Specializes in ICU.

Jo,

Try this. It works for me. Take out a coin. Heads you go, tails you stay. Flip said coin. Is it heads or tails?

Now is the important part: What was your immediate emotional reaction? Were you disappointed by the result? Excited? Wanted to flip again? Wanted best 2 out of 3?

It doesn't really help you weigh the merits of the choices, but it might help you sort out your feelings.

Best of luck deciding.

Well, I blew it. I didn't go. I felt the cards were stacked against me. I sent a corny email to the CNO apologizing. So, I'm here, stuck in the same rut, going nowhere, amounting to nothing.

And I hate my husband (and Bob.)

Specializes in Psych, LTC, Acute Care.
Well, I blew it. I didn't go. I felt the cards were stacked against me. I sent a corny email to the CNO apologizing. So, I'm here, stuck in the same rut, going nowhere, amounting to nothing.

And I hate my husband (and Bob.)

Sounds like your disappointed with your decision. I too was in your position but my boss was very understanding of my decision and did not put pressure on me. I was a floor nurse at my LTC. I started as a LPN and just got my RN. I got a job in the hospital (no weekends) three 12's. I could not pass it up. My LTC wanted me to take a nurse supervior position and manage Med Aides. I was flattered but told them no thanks and stuck with my decision. My boss told me that they would welcome me back fulltime if I ever decided to come back. She also said that she wanted me to take the Staff Development Job when it comes open in the future. The lady is almost 70 and she will retire but she is not sure when.I told her I would consider it. I plan to work PRN. Hope it all works out in the end. Good luck with your new duties!

Sounds like your disappointed with your decision. I too was in your position but my boss was very understanding of my decision and did not put pressure on me. I was a floor nurse at my LTC. I started as a LPN and just got my RN. I got a job in the hospital (no weekends) three 12's. I could not pass it up. My LTC wanted me to take a nurse supervior position and manage Med Aides. I was flattered but told them no thanks and stuck with my decision. My boss told me that they would welcome me back fulltime if I ever decided to come back. She also said that she wanted me to take the Staff Development Job when it comes open in the future. The lady is almost 70 and she will retire but she is not sure when.I told her I would consider it. I plan to work PRN. Hope it all works out in the end. Good luck with your new duties!

I'm anything but flattered. All I can see that I will do is shuffle papers around for a few hours.

I wish I knew if that hospital job I just passed up was no weekends. I know they charge almost $400/month for their daycare for nursing staff. I was assuming I would have to find coverage on the weekends.

I wish I could have discovered this before I let the job go, but I wasn't aware no weekends was an option.

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