Which one is more stressful: med-surg or LTC

[ijuanabhappy]

I just started a job at a LTC and do not want to go back. I'm an inexperienced RN and got hired on to do weekends only; two sixteen hour shifts back to back. I absolutely love the residents but this job for a relatively new grad seems dangerous to me. I only got three days of following someone around before I started on my own. It was crazy. I had a hall of 30 patients on my own. All weekend I didn't even get around to the mountains of paperwork because number one I didn't have a moment to sit down and number two, I didn't know how to do the paperwork. There were so many things going on at once and I didn't know what to do.

There was a patient actively in the dying process, a lady needing an immediate suppository while her overbearing family was following me around, asking when I would tend to her. I was drawing up insulin while this all occurred. For most of the night I had to keep a close eye on a lady who kept getting up and walking with her IV pole despite being dizzy and told she would fall. I went in to check on her and she was standing by her bed with her head hanging down. As soon as I walked behind her, her whole body weight collapsed on me and with one arm I lowered her to the floor and tried to keep the IV pole from falling with the other. The IV pole bonked me on the forehead, but I managed to keep her from hitting anything as I lowered her to the floor. I called out the hall for help and not a peep from anyone. The other nurses were in their own halls which were far away. No paperwork got completed this night and I felt so completely stressed and scattered. I was asked to pronounce someone's death since I was the only RN in the building. I told them I didn't know the protocol and could someone direct me.. (didn't realize it was as simple as feeling for pulse, listening to heart with stethoscope and calling a time)... but I got major attitude that I am an RN and should have learned this in school.

I interviewed today for a med-surg position at a hospital. I have read on this forum that LTC is less stressful than the hospital. After this weekend, if med-surg is more stressful than what I experienced... maybe I am just not cut out for nursing.

[WickedRedRN, BSN, RN]

Worked in both and hands down I would choose med-surg over LTC any day. MS in a hospital generally tends to give you a better new nurse orientation imho. Don't get me wrong, it is stressful, but it's a different kind of stress.

[nursingcares, RN]

Where I'm at the facility has to give you a death pronouncing class before you can pronounce!! I wouldn't have done it if I were you- I would have told the supervisor they needed to call in someone who was qualified. Let them figure it out it's not your responsibility! I work LTC and it gets better..I'm still trying to get a medsurg job and I'm nervous as all get out that I will have forgotten many things since LTC is so different.

[SWiseRN]

I'm just starting out in LTC myself, and I find it very stressful. I'm not opposed to a little stress and adrenaline, but I too don't know if this is something I can do for much longer. I'm still within my orientation period, so I haven't been "cut-loose" yet. I'm also very fortunate to have a much longer orientation than most new grads at other facilities. However, I can already tell that this isn't something I can keep doing. I didn't go to school to just pass meds to 35 patients constantly throughout the day. Luckily I landed an interview for an adult day care and I'm very excited about it. It's still within the population group that I'd like to be in, but it'll obviously be a little less stressful. If I get hired, I'd like to go PRN with the nursing home (although I'd like to just leave altogether!) My advice to you would be to go to med-surge. Yes, it will be stressful but I think you'll gain more experience. Good luck with whatever you do and please strive to be happy!

[steelcityrn, RN]

I would vote med surg due its ever changing events that can take place. At least when its LTC, you are used to the patient and families.

[nurseprnRN, BSN, RN]

regardless of what specialty you choose in the long run, you definitely need to get out of that unit now. its staffing is not safe, a/e/b nobody to respond to you in an emergency, and by staffing two sixteen-hour shifts back to back with a new grad (not that this would be safe with florence her own self).

you need back-up at this point in your career. go to the med/surg floor, learn a lot from the other nurses there, and revel in the luxury of having actual physicians and nps around when you need them. (slight sarcasm here, but it's a dang sight better than having nobody).

and about getting cracked in the head with the iv pole, be sure you report that in writing to the institution's risk manager-- i can promise you they have one who will be interested in hearing the circumstances. give it to them with complete detail. send it certified mail so you get a card back indicating who signed for it. that lets them know you're serious. if you have a buddy or a cousin who is an attorney, send it on the office stationery. that will really get their attention.

[ijuanabhappy, ASN, RN]

I didn't get the med-surg position that I interviewed for yesterday.

I'm so depressed now. I cannot go back to the LTC job. I love, love, love the residents but that place is not run properly and I can't risk losing my license. I've been out of school for a year with no decent experience except for clinic phone triage. Who will hire me now? I've probably forgotten most of the information that I learned in school by now. I have one more interview for a pediatric home health position on Monday. Really wish there was some way I could get into a public health type position without that year of floor experience.

[Karl Farmer]

HH is unstable. You fill out paperwork mostly, and waste gas and time driving. Sad it has come to this despair for nurses. But in LTC they will throw you under the bus first mistake you make. And public health jobs are being slashed.

[Leelee2]

16 hour shifts in LTC, very little job training....RUN to med-surg!!

[pale_pilsen]

Med-surg is no better than working in LTC. Yeah, its a different kind of stress, but in reality, im telling you right now, based on what ive experience, ran away from both LTC and med-surg as far as you can! Find a nursing job as a hemodialysis nurse, OR nurse, or home health nurse and you will thank me one day (if you can get a job in these field..then goodluck). The reason why I tell you this is simple, nursing jobs in these kind of specialty are HARD TO GET into because nobody wants to quit because they like their job. Unlike in most med-surg or LTC where they have a low nurse retention rate. Also be aware of nursing jobs that hires new grads in and out because more likely, workers are unhappy and workload is unbearable. I suggest volunteer first in the med-surg floor in your local hospital to see what is like. I think most med-surg floors are the same. Like what they say, seeing is believing. If someone would have told me this advice before, i would have had a different perspective about nursing. At least now you've been WARNED.

[diva rn, BSN, RN]

I didn't get the med-surg position that I interviewed for yesterday.

I'm so depressed now. I cannot go back to the LTC job. I love, love, love the residents but that place is not run properly and I can't risk losing my license. I've been out of school for a year with no decent experience except for clinic phone triage. Who will hire me now? I've probably forgotten most of the information that I learned in school by now. I have one more interview for a pediatric home health position on Monday. Really wish there was some way I could get into a public health type position without that year of floor experience.

The pediatric HH position may require home vent experience so I am just preparing you for that. Also, they should require Peds experience..if it's a good agency they will. PICU was my specialty and kids are different. They aren't just little adults. I'm not trying to be negative--just letting you know what to expect.

How about school nursing? I don't know how it is done in your state/county. I did this for 2 years, and it's a riot! THe kids are great, the hours are great..the pay is so-so but you get all of the holidays off and the summers. NO stress at all. I have done virtually all areas of nursing..and I have been trying to think of areas for you that are less stressful. Medsurg is less than LTC...get out of that one NOW. I loved Hospice..that was actually not that stressful...home health is not stressful..but all of the home health agencies I think are going to want some experience but your LTC should count for that. Home Health can be nice. Your time is your own. You can drive around and do errands and the people are nice and usually appreciative. The cost of gas is a problem now. BUt maybe you could do that until you find something else..I have friends doing dialysis and they seem to like it. How about that?

Good Luck...

[happy place]

Better question after reading these posts:

Where are you least likely to lose your license?