So is hospital nursing better than long term care?

ERRNTraveler, RN · Jun 29, 2007

I am a fairly new - licensed last june, in fact - LPN. I'm now in my second position.
This place has the following nurse pick up and document any med errors. Well, I'm fine on my own unit but when I go to a unit of 30 - 40 people where I haven't popped meds in three weeks I inevitably make a couple of errors of neglect.
I. hate. meds. I hate having 30 - 40 people who all want something and I have to rush past them. I hate having to ASK if I can hold a freaking colace or give an Ativan to someone about to smack an aide and elope through the front door. I hate the smarmy social workers who actually think they're doing something good for these poor folks in God's waiting room. I hate nurses tattling on one another per facility policy on missed meds. I hate it. I do love my residents. Passionately.
Is there anything better? I'm pursuing my RN, but will it matter?

1. If you hate giving meds, you might hate being an RN, because then you'll not only be passing pills, but giving IV meds as well.

2. If you notice that another nurse missed a med or made an error, it is not only your facilitiy's policy (as you stated), but it is the PROPER THING TO DO to report it. Not saying anything when you discover an error is WRONG, and makes you just as much to blame as the person who made the error.

3. If you are "inevitably making a couple errors of neglect" every time you pass meds on another unit, you might want to seriously consider another line of work. Sorry if this sounds harsh, but any nurse who is making that many med errors on a regular basis is a danger to his/her patients, especially if you then become upset at your co-workers for discovering & reporting these errors.

SuesquatchRN, BSN, RN · Jun 29, 2007

I suspected I'm in the wrong line of work.

NeosynephRN · Jun 29, 2007

Wow...that seemed a little harsh. OK I have never been a nurse in LTC..but I can see why you would hate meds there...I mean that would take up sooooo much of your time, you probably do not get to spend much with the patients/residents. Sure in hospital nursing includes passing meds...I had no doubt that you knew that...but you also have many other things to do...like full assessments, which you probably do not do much of at the LTC. I think it is probably very different, and like I said I have never worked LTC. But maybe try out a hospital job, and see what you think...

SuesquatchRN, BSN, RN · Jun 29, 2007

Wow...that seemed a little harsh. OK I have never been a nurse in LTC..but I can see why you would hate meds there...I mean that would take up sooooo much of your time, you probably do not get to spend much with the patients/residents. Sure in hospital nursing includes passing meds...I had no doubt that you knew that...but you also have many other things to do...like full assessments, which you probably do not do much of at the LTC. I think it is probably very different, and like I said I have never worked LTC. But maybe try out a hospital job, and see what you think...

Thanks, Calla. Very much. I'm pretty whipped today and I needed the encouragement.

TazziRN, RN · Jun 29, 2007

Sue, it's not that hospital nursing is "better" than LTC, but just as nurses need to find their niche within the different acute-care specialties, all nurses need to find their niche within nursing. The reasons you listed are the reasons I will not work LTC unless I had absolutely no choice, because I would not like having to divide my attentions amongst 40 pts per shift, always wondering if the problems that occured that shift could have been avoided had I been on top of things. I don't think it's passing meds that you hate, but the sheer volume of meds per shift because of the sheer number of pts you have. Even in states without mandated ratios acute care nurses will not have that many pts at one time.

From what little I've read of you on here, I think you're a good nurse, you just need to find your "spot". Go apply at an acute care facility or a clinic. I think you'll be surprised at the difference. Or go to home health. After 19 years of ER chaos, the flexibility of home health is very attractive to me and I'm trying that now. It's been a week and from what I've seen so far, I think I'm gonna love it.

Hang in there, do not give up. There are so many opportunities in nursing that you really need to try different areas before you decide you made a mistake.

SuesquatchRN, BSN, RN · Jun 29, 2007

From what little I've read of you on here, I think you're a good nurse, you just need to find your "spot".
.....
Hang in there, do not give up. There are so many opportunities in nursing that you really need to try different areas before you decide you made a mistake.

Tazzi, thank you more than I can say. I just came in from a lo---ong run, the first I've taken in a long time, read your post, and started to cry.

Thank you.

UM Review RN, ASN, RN · Jun 29, 2007

:icon_hug::icon_hug::icon_hug: Sue, a lot of the problems you're encountering are inherent to LTC facilities, which is why I choose not to work in them any longer. Just cannot deal with the politics and the understaffing that creates workloads that are too much for one person.

Depending on the hospital, you have way more choice, education, training, and opportunity in a hospital setting.

Pick a good hospital and you'll get the orientation, mentoring, and experience that you are lacking at this facility.

I agree that you are a good nurse who has the potential to be an excellent nurse. More than because you care, it's because you have actively tried to improve without much support from your peers or your bosses.

You do need support, encouragement, and opportunities to learn and grow in any job, but especially nursing. So I would recommend that you try working at a good hospital for awhile and hone your skills.

Best wishes to you, Sue.

SuesquatchRN, BSN, RN · Jun 29, 2007

Thanks, Angie.

I'm pretty limited until I get my RN, which I'm doing online. So I am not picking up any days off my unit - where I don't make med errors - and that leaves me three days a week to work and four to study. I should be through the classes by October and then that leaves the CPNE.

I also live in an area that my county has three times the people of my last corporation. I need to get back to the city. I ain't country.

:)

withasmilelpn · Jun 29, 2007

LTC is very difficult. I think errrors are made all the time because of the patient load. I did it for years and really loved the patients but the frustrations were getting to me. When doing the best I could wasn't even close to good enough, I switched to our rehab unit which had a better staffing ratio. MUCH more satisfying! I've found it's very similar anyway, alot of our patients are geriatrics and the facility was constantly putting rehabbers on the LTC care floor when the beds were full on the rehab unit, so not alot has changed for me, just the amount of patients! Good luck to you, you seem like a very caring and competant nurse. My advice is to look for a place with lower ratios in LTC or switch specialties. I'm sure you'll find your nitch!

SuesquatchRN, BSN, RN · Jun 29, 2007

Thank you.

:)

dekatn · Jun 29, 2007

I live in a rural area, have worked LTC for 10 yrs., I finally threw in the towel and applied to our small hospital. Now working med surg 7p to 7a and don't get me wrong, we stay busy, but after working LTC with all the meds and short staff, it's almost like vacation. The winter is the worst with all the flu and URI. Right now it is really slow, guess people don't get as sick in the summer!!! Never say never, but, I hope I never have to go back to LTC. It will suck the life out of you if you let it. I agree with the others, you sound like a good nurse, you just have to find what is comfortable for you. Good luck to you.