Im new to the forum, and well not so new to LTC. I chose to be a CNA while going through nursing school and worked in LTC. My mind set at the time I chose to do this was: If I can't cut it as a CNA in the worst place (at the time I thought) to be a CNA, then I just can't cut it as a nurse.
You know what... my thinking changed. I LOVED IT!!! My favorite patient population is the elderly. Don't ask me why.. I can't tell you. When I was younger... the elderly scared the crud outta me.... now I find myself sneaking peaks at the old old couples helping each other out of cars.. holding each others hands and they shuffle their way into stores, or talking to complete strangers who are very elderly out in the public.. and having a grand old time..... I just love it... I think my husband thinks I am nuts.
BUT... here is the jist of this post... My specialty has been ICU/CCU nursing I also have a specialty in Cardiac/Pulmonary. I have Rhuematoid Arthritis which has made it increasingly difficult physically for me to do what I love. Then this past August.. my husband and I doing one of our FAVORITE hobbies... FISHING... I got hurt. badly hurt. I was out of work for over two months.
I can no longer work the 12 hour shifts, I can no longer lift, I can no longer do what I did in acute care. So I applied to a LTC center. Everything is so different. I am so used to the state of the art equipment and autonomy.... and when I call a hospital on a patient who has fallen OOB and cracked their noggin to the point where she had blown a pupil... and when I start to go over the neuro check... the ER nurse is like have you ever done a Neuro check before... OMG... do they always treat LTC nurses like that???.... I didn't even get to tell her the results before she interrupted me... had she shut up.. she would have known..lol... but I think she got the point when I was finished giving her the report....
I guess I'm not used to having someone question me like that before.... guess I will have to get used to that... I didn't have time to set the woman straight.. I needed to get my resident out of the building and into the ER.
The documentation is different... I laugh because before our hospital went to magnet.... we did narrative charting.. we haven't done that now in years.. everything is done by computer... which I hated.. and I griped about for a few years.... now I have to go back to endless paperwork, and narrative charting.. and quite frankly... I need to remember how to do it.. LOL Lord help me..lol.....
I didn't have to deal with medicare and medicaid charting and their legalities.... we did acute care... so I will be haunting the LTC forums alot asking questions... and so forth...
I just wanted to clarify... it's not that I think that LTC is less physically demanding.... because I'm finding that its not... It's that our hospital was UNWILLING to allow me to work 8 hour shifts. I'm older.. I know that.. and because it was not a WORK related injury.. they did not have to accomodate me.
I'm back working with my favorite patient population.. but Im finding that being the nurse this time.. is sooooooooooooooooo much different. I want to excel here... I like the LTC facility that I work at... it's not the best, it's not the worst... it needs a lot of organization.. but I can fit here.. I like it there... and it feels like home if that makes any sense....
I know it will take some time to feel comfortable in my role there... I just feel so stupid... when where I was before.... I was looked up to by co-workers and respected by Doctors alike.. because I knew what I was doing..... now in a new town. ( The hospital I worked before was about 40 min from where I live... now I work two streets away from where I live..lol ) .. I dont know the Doctors here... I have to restablish myself again.... I can do that but it will take time.
I'm not really ranting... I'm just vocalizing what I'm thinking.. just not sure where I can go from here..... LOL... oh me... Any suggestions for an easier transition from you seasoned LTC nurses...
Oct 14, '07
Congratulations on finding a job you like. I got into LTC after a divorce. My ex repaired Nuclear Medicine equipment and managed to find me no matter where I worked. I didn't want the divorce, he did. LTC was the only place I could be sure I wouldn't run into him and it turned out I loved it, too.
Unfortunately, alot of Acute care nurses look down on us. With time, they will realize you know what you are talking about! There is a lot more responsibility on LTC nurses than they realize, because doctor's aren't availablre 24/7.
Oct 15, '07
I have no insight into making your transition easier I just wanted you to know that you have my uttmost respect and admiration. Changing careers is never an easy thing to do, and LTC is not easy by any means. (I worked as a CNA for 15 years before going to nursing school. I too have a special place for the elderly.) I think alot of people would not have been willing to make the changes you did in order to stay working. It is very admirable and is the act of someone who has a true love of nursing.
I always hate when one specialty looks down on another. It's very unbecoming of our profession.
Oct 15, '07
rae. . .as my back was dying i spent my last 4 years of work in nursing homes. i had started my career in nursing homes anyway and always liked it. yes, you do have to deal with people in the acute hospitals sometimes treating you like a dummy. that's because they are at the other end of a telephone line and don't know anything about you. just ignore it. we both know there are some dumbbells working over in the acute hospital. (i worked in the hospitals for many years and was a nursing supervisor and manager.)
what i found was that ltc is a place where you can have a lot of autonomy. as you've already seen, a lot of organization is generally needed. you can provide that. the opportunities are just waiting to grab up because i can guarantee that no one else wants them. pick something that you see needs some improvement and change and go for it. i would let the don in on what you are doing so there are no hurt feelings. in my case, i started weeding out the unnecessary orders in the charts of my patients. it was a big project that took months, but when i was done i had all kinds of old orders d/c'd and made sure that every chart had either a dnr or full code order which was required by the state. nursing homes don't usually do chart checks to see that orders are signed off every shift like they do in the acute hospitals. however, some of the biggest med errors we found in the nursing home were do to orders not being noted off. i started doing regular checks of my patients charts for new doctor's orders. i've mentioned it occasionally on this forum and many people poo-poo it. it only takes 5 or 10 minutes to go through 30 or 40 charts and saves a whole bunch of trouble in the long run. but, i take the position of being a charge nurse seriously and i want to know about every order my patients have. i was right in there during the monthly reconciliations of the mars/tars each month (another big job) to make sure these sheets were done correctly and with as few errors as possible. i made calls to the pharmacy service a number of times to find out how the computer service worked so i could get the corrections done the way i wanted. no one stopped me or said, "hey, what are you doing?" in the end, everyone made comments about how organized things were. since i like working on the computer, i designed pre-printed fax sheets to notify the docs for skin tears and falls, so the other nurses only had to fill in specific details instead of having to write out an entire fax message. and, there was more stuff that i did. i can't just sit around and gab. it's not in my nature.
i'm sure you can find similar things that need to be done. your hospital background will be a big help as well.
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