Thinking of transitioning to LTC from hospital acute care...

Specialties Geriatric

Published

Specializes in Telemetry, PCU, Private Duty, Hospice.

Hi There,

I have been a nurse for 3 months now. I am currently orienting on a progressive care unit in a hospital and hate it! I am completely overwhelmed most of the time. The unit is extremely busy with transfers, admissions, discharges, so many physicians rounding on the floor at one time, and family members with multiple questions that I can't answer. I can't get myself into any kind of routine because every day is different. I am a person who needs routine to help me learn and build confidence. Right now I feel like I am an incompetent failure of a nurse. I have several preceptors who I work with, some better than others. They tell me I'm too hard on myself, but it's extremely difficult to go to work every day feeling no confidence and not enjoying what I'm doing. I have worked my way up to 4 patients, which I know is peanuts compared with other units and LTC. There is just not enough time to do everything that I need to get done and I fall behind and have to then leave tasks for the next shift. One of my major frustrations is not being able to sit and talk with my patients....sometimes I can't even talk to them about what brought them to the hospital, who they live with, etc. and that is very frustrating to me! Because of my feelings, I am thinking of applying to long term care. From what I know about LTC, it would be more routine than a hospital setting and a slower pace...still busy, but slower because there is less traffic of people. I would get to know the residents and that is really important to me.

I have some questions from the expert nurses in LTC.

What is the role of an RN in your facility? What is the role of an LPN/LVN? What are aspects that you enjoy each day at work and what are things that frustrate you? One of my concerns about switching to LTC would be the fear of having to sit behind a desk and complete so much paperwork that I don't get to actually complete any nursing skills/tasks.

Thank you for listening!

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Specializes in LTC, Med-SURG,STICU.

It is lots and lots of paperwork. More than the hospital from what I found. You do not have time to sit and chat with the residents. When I worked LTC there was some residents that the only time I saw them was when I was giving them their morning meds.

However there is more routine in LTC and you do learn your residents little routines. I loved going in and some of the residents would smile and tell me how they missed me on my day off. I have some of my most fond memories as a nurse while working in the nursing home.

Just be careful that you get into a good one. Take a good look and smell around. If the place looks bad and smells bad that is a good sign that the management does not care about the residents or its staff.

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You must be working the day shift. I was in the same situation. I transitioned from nursing home to the hospital and I was oriented on the day shift and I was feeling so overwhelmed with everything you have described. When I was done with my orientation I was supose to start on my own on day shift but I told the nurse manager that I dont think i can handle the day shift and requsted to work night shift. How can I when even an experienced nurses are struggling to keep up with everything? A night shift was so much better. No doctors coming in and out, patients not going to the surgery or procedures. Night shift was more of routine work then the upredictable day shift. I had time to sit and look at patient's histories, and their progresses. I've learned alot by working on the day shift. I suggest you to work night shift. Or try long term acute care where patients stay longer and its suppose to be less hectic than acute care but its still acute care. Try to stay in acute care for a year then you can try something else in case you want to come back to the acute care.

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Specializes in Telemetry, PCU, Private Duty, Hospice.

JB2007, thank you for your advice!

Ms.RN, you are correct! I am orienting during day shift and am slated to switch to night shift in about 3 weeks. I think night shift will fit me better than day shift, but I don't truly know how different night shift is. I'm trying to hang on awhile longer, but the feelings of failure are eating me alive and I've been applying elsewhere. I have trouble sleeping. I wake up thinking I forgot to do something, did I give the right medication, right dose, is my patient alright? I call the unit sometimes if I forgot to mention something in report. I did go see a doctor about all this and I'm hoping to see some improvement in the next couple of weeks. I did really well in nursing school, but school seemed to shelter me from the real world of nursing....quite a culture shock to say the least. I wasn't expecting it to be quite so difficult for me to adjust. I just want to be a great nurse and so far, I'm not!!! I know I'm learning, but I fear making mistakes because I don't know any better. Anyway, thanks again. I really appreciate the advice.

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fireball, hang in there. ALL nurses walk around feeling as if the Sword of Damocles is over their heads for the first year. Really. In LTC or in the hospital. It gets better.

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fireball, I have been sharing the same feelings as you. However, I transitioned from LTC to acute care. I am finding that I miss LTC/hospice care and building a relationship with the Residents. How are you faring these days? I hope all is well! I'm really interested in hearing about your insights... All the best to you!

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Specializes in Telemetry, PCU, Private Duty, Hospice.
fireball, I have been sharing the same feelings as you. However, I transitioned from LTC to acute care. I am finding that I miss LTC/hospice care and building a relationship with the Residents. How are you faring these days? I hope all is well! I'm really interested in hearing about your insights... All the best to you!

Hi Juice!

Thanks for your reply! Well, I have been a nurse for almost 2 years now. I've worked in progressive cardiac care for 11 months, LTC for 1 month (ratio too high 60:1!), Med-Surg for 4 months, and these past 4 months I have been working in Pediatric Home Health which I love!! I will definitely never work in a hospital again. I am a complete perfectionist and not being able to provide excellent (or even adequate) care to some of my patients really weighed me down and I took that home every night. Now, I have very little stress working in home care and I work with one patient at a time so I can give all the TLC I want too. It's great!!

I would love to work in hospice, but after all my applications over the years, I only got one interview and I didn't get the job. So, maybe it's not meant to be for me.

I hope you are enjoying your tenure in acute care and really appreciate the experience. It is definitely different from LTC that's for sure.

Thanks again. Take care :)

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I want to get out of LTC, because I am experiencing many of the same problems. I recently went from PRN at another facilty to full time at another. I totally regret it, and this facility is a focus facility. I am off of a three day orientation, and a hospice patient died during my first night. It is only me and another RN at night, with about four nursing assistants. I have thirty-five patients. I am so miserable, but I do not have anything else. Very few places are hiring, and I do not have the experience that hospitals want. I am starting to think that hospitals and LTC may not be for me. My main interest is in psychiatirc or public health. I hope you are able to find your niche in nursing. It is hard out there! Stay strong.

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