Long term acute care hospital

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    Does or has anyone worked in a long term acute care hospital? I am a new grad and recently got a job offer for a local LTACH. I am just wondering a little bit about this area since I have no experience in it. What kind of patients do you usually get? What is a typical day like? Any information you can give me will help. Thanks.
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    Quote from muzikluvr83
    Does or has anyone worked in a long term acute care hospital? I am a new grad and recently got a job offer for a local LTACH. I am just wondering a little bit about this area since I have no experience in it. What kind of patients do you usually get? What is a typical day like? Any information you can give me will help. Thanks.
    I was a new grad when I started LTAC and going on my fourth year. The type of patient has a general stay of greater than 25 days; ventilator dependent and sedated; some other drips that require hemodynamic monitoring such as levophed, amiodarone, etc. The goal is to wean them off the vent. You also have wounds that require intensive treatment; all patients need PT/OT etc for strengthening as they are debilitated. Typical day is extremely busy; I have had as many as 3 vents at once or as many as 6 wounds at once. GREAT place to get diverse skills: central line, trach, PEG, identification of dysrhythmias. Not for the faint of heart, you are pooped at the end of your shift. I had a 3 month orientation with close support - if they do not offer this, I would be careful. As a new grad, you have a lot to learn and will be given great responsibilities.
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    Muzik,
    Then there are NG tubes, Iv starts and foley insertions. Hopefully you get atleast one month orientation. This could be great for your career because if you are successful in this setting it would be hard to overwhelm you in the future. LittleOneRN is all over it in her reply. You can further your orientation by watching youtube.com videos.
    Good luck.........
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    LTAC's are a unique combination of very sick patients in a LTC setting. These people are the SICKEST of the sick AND they have had complicated hospital course. A 4:1 ratio may not seem like very much but in an ICU setting in an LTAC are the failure to weans so you will have 4 vented patients. Most will have multiple lines including PA Catheter's/Swan , including pressors and IV's.

    Any LTAC I have seen or worked in is a tough environment. These patients are SICK!!! They have just "run out" of acute days and are sent to the LTAC. These patients are the ICU patients that remain critically ill but have run out of "paid days" on insurance/medicare. You will see a ton of stuff.......everyone else's failure to discharge home. Open hearts with complicated post op courses, trauma's with Halo traction, many unique disease process with complicated recoveries, open wounds, chest tubes, vac dressings, wound irrigation's. You will give TPN, blood, do labs...your IV skill will make you valuable to them. These patients are mostly full codes and every attempt is made to get them home.....but with a fraction of the nursing staff in an acute care setting.

    The LTAC I am familiar with had an ICU and these patients were not DNR's, they were vented, with lines and drips. They are a collection of the most medically complex patients that have suffered complications and rough hospital courses due to comorbidities. The floor patients can be vented, multi lumen lines, feeding tubes, IVF, antibiotics with complicated wounds still receiving aggressive treatment to get them well enough to got to a rehab, SNF or home.

    The nurses perform like any other "acute care nurse" and more "acute care" nurses and hospitals/administrators need to respect what these nurses do with little to NO help. They process labs, drugs, give blood, pass meds. I have seen HALO traction many times on the elderly who have fallen. There are a ton of young trauma victims that are not doing well as well as the complicated open hearts on telemetry. They will seen neurological diseases like ALS and weird meningitis like listeria.

    Any nurse will work very hard....I think a new grad who is bright and a go getter with a thirst for knowledge and confidence is a good candidate. They usually have extensive orientation programs and are will to invest i the nurses education....but you will work very hard. The patient load is double...example most ICU patients are 1:1's or 2:1's when they leave the hospital....they are 3:1, 4:1 at the LTAC.

    The opportunity is there to learn a TON. Here are somethreads about LTAC's

    You will gain a TON of experience and at least they do have great orientations. I wish you every bit of good fortune and luck in your new journey. If you have any other questions about and LTAC....PM me.:heartbeat
    Chris81 likes this.
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    Many LTACHs have the same type of patients that may be found in an ICU step-down as well as complex MedSurg patients. You will most likely be able to gain experience working with all the 'stuff' that is found in an acute care facility & the patients have a longer length of stay, so you don't have to deal with the rapid cycle admits & discharges.
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    I'm glad I found your post because you just answered my questions. So you are saying that a 3-4 month orientation is good? I guess it takes that long to adjust as a new grad or what are your thoughts on this? Please
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    We just developed a new Long Term Acute Care (LTAC/LTACH) forum.

    Great description of this specialty here:LTAC vs Hospital - what's the diff?

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    Thank you!!
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    threads merged.....


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