LTAC ? Good or Bad? - page 2
I am a new grad and was offered a job in LTAC for $30/Hr with a 6:1 nurse pt ratio (no vents-they are in our ICU). As a new grad I am having a hard time finding a job and it's this or LTC ... Do hospitals frown on this sort of... Read More
- 4Aug 14, '10 by davesLTACs, like any other hospital or hospital type, vary greatly from town to town. Your patient ratio is probably going to be twice that of an average ICU, but less than on Tele. And thats about right - its sort of a cross between the two. What saves you is the one "easy" patient that you hope to have.
Patients tend to be there a long time; weeks certainly. Many come on a pre-approved 30-day insurance authorization. That means every one gets pretty familiar with them sooner than later. As I made assignments daily, it became a matter of matching total acuity with nurse capabilities.
Covering LPNs is certainly a consideration. For one thing, some LPNs can act practically independant, almost as an RN. Other LPNs - not so much. As far as new nurses on a busy and high acuity LTAC, the most hopeful thing I would point out is you would get a lot of experience a whole lot sooner than on MedSurg.
And like any other first job in this biz, the most important thing is to learn how to prioritize, make fast assesssments, and ask smart questions (before you get into trouble).
- 6Aug 15, '10 by grandmawrinkleI'm an ICU nurse. I've never worked in a LTACH but my two cents is this:
The patients we send to LTACHs are the ones we can't get better in a finite amount of time and we need to get them out of our ICU to free up beds. These patients are too sick for the ward or even the stepdown -- most of the ones we send won't wean from the ventilator, and we don't have progressive care or vent weaning beds at my facility. They are also otherwise medically complex with other issues to monitor/treat.
I personally think that this would be excellent experience for a new grad that wants to get into an acute care hospital eventually -- really, it's the next best thing. I think most of your patients will be higher acuity than med/surg patients in the hospital, actually. You'll be getting patients that are somewhere between the ICU and the regular floor as far as level of care required. I think from there, you'd walk right into a med/surg floor and think it was easy, and if you'll be trained into vents, it would be a fairly easy transition into a hospital ICU as well.
I think this is a good move for you, and would take it. You are going to be tired and overworked, but hopefully it will pay off with a hospital position for you after a period of time. Good luck!
- 0Aug 15, '10 by Flying ICU RNPosts #10 and #12 are particularly valuable in the advice given, I concur.
As for rate of progression beyond initial hire to say,... ICU, my first year of Nursing was in fact LTC not LTAC. My professional background prior to Nursing piqued management's interest, and the interview sealed it. That was 17 years ago.
Your career progression as a Nurse (in my opinion) is entirely in your own hands. The current downturn is not sustainable.
- 1Aug 16, '10 by davesForgot to repoint out the most important parts that I intimated in another post: Make nice with your Resp Techs and CNAs. Not only do they know more about their fields then you ever will, they will sooner than later Save Your Ass; reference keeping small fires small before they blow up in your face.