Hummm....LTAC....Where do I begin???
Ok....LTAC. Long Term Acute Care. These facilities are licensed as acute care facilities but do not have "emergency departments". per say, although some still do carry a "walk in" status for emergency preparedness. They can perform simple surgical procedures (endoscopes) but lack the anesthesia support for complex procedures. They have 24/7 MD support, pharmacies on site as well as radiology. These are ACUTE patients that have "RUN OUT" of acute days.
These are medically complex patients with complicated hospitals stays and require complex acute care. The LTACS I am familiar with have ICU's and accept ventilated patients including post open hearts that still have PA-lines, A-lines and drips.
These patients sre usually full codes with treatment goal of rehab and then home. They have 24/7 in house respiratory therapy, run their own codes and have radiology available 24/7. These patients are also on telemetry and recieve interventions for their symptoms and arrythmias. These patients are acutely or critically ill but no longer have "acute care days" that pay for them to stay in the hospital.....it used to be called when a patient goes on an "outlyer"....out of days and the hospital just sucked up the cost of the lower reinbursement but the patietn still requireing the higher level of care.... Now they just discharge them to the LTAC.
Although they are licensed as ACUTE CARE they are not reimbursed as well as acute care.
This is one of the ongoing debates about adding another tier of payment through medicare/insurance as these patiens require a high level of care. You will see many things there that you might not see in a hospital unless you changed specialties. In one intensive care there were 8 beds and in those 8 beds were 6 vents 4 PA lines 7 A-lines multiple drips (dopamine, neo,dobutamine, epi, TPN,heparin,and cardizem) and a halo traction. 4 open hearts, 1 MVA quadraplegic, 2 head bleeds and an ALS patient.
Traches, vents, complex wounds and chest tubes are common. SO, they take care of the same patients, all complex....collected from many facilities...all in one building........with less money.
Working in an LTAC will give you an enormous amount of experience. Hospitals actually don't realize what the LTAC does. I admit I didn't until a friend became a director and I went to work for her as a supervisor. What I learned shocked me
......I had NO idea these kind of facilities existed.....until I work for one. If you work in one be prepared to do a little teaching when applying to hospital acute care just because they simply aren't really aware what an LTAC does. All they know is that when they need to get rid of the financial burden of complex medical cared for patient......they go to the LTAC...... END of story.
NOW........ for the other side of the experience......comming from acute care I was shocked at the acuity of the patient and the amount of nurses (and lack therof) that cared for these patients. The LTAC I knew is NOTROIOUS in the area for being cheap to the staff, sick patients and no help. Saftey can be an issue. In that ICU of eight patients there would be at the most on days 3 nurses....the other shifts were 2 nurses and sometimes and aide. The patient assignments were 7-10 patients to one nurse with an aide per nurse and sometimes and extra aide for the floor. The work load is heavy....really heavy. The LTAC I speak of wouldn't even allow disposable coffee cups because of the "waste" and the staff would wash out dinner cups for water cups for later for the patient. Staff provided their own coffee and cups and there were NO snacks kept on the floor.......they were signed out by the supervisor and there had better be a good reason.
There is a high turn over rate and a constant in flow/outflow of staff with little to no resources available and administration oblivious to everything but the bottom line.....money. Which by the way you aren't making....they do pay less than hospitals. Actually, reflecting on it, it isn't any different that acute care there is just less staff around to help.
Pay attention when there as a student. Keep your ears and eyes open to what's going on around you. Grasp EVERY opportunity to learn and do because you are right.......that's the place to get overdosed on it. BUt whether to work there later? I think you'd get valuable experience......and if you can't get an acute care position or don't want to, I'd go to the ICU or telemetry. YOu'd be more marketable later and they'd be willing to train....but never tell them this is a stepping stone....they'd dump you in a heart beat.
YOu are going to learn alot....you can PM me if you have any other questons........Good luck:heartbeat