New Grad in LTAC

DookieMeisterRN · Aug 10, 2011

You're going to have the most difficult acute care cases. In the hospital you would only get one high acuity patient. In an LTAC you will have 4-5 high acuity patients with limited resources and corner-cutting management with poor ethics. May not be the case everywhere but that's what I've experienced and heard of about LTAC 's across the country.

Good luck!

mandyc8047 · Aug 10, 2011

Wonder if where you were was associated with where I am? I'm working for Select Specialty Hospital

mandyc8047 · Aug 10, 2011

Thanks for the well wishes. The faster the pace, the better I work, so I think it's gonna be a good fit for me. I've been in healthcare for a long time and sort of know the ropes.

deemalt, BSN, RN · Aug 10, 2011

You're going to have the most difficult acute care cases. In the hospital you would only get one high acuity patient. In an LTAC you will have 4-5 high acuity patients with limited resources and corner-cutting management with poor ethics. May not be the case everywhere but that's what I've experienced and heard of about LTAC 's across the country.
Good luck!

DookieMeisterRN had a very accurate assessment of what it is like to work in an LTAC. I went into LTAC as a new grad. It was not easy. Minimal resources w/ very difficult patient cases that almost always had some underlying psych issues and wacky family members.

On the plus side, you will learn tons, you will see things that you would never normally experience on a med-surg floor. Vents, trachs, tele, g-tubes, flexiseals, tons of IV's because they need to be changed Q4 days. You will learn to be resourceful and deal with challenging pts and situations. It will help your confidence and critical thinking skills later on.

I moved into med-surge at a well-known teaching hospital after 8 months at an LTAC. I can tell you I have probably done more wound care and had more tele, and vented pt's than most of the staff put together. I was able to walk into my interview with confidence and had lots of examples when asked situational questions. I am very happy and thankful to have been hired at my present job but the LTAC experience was a very good foundation.

I wish you luck and if you have any questions feel free to PM me!

Meekmom · Nov 4, 2011

I have had heart palpitations since I started for them. Has not gotten any better.

NenjaRN · Nov 22, 2011

My first RN job was an LTACH. I worked there as an STNA for a year first. I only lasted about six months as an RN full-time and stayed on contingent for another six but eventually just decided it wasn't worth it. It wasn't my cup of tea. Some LOVE it. The other responses summed it up well. The experience you would gain is wonderful, but I had many near panic attacks about work. My place was a mess though...I ended up with 8-10 patients most nights and staff turnover was horrendous. If you're going to do it, know the most common meds you'll give. Remember many will be on heart meds. Ask questions and be hands on. Study rhythms and take ACLS. Make good relationships with your LPNs and STNAs because you won't survive without them. Good luck!

poopprincess · Nov 23, 2011

OP, how is it going?

ohmygoditsmimi · Mar 12, 2012

I have been working at an LTACH for almost 2 years now. I love this job!!! I cannot wait to go to work every day, and love how fast the pace is. We have a lot of codes and rapid responses because our patients are the sickest of the sick, our wounds are very complex, we have several on vents, plenty on tele...there is never a dull moment. It can be overwhelming at times, but I work with a wonderful team of nurses, doctors, respiratory therapists, and other departments that are just fabulous. The experience has taught me so much and really sharpened my critical thinking skills as a nurse.

poopprincess · Mar 15, 2012

You are going to learn so much! I did it for 8 mo and I didn't realize how much I knew until I left. You will work with central lines, IV's, G-tubes, feeding tubes, pts. on artificial nutrition, ventilators, total cares, extensive (unstagable wounds), codes, telemetry, cardiac drips, heparin drips, and multi-system organ failure. It is very fast paced and the pts. are SICK. Most people don't realize exactly what LTAcs do. I can't tell you how many people thought it was just LTC and it if not even close to that! I like my new position but it was mistake because the pts. aren't as sick. I feel as if I took a step back, but it is making me look good because I have a lot of knowledge and skills compared to the other nurses. Hoping to transfer to ICU in 6 mo. Anyways-it is stressful and chaotic at first but stick it out for at least 6 mo. You will be able to go anywhere afterwards, but then again you may want to stay. Just don't make the mistake I did and not realize the skills you build there. I down played myself majorly in my interview because I was a new grad and didn't know just how far I had come. That was my only position as a nurse and I didn't have anything to reference until now. GOOD LUCK!

JustBeachynurse101 · Aug 3, 2016

I start at a LTC as a NEW NURSE yeah for me!! and was thinking and feeling the same way as you:nurse: Im happy to hear all the positive comments from the experienced nurses on here I was just wondering any tips for surviving the first three months? I was told that I get three days of orientation and they set me free:yes: I have been working in Peds homehealth care but with that said its one pt at a time and that is why I made the change, I also worked in LTC and hospitals 10 years as A CNA and became a EMT in the process so Im hoping this will help with multitasking however, I know I am still a new nurse in many many ways Im just a bit stressed because I do understand how sick most of these Pts are.and three days only yikes!!!

mrsboots87 · Aug 5, 2016

I start at a LTC as a NEW NURSE yeah for me!! and was thinking and feeling the same way as you:nurse: Im happy to hear all the positive comments from the experienced nurses on here I was just wondering any tips for surviving the first three months? I was told that I get three days of orientation and they set me free:yes: I have been working in Peds homehealth care but with that said its one pt at a time and that is why I made the change, I also worked in LTC and hospitals 10 years as A CNA and became a EMT in the process so Im hoping this will help with multitasking however, I know I am still a new nurse in many many ways Im just a bit stressed because I do understand how sick most of these Pts are.and three days only yikes!!!

LTC and LTAC are two different areas of nursing. LTC is usually geriatric care of very low acuity patients. LTAC is also a lot of geriatric care with some younger patients, but is generally MUCH higher acuity d/t the patients being very sick and needing more than the 5-6 days of hospital care that the hospital has resources to care for.