JBMmom, MSN, RN 9,227 Views
Joined Jun 24, '09.
JBMmom is a Nurse.
She has '4' year(s) of experience and specializes in 'Long term care; med-surg'.
Posts: 502 (43% Liked)
I started out in long-term care over five years ago, I've been a charge nurse and supervisor and still work per diem because I really like my coworkers and residents. I transitioned into an acute care med-surg position this past summer and I'm transferring to the ICU in the next month. I've seen many new grads lament that the *only* thing they can find is LTC positions and will that effectively end their career if they start there. I wanted to share to not only let you know that a long-term care position is not only NOT the end of a career, but you shouldn't underestimate the value of the skills that you will develop in that care environment.
When I first started, I had classmates that would apologize to me when I told them where I worked, as if their hospital positions were what I really wanted, but just couldn't get. In reality, the schedule options of LTC worked for me, not a hospital job. Learning how juggle med passes, treatment passes, dealing with families, getting lab and test results, calling MDs, and spending time with patients with a 30 patient assignment was a great way to learn time management. Having many stable patients, not everyone gets daily vitals, I had to develop strong assessment skills to identify patients that had a change in condition (like a non-verbal quadriplegic going into sepsis). On our short term rehab unit we've had probably 20 of the 30 patients that were easily as acute as the patients on my current med-surg floor, IVs, wound vacs, dressing changes, etc. And it's a 4-hour med nurse and the charge, for all 30 patients, with 3 CNAs. Those were some run-your-butt-off shifts, and my hat is off to my coworkers that pull those shifts day in and day out. Point being, the skills of prioritization and assessment are key to success in that environment and those skills are hugely beneficial when faced with a 6-8 patient acute care assignment.
When I started in the med-surg position, I was a little intimidated at first by the change in acuity, would I know when someone was facing a crisis? Could I handle the higher acuity environment? Turns out, the skills I developed in LTC continue to come in handy and my new manager in the ICU even commented that she has found that nurses with similar backgrounds have to have strong assessment skills and when they're given the extra tools of constant monitors in the room, they often find success. I hope that will be the outcome of my story and I'm excited for the new challenge.
I hope that my story helps others considering or currently in long-term care positions that don't feel they're putting themselves in a position to move out. And for those that love LTC and want to stay there, more power to you, we're all nurses and we're all using the skills we learned to make a positive impact on the lives of our patients.
Thank you to you, and your fellow staff members, for all that you did for those patients and their families on such a tragic day. While it must a have been a horrific experience for everyone, you did your best to help, my thoughts and prayers go out to you and your colleagues.
When I first saw it I found it amusing, but wondered whether because she gave prescribing information without doing an individualized detailed assessment, did she overstep her scope even though it was only over the counter medications that she discussed? I think that might depend upon the individual BON for the state, but that's the only thing I think it really potentially a problem. Other than that, it's a social media post- some people will like the tone and some people won't. These days I think posting anything about any job on a social media post is potentially trouble. I truly hope nothing bad comes of it for her, she seems like it was really meant in the best interest of people in addition to just blowing off a little steam.
The only one I had more than once was when I first became charge and I dreamed that I forgot to assign a patient for day shift and they died. A couple times I've run downstairs in the middle of the day to find a COW in my kitchen to pass meds to the patients (in my kitchen?). And the other night I took a nap on my break and had a dream my patient was in the middle of my kitchen floor. I checked on him when I got back from break and told him I was glad to see he wasn't on my kitchen floor- he thought it was pretty funny.
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