ICU within an LTACH center

[Squeaky44]

Has anyone worked in an ICU that is based within a freestanding LTACH center??? If so, could you tell me about the pros/cons and any other issues that you may have come across? I would greatly appreciate it. Thanks. :)

[mykrosphere]

i work in an ltac.

we have two units. icu and med surg.

i primarily work in the med surg part but have been over to work in icu quite a few times as well.

the ltac icu is hard to describe though.

i have taken care of patients back there when i wonder why they are back there...they even get discharged from icu, which may or may not be a physician thing...

some of the patients definetly need to be back there and are on drips (mostly ones i see are levophed, dopamine, and diprivan.

almost all of the patients are vented, though there are some that are not.

the only difference i have noted between working icu and med surg in an ltac is that on med surg we will generally start a drip, but if theyre going to be on one, they go to icu. we have patients who are on vents in med surg.

also, the patient load is different. icu has 2-3 pts. med surg we will have 4-5 sometimes sicker than icu patients.

if youre in icu and theres not a lot going on, theres a lot of down time.

med surg there is never any down time!

also, sometimes there is no pct in icu. but the teamwork is exceptional where i work and everyone helps everyone else out. no matter if its icu or med surg.

i have not really come across any issues per say, but i would rather work in med surg in an ltac i think if for the sole reason the night goes by way faster.

of course, i havent had a pt. crap out on me over there, and since i dont normally work over there, they are pretty good about not letting that happen. my opinion is probably biased.

i have worked in a community hospital icu and its very similar, if you have any dealings with that.

in an ltac, there are just some things that cannot be done due to things like pharmacy and radiology not being there at night, or whatever. although we have pretty good on call docs that stay the night every night.

if the patient is seriously critical, say, an active mi or something like that, we usually send them out. there are also not really any acute trauma pts.

there is no er so we see a lot of the same type of patients. mostly neuro and respiratory.

there are limits to working in an ltac as opposed to a established hospitals icu,

but its not so bad :)

there is a lot of room to try new stuff out and do new things.

[Squeaky44]

Hey thank you so much for the info. I really appreciate all of your input because where I work is going to start an ICU sometime soon and I was very curious as to how it differed from the regular hospital. I now have a much better idea! :)