LTACH experience

Specialties LTAC

Published

I have been a RN for ten years. In this time I have worked in several specialties. My most current specialty is in end-of-life care and I even hold a certification. I am also in my first semester to become a FNP. I am still thrilled about getting accepted. My patient care in hospice is soul filling but I was ready to get back into acute care. I applied to numerous positions at local hospitals. I even received some call backs. Most hospitals that called me didn't have any open positions. The problem that I saw was that I have been out of acute care for three years. I new of a small long term acute care center that served a great population of patients that had exceeded their time allowed in hospitals. They have an ICU, Med/Surg and rehab facility. They offered me a position working nights. 31 dollars an hour for weekdays and 37 dollars an hour for weekends. Do you think this will be a good area for me to gain knowledge to become a strong FNP? What do you think of the pay? Thank you in advance for your feedback.

FNP2B

Specializes in SICU, trauma, neuro.

Yes, you will learn a ton. These people are really, really sick; their hospital courses are long (several months in some cases) and they get very complicated. That will be good for you as a future FNP, since you'll be exposed to a big picture the likes of which you've probably never seen.

Honestly that pay sounds low to me for how hard you'll work, but I don't know what the going rate in your area is. Mine paid me $44/hour for per diem on days, and I definitely earned every penny. Although to be fair I don't know what the FTers' hourly wages were; per diem was given a higher hourly wage in lieu of benefits. (and they did not hire for regular PT--it was either FT or per diem.)

Like you though, I needed to update my hospital experience. I'd been out of the hospital setting for some years, I wanted to get back into critical care, but couldn't even get an interview without *current* hospital experience despite having previous ICU experience. The fact that they had vents, tele/bedside monitoring, and an ICU really helped; and actually, my ICU that I now work in sends a lot of people to this LTACH. Many people have exceeded their allowed acute-care days in a typical hospital but still need to be in the hospital; others may not need a typical ICU anymore, but haven't been able to come off the vent so can't transfer to the med-surg floor.

Before working in an LTACH, I actually didn't even know what one was. My area has a larger LTACH and this smaller one that I worked in, and I had had pts go to them when I'd worked in the hospital before. But I thought it was a rehab place that happened to take people on a vent. It is definitely hospital work though, except longer and more complex than your typical hospital populations. PM me if you have other questions :)

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Welcome!

What part of the country are you in? That has a huge impact on your pay. I think you will gain TONS from this experience!!!!

These patient are the sickest of the sick with multiple co-morbidities all under one roof. You will work hard. I was a supervisor in one for a while....you can post here in this forum of drop me a PM

Thread moved for best response.

I left acute care back in 2008, did Home Health and then moved to Sub-acute in LTC, I learned a lot in sub-acute, like dealing with patients who are as sick as in the hospital but without all the nifty equipment, learned how to make a lot of decisions that before were being made for me. I grew a lot and now feel that I am ready to return to acute care. The experience in LTACH will benefit you and most likely prepare you for re-entry to acute care. Check out the requirements for Neonatal NP and make sure the path will be available for you to get the experience you need to return to acute care. I say this because one of my sub-acute co-workers was working on his RNA and had to have so much critical care experience that it took him a while to get back to acute care and have that experience to get into critical care. It may be a time-lengthy process, so try to have your ducks in a row!! I loved sub acute because the patients were sick enough but not crazy sick, the challenge was getting the patients the follow-up they needed with MD offices and contract type services for x-ray, labs etc. I learned how to put more pieces of the puzzle together and how diseases inter-twined together to present the bigger picture. My assessment skills grew and my critical thinking skills grew as well. I am sure the experience at the LTACH will help move you in the direction you want to go. Good luck!!

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

An LTACH is NOT sub-acute.

An LTACH is a licensed acute care hospital that functions just like any other hospital except for surgery other than endo and G tube/trach placements. These patients are very sick with multiple co-morbidities that have complicated recovery processes. These patients are being actively treated do they may at some point go to sub acute. These facilities have telemetry units and intensive care units and the patient do have monitored drips for vital signs and cardiac arrhythmia's. These patients are multi-factorial with complex dressings and will receive blood transfusions and antibiotics. They usually will have a hospitalist on duty as well as a radiology on site. The labs may be done there but many are resourced out to the closest facility.

These are acute care patients that have "run out of days" yet still need the intensity of acute care and are all under one roof.

Many in healthcare do not know what a LTACH is and assume it is LTC....nothing is further from the truth.

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