New to LTAC

  1. Looking for some info or reassurance. I've been an RN for 24 years with all my experience being in med-surg in hospital settings. I've recently accepted a FT night position at the LTAC here in town whose parent company is ErnestHealth. It is a 20- bed facility with a "high observation" unit with some patients who are being weaned from vents. Been doing some research and from what I've read most LTAC patients are admitted from local ICU's I don't have critical care experience and have no experience with vents. Am I getting in over my head? DON who hired me on the spot in my interview also indicated I would be working with nurses with a lot less experience so a little overwhelmed by that idea as well.
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  2. 6 Comments

  3. by   cagjlg
    Congrats on the new job. You have a great opportunity to learn a lot! I'm not familiar with that company, but am familiar with other companies that keep high obs patients. The CMS rules are changing for LTACs so the acuity that you will see in all the patients will be higher. However, you probably won't be given the vent patients without warning, training or experience. The advantage to LTACs is that you have an RT with you for those patients, maybe two RTs to the floor depending on the acuity. I've been in LTAC for six years and love it.
  4. by   BmoreOrioles
    I am almost done my 2nd week of orientation/training on a LTAC unit and I love it. I have learned so much from the other nurses and the patients. I was working in a SNF with high nurse to resident ratios so I'm loving the 1:10 ratio in LTAC. We always have a RT on staff so the change trachs/suction/give nebs. My advice is to ask questions. The other nurses may have less nursing experience but they know all about the LTAC. Before I started I dug out my old nursing school text books and read up on ventilator care, wounds, feeding tubes, etc. Good luck.
  5. by   gelli.25
    I worked at a LTACH as my first RN job out of nursing school; I was a newbie, didn't know much about the job and took it. Boy, was it tough. There was 2 floors, a med-surg like floor and a critical care floor. I worked on the critical floor majority of the time; the acuity was very high. There were vented patients, septic patients requiring continuous antibiotic therapy, extensive wound patients, patients requiring TPN and lipids, patients requiring hemodynamic monitoring and drips, bed-bound patients, patients with multiple disease processes; it was pretty much like an ICU but the patients were there for an extensive time period. The ratio was 1:2 up to 1:3 or 1:4; I cannot recall, it was a while ago. I dreaded going to work because it was stressful. I also worked nights which didn't make it any better; my commute was like an hour! Don't get me wrong, I learned plenty. But, I was so burned out that I almost questioned if I wanted to still be a nurse. I was there for 9 months then transferred. I now work in the OR, have been in the OR for 3 years now, I love it! However, I am now a graduate student with a FNP concentration. Don't let me scare you, working in LTACH is rewarding, especially when you care for a vented patient and 2 weeks later...they're on room air; it's amazing. Good Luck!
  6. by   KatieMI
    It really depends on what kind of med/surg experience you have. If you were working for a long time in a unit which only takes patients with certain pathologies, it could be a good idea to get out some sort of med/surg book and read about those chronic conditions you feel like you might forgot a little bit. Common things that are useful to know are arrythmias/lytes, care for chronic quads, wound/stoma care (pathophysiology, not dressing details), sepsis, end-stage renal disease, malnutrition/therapeutic hyperalimentation and subacute mental health issues (delirium, depression, etc).
    Since LTACHs take very diverse population of patients, it is usually the case that nurses have mixed backgrounds and may be even known for being especially skilled in dealing with some particular type of diseases or patients. If it is so in your new place, try to learn from your colleagues. RTs and HD RNs often love to teach too. Even if your hospital has specialized team (like wound care, line care, IV, etc) try to either shadow and assist them as much as possible, or just do the job for them as soon as you feel comfortable. They will love you for doing it, and you'll become an expert in new skill set free of charge

    Congrats on new job!
  7. by   Trevi
    This is my exact scenario! Except I have 3 years experience in med surg and Tele, and rehab. I have no experience with vents or critical care. I was hired on the spot at Vibra Hospital and started my first week of orientation! Hope all is well for you! I can't wait to learn and grow in this new position.
  8. by   Trevi
    This is my exact scenario! Except I have 3 years experience in med surg and Tele, and rehab. I have no experience with vents or critical care. I was hired on the spot at Vibra Hospital and started my first week of orientation! Hope all is well for you! I can't wait to learn and grow in this new position. 🏫😊

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