Agency LTC or Staff LTC

casi, ASN, RN · Feb 9, 2011

LTC staff. You get training.

agldragonRN · Feb 9, 2011

with the bad economy, i'll take who ever offers me full-time. if both job is offered, i'll take ltc staff because it is more secure than agency. your hours at the agency are not guaranteed. you will get a higher pay though as an agency nurse.

good luck.

grateful2010, LPN, LVN · Feb 9, 2011

Thank you!

In choosing a nursing home is it better to work for a large Nursing home or a small one? Since I have no experience working in a Nursing Home I really don't want a large patient load. :uhoh3: (About 20 is good for me, No higher than that).

TheCommuter, BSN, RN · Feb 9, 2011

Thank you!
In choosing a nursing home is it better to work for a large Nursing home or a small one? Since I have no experience working in a Nursing Home I really don't want a large patient load. (About 20 is good for me, No higher than that).

All of the nursing homes where I've worked have had patient loads that exceeded 20 residents. The major exception would be the Medicare skilled residents. Nurses typically receive less of these types of residents, but they tend to require more care, be needy, and consume lots of time. Many of the Medicare residents will be postop cases (laminectomies, knee replacements, CABGs, pacemaker placements, etc.). Some will be there for CVA recovery, debility, cancer, s/p acute MI, and so forth.

kythe, LPN · Feb 9, 2011

My first job as a new grad was on a dementia unit for 20 residents. The low number does not necessarily make the work load easier since you have a lot more behavioral issues. I didn't do well at my first job, but I lasted 5 months before moving on to agency work. It was long enough to get some real training and experience, you need to get your foot in the door. But I can understand why agencies (the good ones anyway) like their employees to have at least a year of experience before being sent out to fill in for unfamiliar facilities.

With agencies, you need to have the knowledge base, nursing skills, and time management skills to be able to step into any situation and do whatever they ask. Also, it is sometimes easier for agency employees to be blamed for errors because they lack the rapport with management and other staff. Most work places have a system for warnings and write-ups (another advantage of a staff position). But if you make a mistake as a visiting agency employee, you are typically asked not to return. Agencies can sometimes send you into situations where you are asked to do work outside your comfort zone according to your abilities. You have to protect your own license and learn to say no to assignments where you do not feel safe or are overwhelmed, and without looking lazy or unmotivated.

I enjoyed agency and worked in several facilities regularly. But I had to get a regular position over a year ago because agency work declined to a point that I could not support myself. Using agency is very expensive for companies and many no longer have the budget.

CoffeeRTC, BSN, RN · Feb 9, 2011

If you are new to LTC....no agency. I cringe at the thought of a new grad or new to LTC nurse doing agency. Def get the experience in a LTC as staff and then you can move on.

Even if you have the nursing skills down pat, there is the time management aspect, LTC regs, staffing issues to deal with etc..

You might need to do some looking to find a staffing ratio less than 20 residents. Bigger facilities might have more support staff or nurses on the unit where as at a smaller place you might be it. (I'm the floor nurse/ desk nurse/ supervisor in a smaller facility)

Non profits tend to care more about the resident than the profits.

gentlegiver, ASN, LPN, RN · Feb 9, 2011

I t depends on how long you've been a nurse. Most Agencies wont touch you w/o 1 yr experience, you have to be able to hit the floor running in whatever facility they send you to. That said, Agency work really improves your assessment skills, exposes you to different DXs and treatments, I found it really gave me the best learning experience, and, the pay is way better. And you can make your own schedule. Down side - frequent schedule changes, hours dropped when not needed (I found this was common from Oct. thru Jan.), sometimes long distances to travel to an assignment. Also your benefit package is not as great, harder to acquire vacation time, insurance can be more expensive.

LTC provides stability, but it can become boring, same hours every week, same patients, treatments, DXs, meds. And it also can be extremely hectic. I prefer a smaller LTC, on the 7-3 or 3-11 shifts you usually would have 20 to 25 pts to care for. The staff seems to work more as a team,(not to say you can't find teamwork in a large faciluty) and you get to know your pts and thier families better. So, it all depends on what your looking for.

WittySarcasm, BSN · Feb 16, 2011

I started out as an agency nurse for LTC mainly because there was NOTHING ELSE out there. After a year and half I went for the first thing that called me. And now I work at a LTC as a full time nurse.

I can officially say try to work at a LTC, and not as agency. It will cause added stress. Especially when you have to self teach yourself everything. The first couple times I sat in my car and cried before and after a shift. There is no training. They will put you in the first nursing home that calls for a nurse. And when you get there "I'm a new grad" will not get you any easier times. They give you the job that you were needed for.

However when I went to the LTC place I work at now I got training (because I was still a new grad). I learned how to pass meds (though by that time I had gotten a pretty good system going). I learned how to do everything.

That's why I say to try that way first. I had to go the backwards way mainly because of the fact that after a year and half of looking I had to go with what would take me. That is the ONLY reason you should try what I did, otherwise it will cause added stress at first!