Any nurses work ER and LTC in the past?

JenniferSews · Oct 18, 2010

I agree with many others. I work subacute and my patients are as or more acute than my clinical patients in med surg! A big part of the family issue is that often their loved one when from ICU to a day or two on the floor to the subacute unit. Meaning they went from 1-1 or 1-2 patient ratio to a day or so of 1-5 or 1-6 ratio to 1 to 15 in the space of days! Many cannot grasp why their nurse simply cannot give them the individualized attention they received in the hospital. 15 patients in an 8 hour shift leaves less than 30 mins per patient, including 4 med passes. They feel abandoned and neglected, and both the patients and families will drive you NUTS trying to carve our a little more than those 30 minutes. But if you give that, then someone else is getting shortchanged or you are staying late. As charge, you may end up dealing with those families. IME though, you have more time to deal with them and make them happy. It has it's rewards, but it's not easy.

lpn-ny · Oct 18, 2010

I am a charge LPN in a SNF. Each floor has 21 patients, 2 CNA's. I am in charge of 21 patients meds and treatments and everything in between. I am also in charge of the 2 CNA's on my floor. For each shift there is one RN that is the supervisor for all the floors, there are four floors in my facility, they are the person you call if a patients condition changes, they notify the families and Dr's. They are also the ones who fill out the paper work if there happens to be a fall, and they do head to toe assesments if there is a fall or change in patient condition. It's a chain of command sort of thing. The RN's are in charge of all the patients on each floor, the LPN's, CNA's. The LPN's are in charge of the patients and CNA's on their floor. The CNA's do the ADL's for the patients on their floor and report back to the LPN's on any changes in the resident, the LPN's then report to the RN's. While in school I did alot of clinical's in hospital's and some in the ER. I enjoyed the med-surg hospital units, and once I finish my RN schooling thats where I'll hopfully go. Or maybe the ER because I work well in a fast paced enviroments. Good luck in what ever you do. SNF can be draining, it's alot of repetition.

CoffeeRTC, BSN, RN · Oct 18, 2010

Ugh...lets not do another LPN VS RN thing.

Head over to the LTC threads and browse thru them. I think there was a thread about this excact same question.

Remember that no two places are the exact same. LPNs dont "run" our place or any that I've worked in. They do play a valuable role in the nursing care tho.

Being the supervisor might be a nice change of pace (slower at most times) but you will have tons of opportunity to pitch in and get busy.

PAERRN20 · Oct 19, 2010

Thanks for all the advice!

agldragonRN · Oct 19, 2010

this is a long shot...but i'm wondering if anyone has worked both er and ltc. i am currently an er nurse and considering some per diem nursing at a ltc facility. i'd be charge nurse. i'm a little bit scared and wondering if i can even do it! i know that sounds crazy but all i know is er nursing. i'm nervous to switch to a whole new world with an md right there. any input appreciated!

good luck with the new experience. ltc can be overwhelming for you as well even if it's "slow" pace. since you will be the rn supervisor, your experience will be different compare to the staff floor nurse. my 3-11 rn supervisor has rarely help me with anything. i almost do everything for my 25 patients e.g. calling mds, doing admission including initial assessments, filling out the incident reports, etc... as an lpn. i guess your job description will be thoroughly explain to you. i agree with the poster who said some lpns not all will resent you because you are the rn. heck, as soon as i became an rn and was trying to help an lpn with something, i get this "oh just because you're an rn now doesn't mean...yada..yada...".

on the other note, i recently applied to a couple of er jobs i've seen in the classifieds. i want to try hospital nursing.

good luck,

angel, rn

SunshineRN79 · Oct 19, 2010

We need to stop with the RN LPN thing! My first job was in LTC and the LPN's showed me how to be an nurse! They were awesome its just being in charge of 60 patients was NOT awesome!

jmokeefe · Oct 19, 2010

I work critical care now and I used to work LTC. LTC was very different obviously that there are more patients, less nurses (more techs) and more family visiting. This is all in my experience of course. Our hours in LTC were 8 hr shifts, not 12, so full time was 5 days-not for everyone. I actually had my first code in LTC, go figure. The facility I worked in was 1/2 LTC and 1/2 rehab, so there was a definite mix of patients. I built a relationship with the families and really got to know a lot of the patients, which was awesome. In critical care, as I am sure you are well aware of in the ED, its sooo not like that-in and out is more like it! The LTC setting was more like a family, if that makes sense. I liked it but left because I didn't like their 8 hr shifts, and also I wanted to chase the all powerful CCRN, which to be honest I am starting to think is not for everyone!

Take the leap I say, see how you like it, you can always come back to the ED! The beauty of nursing :)

PAERRN20 · Oct 20, 2010

I work critical care now and I used to work LTC. LTC was very different obviously that there are more patients, less nurses (more techs) and more family visiting. This is all in my experience of course. Our hours in LTC were 8 hr shifts, not 12, so full time was 5 days-not for everyone. I actually had my first code in LTC, go figure. The facility I worked in was 1/2 LTC and 1/2 rehab, so there was a definite mix of patients. I built a relationship with the families and really got to know a lot of the patients, which was awesome. In critical care, as I am sure you are well aware of in the ED, its sooo not like that-in and out is more like it! The LTC setting was more like a family, if that makes sense. I liked it but left because I didn't like their 8 hr shifts, and also I wanted to chase the all powerful CCRN, which to be honest I am starting to think is not for everyone!
Take the leap I say, see how you like it, you can always come back to the ED! The beauty of nursing :)

Thanks....this is what I was hoping to hear!

PAERRN20 · Oct 30, 2010

Just a little update for everyone....I am still trying to find a job in LTC but have not had any luck. I had no clue an experienced ER nurse would have so much trouble finding a LTC job!