Anyone go to LTC from a hospital??

HeatherLPN · Mar 23, 2006

I think a lot of it depends on the facility--how many clients you'll have, what hall you'll be working or if you'll float, how good they are about staffing, if they mandatory you to stay over or come in, ect. I'm happy where I'm at, and I do use my skills there.

Antikigirl, ASN, RN · Mar 24, 2006

I worked in LTC and ALF's and found that is was an awesome and humbling experience. I learned so much about the majority of patients in this day and age...the elderly, and their needs. This is very valuable experience...and an excellent place for using your patient advocate skills!

Alas...I worked at a ALF for 4 years and really wanted to switch to something a little more autonomous. I had to get orders for every thing and call the family for everything...including bandaids! After 4 years of this..and rules getting even more obserd about getting orders and nurses having their role dwindled to nothing but faxing/charting/and explaining the needs in a way that medicare would accept treatments...I wanted to go back to being able to talk with MD's in person, having a little more autonomy over dressing choices or treatments as an RN I can order without faxing an MD, and a little less of the paperwork chase I had to do in LTC and ALF to CYA all the time!

I went agency to hospital work...and I love it and will never go back to LTC/ALF! I feel like a real autonomous nurse in a team of professionals again! I can do technical things I haven't done before, learn daily, am challenged daily, and can actually put on a bandaid without an order!!!! I don't have to sweat all the medicare/medicaid stuff (they have a department for just that aspect), don't have to deal with sending folks out to the hospital and the 1001 questions why I did it, and I don't have to bother doctors with all the protocol manadatory faxes about every tiny detail (I mean come on...my MD doesn't want to know about a under 1cm bruise someone noticed that is yellowing...but I had to fax, and a newer rule also had me ask if their asa tx was necessary...ummmm on a cardiac pt??? umm I think that little asa outweighs a bruise potential...and the Docs know nurses know that...so it was so degrating to me!!!)....

But again...the experience working with the geriatric patients and even the younger ones living there who are disabled and have to have full time care...was a very worthwhile experience for me! I learned a TON...and that is helping me greatly today in hospital!!!!!!

Good luck..and maybe you can shadow a RN in a potential employement place to see if it is what you wish to do!

johnson0424 · Mar 26, 2006

great response and just what i was thinking your every move in LTC is dictated. it is ridiculous but i love LTC but like u am ready for a change.

Long Term Care Columnist / Guide · Mar 26, 2006

I am back in LTC after working in acute care the past 3 years. I'm the DON for a 42-apartment ALF and am actually quite autonomous in my practice. I make many decisions and recommendations every day as to what my residents need to function at their maximum potential; of course, I do involve the residents, their physicians and their families, but mostly, the buck stops here.......with me. (BTW, the paperwork isn't half as bad in ALF as it is in SNF/ICF, although there is indeed plenty of it. )

I'm fortunate in that most of my residents' families are supportive of the care my facility provides, and they trust my judgment. Of course, I'm pretty assertive in letting folks know when I believe it's time to adjust the service plans, call in physical/occupational therapy, refer them a specialist, or even recommend hospice services........I have no problem notifying the MDs either, and I'd say about 95% of the time, I get exactly what I want.

You just have to be creative, and to keep in mind at all times that the RESIDENT is the person you work for---not the corporation, not the MD, not even the family. Sometimes you have to be willing to fight for what you think is best for them, even if the family doesn't like it or their doctor doesn't want to bother writing an order for it or Medicare/Medicaid doesn't want to pay for it. LTC can be a terrific opportunity to be a patient advocate, although it does get frustrating at times (I have been observed by my staff on the telephone in my office, sweet-talking an insurance company into understanding why the resident needs that case of Ensure or that wheelchair cushion, and making rude gestures and facial expressions all the while---cracks 'em up, I tell you;).

Good luck to you!

Daytonite, BSN, RN · Mar 26, 2006

Hi, Terese!

I've gone back and forth between the hospital and the nursing home throughout my career. I like both, but there are differences. As an LPN you will have a lot more independence and autonomy in a nursing home. You will most likely be a charge nurse and will function very nearly in all the ways an RN does. There is a lot of paperwork that needs to be done and that is mandated by law. I like knowing that I will have the same patients every day and will get to know them, the same meds, the same treatments--sort of. I guess the only way you will know if you are going to like it or not is to get in there and try it out.