Anyone that's worked both LTC and hospital settings

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Specializes in hospice, ortho,clinical review.

I'm curious on the feedback from people who have done both. At my place there are nurses who have come from the hospital but say this is so much better. Now that we're getting more intense residents (in the last 2 weeks it's started) they are becoming more disgruntled, reasonably so as we care for about 24 residents but add in the unstable to the mix and it's really daunting esp to a new grad.

As much as I do love "where" I work, very supportive etc.... I'm not 100 percent sure at this point I will want this for the long term as I have issued how things must be handled (short cuts, but not when state is there) and I don't feel I can provide the level of care I want to b/c of the setup this will equal frustration and burnout, I know myself that much.

I take the one that I have on a feed, o2, many meds, must be mummy wrapped or she'll pull her g-tube out, is completely disoriented cannot talk and is rather unstable, she needed much of my attention on my past shift. I'm thinking that 5 or 6 patients like that on a normal med surg floor will still seem more doable than running back and forth between 20 or so others and making sure the 3 that are unstable are not crashing.

Please enlighten me to the pros and cons that you see on both. I am in NO way saying med/surg is easier, or less stressful. I am saying BOTH are stressful and not easy. But I'd like to understand exactly what are the difficulties in the hospital setting caring for less people but more issues. vs LTC where "most" are more stable albeit more confused which is a different challenge that I'm finding much more trying than anticipated because, I love interaction with residents/patients.

If I make a move 6mos to a year from now I'd like to know what I'm setting myself up for. Like I said, I love the "place" and that's hard enough to come by, so maybe the frustrations are there no matter what.

Also not just hospital med/surg...if you've done LTC and then went to something more critical or rehab I'd love to hear any/all veiwpoints. Thanks.

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Specializes in IMCU, TELE, ONC, REHAB, LTC, SNF, ETC....

I've worked just about everywhere. E.R., PACU, Oncology, Telemetry, Women's Health, Peds, Geriactrics, Psych, IMCU, LTC, etc.

I've been a hospital corpsman, pharmacy technician, nursing assistant, lpn staff nurse, lpn charge nurse, lpn supervisor, coordinator of 1:1 internal care agency, and now MDS coordinator.

My years of medical experience exceed 15 years, 11 as an lpn. I don't remember a time that was free of frustration. I do remember co-workers asking me why I was smiling all the time, and when I said, "I just really like this job, taking care of people, I'm happy here", they responded, "give it another 6 months and you'll be like the rest of us".

I did become like the rest of them for a short while, then I realized it wasn't the job position that I loved, it was being able to do something for others and the way it made me feel inside. When that one patient says "thank you", or "you are a really good nurse".

There are no stress free jobs. There are no perfect facilities with staff that do everything correctly. But you alone, can make a difference. Maybe not in the way the staff perform, or even the policies and procedures that they are supposed to follow. But in that one patient, or one Resident that you are caring for.

Keep your head high. Do everything you can to avoid shortcuts, and do the best job you can. Show a little love, a little caring to those you take care of. You may have to leave late, you may be exhausted when you get home, but your mind will be sound, and your heart full of joy.

Serve others with humility, and show your gratitude through your actions. Service to others is the most enduring of human pleasures.

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Specializes in hospice, ortho,clinical review.

Those are beautiful sentiments truly.

I just don't know if I'm finding out LTC is not for me b/c of the never ending med pass plus everything else even though the facility itself really is great. Or if I'd encounter dissatisfaction wherever I'd go. :confused:

The only time I felt really good about a rotation in school was the burn unit. I loved it, but 2 days probably isn't enough to make a full determination of the true day to day.

I know being a new nurse would be overwhelming no matter what. I just wonder if it is true that some found out they were overwhelmed by LTC but settled into a hospital setting better.

I just seriously didn't think I'd feel this way, doubting everything :(

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You probably need adrenaline and something challenging.

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Specializes in hospice, ortho,clinical review.
You probably need adrenaline and something challenging.

Ha! Yeah well you'd think so, but actually I wonder about that. I had a good deal of stress/anxiety in school and so far with this job I don't feel the nervous anxiety of the nauseous type. I read about other new nurses that work in the ER and the stress levels and how they go to work nauseous every day, I couldnt' cope with that. Plus I'm more warm and fuzzy than cold and clinical. So I'm concerned if I'd "fit" in an ICU with those types, although I love to learn new things.

BUT I loved the burn unit. Odd as it were my anxiety never kicked in there either. It's like I was transformed and just did what needed to be done. Truly I would have thought it would have triggered over the top panic but it didn't that's why I'm on the fence. To me it was the perfect blend of med/surg and ICU with really awesome wound care, I really enjoyed dressing the wounds. Maybe that's weird. Maybe I'm only seeing it idealized as it was only 2 days.

I just can't believe I'm having these doubts about where I am. I loved the place, I do not like having to mix meds in pudding and cajole people for 5 minutes to take it. (I wouldn't want to take it either). I do have a great respect for the elderly, I think the elderly now are of the greatest generation that will never be. But I'm finding I'm not crazy about "working" with them and dealing with the sundowning on a nightly basis and that makes me truly sad :(

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Specializes in telemetry, ortho, med-surg.

I graduated in May 2009, started as an RN in a hospital on a telemetry floor for almost 3 months. I quit the hospital to move closer to my fiance because we did not want to have a long distance relationship. I started working in LTC 2 months ago so I think I can compare the two. The work load is definitely heavier in LTC. Recently, the acuity of residents in the subacute/rehab area where I work has increased. At present time, 4 out of 20 residents are post-op open heart surgery. Sats drop, HR increase of decrease so you have to keep a pretty close watch as they can go bad at the drop of a dime. 7 of the 20 require accuchecks with insulin injections at least 2x's on my shift. Blood sugars drop to critical levels or shoot through the roof so you have to keep an eye on those folks as well. IMO, I was able to provide better care to my 5 pts on telemetry when I worked in the hospital. I was able to be more attentive when I needed to be. I liked that I could ask my charge nurse for assistance and guidance if needed. Where I work now, there are no clinical pathways for the residents so I rely heavily on what I've learned in the hospital.

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Specializes in hospice, ortho,clinical review.
I graduated in May 2009, started as an RN in a hospital on a telemetry floor for almost 3 months. I quit the hospital to move closer to my fiance because we did not want to have a long distance relationship. I started working in LTC 2 months ago so I think I can compare the two. The work load is definitely heavier in LTC. Recently, the acuity of residents in the subacute/rehab area where I work has increased. At present time, 4 out of 20 residents are post-op open heart surgery. Sats drop, HR increase of decrease so you have to keep a pretty close watch as they can go bad at the drop of a dime. 7 of the 20 require accuchecks with insulin injections at least 2x's on my shift. Blood sugars drop to critical levels or shoot through the roof so you have to keep an eye on those folks as well. IMO, I was able to provide better care to my 5 pts on telemetry when I worked in the hospital. I was able to be more attentive when I needed to be. I liked that I could ask my charge nurse for assistance and guidance if needed. Where I work now, there are no clinical pathways for the residents so I rely heavily on what I've learned in the hospital.

Thank you! That's exactly the kind of comparison I was thinking. I did a cardiac step down for my preceptorship 3/12's for 6 weeks so I think I got a good grasp of what was involved. By the end I had 5 patients on my own and even though I didn't know all the ins/outs of exact monitoring etc...I still felt a bit more in control than now. This is utter chaos from start to finish.

I'm starting to see why it's so supportive with the other nurses though. They like things as they were, not as they're becoming. They're a very happy socializing bunch which is all well and good. But they don't want the higher acuity either.

You're situation sounds like how my hall is getting and between the responsibilty of 24 plus not liking the methods not to mention the constant psych problems, perhaps I'm getting my answers. If I ask q's they're nice enough it's just I get the "you'll get a system down" and they all do things different w/major shortcuts to get it done and it just adds to my confusion.

I mean we can't even keep dsg change stuff in the resident's room, it's kept in a main supply cabinet. I much prefer having everything in a patient's room, meds and all. I just know many of the nurses and the one "better" hospital aren't that happy either so I'm just really torn. I know I will stay for at least 6mos. I guess maybe that's good enough to know for now.

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