Does LTAC count as critical care?

allnurses Guide · Mar 10, 2009

Thank you for such a compassionate answer.

What's compassion got to do with it? You asked a yes/no question and someone bothered to provide a succinct reply.

cessnadriver · Mar 10, 2009

I can't see where anyone took offense at anything. Please show me.

Compassion? I answered your question. It was of a yes or no nature.... the answer was NO. You might wonder how I came up with this answer? From being a didactic and clinical instructor in a CRNA program who, in addition has sat on more admission boards than I care to remember. So, as you can see I have the bona fides to formulate a well researched answer... and it remains, NO. I am sorry I cannot change reality to suit your perception of it. I also appears I am the ONLY CRNA who answered your question. Please do not take offense at answers you ask for if the answer is not what you want.

dfk, RN, CRNA · Mar 10, 2009

If you really take that much offense to what cessnadriver wrote, you are gonna have a long road ahead of you in anesthesia school. He/She answered your question, no frills attached. Sorry if the answer wasn't what you were looking for. No matter what others have told you, LTAC is NOT acceptable. If you think they are "sick sick" then you really have no idea. I'm not saying working LTAC is easy, far from it! The kind of experience you need is the kind where the patient is trying to die every 5 minutes, and having 1 nurse to 1 patient is sometimes not even enough. I suggest you shadow at some (real) ICUs, and pick with one has the highest acuity. Forgot LTAC.

:smackingf:yeahthat:

of course, if you don't (want to) believe what others have said/are saying, maybe call the schools you are interested in. the AANA does not recognize LTAC as critical care. for the most part, any unit designated as an ICU is what they are looking for. rarely will ER or PACU be acceptable, but surely i haven't heard of ANYONE EVER getting admitted to anesthesia school with LTAC experience. my recommendation is get yourself to a sick ICU, surgical IMO, but ICU none the less.

Jo Dirt · Mar 11, 2009

OK, maybe offense wasn't the right word. But your "Thanks for your compassionate answer" reeked of passive aggressiveness. It seemed a strange thing to post to someone who succinctly answered your question.

I know when I'm receiving a snarky answer. It reeked of snarkiness.

If that was all they could muster up to say, they shouldn't have bothered. That other dude at least elaborated, though I'm not sure that response was stated out of a genuine desire to be helpful, either. I get the impression at lot of people imagine themselves to be part of an elite crowd because they are on the SRNA forum. Maybe I'm just too down to earth, but I sense some people feel a little cocky and self-important because they think they are doing something nobody else can do, or whatever...I don't like Pink Floyd, but I know what that song about another brick in the wall was talking about.

So, rather, it isn't the information that is offensive, it's the spirit in which the information is delivered (and you know it.)

Unfortunately, some never get over the juvenile tendency to need to feel they are better than everyone else.

So, anyway, I gather that the general consensus is that LTAC is basically a nursing home, is that right?

Home Health Columnist / Guide · Mar 11, 2009

LTACs specialize in providing both critical care and therapy services to patients who are critically ill, have multisystem complications or failure, and require hospitalization averaging 25 days, in a facility offering specialized treatment programs and therapeutic intervention on a 24 hour/7day a week basis. Most patients are transfered from ICU's to the LTAC.

Here's a great description of an LTAC in my area:

They do provide vasoactive drug therapy/drips in this unit.

Since you have not had prior hospital experience, this would be a good unit to get your feet wet and then transition to higher level critical care unit if your area not hiring staff directly into MICU/SICU/Cardiothoracic/Neuro ICU unit. You will need a higher level critical care unit experience in order to attend most CRNA programs.

Take a look at program requirements in your area, in order to make best informed decision. Complete CRNA program list available at AANA website: http://webapps.aana.com/AccreditedPrograms/accreditedprograms.asp

CCRN-CMC-CSC · Mar 11, 2009

in my opinion LTAC experience would count when it came to interviewing for an ICU job. However LTAC is similar to the more stable ICU patients that we have that are just waiting on a stepdown bed or LTAC bed. These are the patients we give to the new nurses or we increase the assignment load for an experienced nurse. For example we use a numerical acuity scale and a trached pt on two drips waiting on an LTAC bed is a 2 while a sick pt is a 4 or 5.

Jo Dirt · Mar 11, 2009

in my opinion LTAC experience would count when it came to interviewing for an ICU job. However LTAC is similar to the more stable ICU patients that we have that are just waiting on a stepdown bed or LTAC bed. These are the patients we give to the new nurses or we increase the assignment load for an experienced nurse. For example we use a numerical acuity scale and a trached pt on two drips waiting on an LTAC bed is a 2 while a sick pt is a 4 or 5.

NrsKaren's post and this short and to the point post was so helpful...not like those other post

Thank you!

CCRN-CMC-CSC · Mar 12, 2009

Yea, well, if this doesn't describe sick patients I don't know what a sick patient is...this is how another poster described LTAC:
working in a long term acute care hospital is challenging......I just started working in one...this is my second job...graduated in june 07...passed the boards July... my first job was not challenging. I love this one......its rehab with med surg and some telemetry. I get at the most 6 patients but 5 is the norm....and our patients stay at least 2 weeks....
some folks confuse LTAC with long term care..........no comparison
Here is a great description of what you will encounter as a nurse in a LTAC:-
LTAC stands for "long-term acute care" hospital. LTAC hospitals treat critically ill, medically complex patients who suffer from multiple organ system failures - active disorders of many parts of the body. These conditions include cardiopulmonary disorders, wounds, kidney diseases, complex infections, and neurological disorders such as head and spinal cord injury and stroke. Because they are medically complex, our patients often are dependent on technology, such as mechanical ventilators, total parenteral nutrition, respiratory or cardiac monitors and dialysis machines for continued life support. At our hospitals, we strive to help our patients recover through a carefully orchestrated multidisciplinary team approach.
great place to gain experience.
First, to correct some common misperceptions:
LTAC is not chronic care.
LTACs are not skilled nursing facilities.
LTACs are not rehabilitation facilities.
LTACs are not short-term acute hospitals.

I agree that LTAC work would be VERY challenging. My father is currently in an LTAC after having a single car motor vehicle accident this past December. The first 3 weeks after his accident he was in the Neuro Trauma Unit at a major university hospital - bilat flail chest, retrosternal bleed with fx sternum, PE, orally intubated, a-line, swan, CT scan every day, multiple vasoactive gtts that changed on any given day due to huge bp swings, gtt, insulin gtt, diprivan gtt, ICP monitoring, etc. He was moved to the LTAC after they trach'd him, PEG tube placed, ICP monitoring out, Swan out, a-ling out, and down to just a Versed gtt and Heparin gtt. Obviously still a very sick patient but just not the same acuity therefore they moved him to the LTAC so they could free a Neuro Trauma bed. LTAC nurses are AMAZING and have many of the skills needed to work critical care. However anesthesia is closer to the skills utilized in the most acute areas. This is certainly NOT a slam against LTAC nurses - heck our program will not take ICU nurses that work at small hospitals that dont do hearts or heads. OR nurses are often irked that they dont qualify for CRNA school but truthfully you need the high end critical care experience to survive school. Not really a matter of if you qualify but if you would survive the fast paced CRNA program. They expect you to already now how to keep a semi-coding patient alive for hours and hours. They dont want the OR to be the first place that you hang 4 or 5 vasoactive gtts and 10 units of blood while juggling ABG interpretations, vent changes, obtaining and treating stat lab results, etc.

Voodoo7 · Mar 12, 2009

I really don't see how you can call Karen's post helpful while discounting the others. I don't think LTAC is just a "nursing home" and I am sure it takes specialized skills to work there. However, if your original question was "Does it count as CC experience in the eyes of an anesthesia admissions committee", you got that answer early on - it is NO. If you choose to work LTAC, great for you, but as far as anesthesia school, it will only help you as far as prepping you for a real ICU.

alterego33 · Mar 13, 2009

I agree with Voodoo. Just getting an interview is difficult, let alone getting admitted to anesthesia school. Admissions committees are looking for the best and the brightest and those who are willing to do all they have to do to get into school. If they think you are trying to get in through the back door, you will look less attractive than an applicant who has worked in the hardest and most sophisticated critical care units.

It has nothing to do with you personally, but you have to do whatever you need to do to become competitive. I have sat in admissions committees for anesthesia programs and have lots of reasons for saying this.

Also, it pays not to be too sensitive. I have been yelled and screamed at in the operating room and have learned early to have a thick skin. It is a stressful area and learning how to handle stress, whether from patients or others, can make or break you as a CRNA.

Jo Dirt · Mar 14, 2009

I agree with Voodoo. Just getting an interview is difficult, let alone getting admitted to anesthesia school. Admissions committees are looking for the best and the brightest and those who are willing to do all they have to do to get into school. If they think you are trying to get in through the back door, you will look less attractive than an applicant who has worked in the hardest and most sophisticated critical care units.
It has nothing to do with you personally, but you have to do whatever you need to do to become competitive. I have sat in admissions committees for anesthesia programs and have lots of reasons for saying this.
Also, it pays not to be too sensitive. I have been yelled and screamed at in the operating room and have learned early to have a thick skin. It is a stressful area and learning how to handle stress, whether from patients or others, can make or break you as a CRNA.

You can't succeed in most areas of nursing and be overly sensitive.

CaOTn96 · Mar 17, 2009

The "No" response was correct. You were wrong to sarcastically thank this honest knowlegible person for their 'compassion'. At least they took the time to answer your query with the truth.

LTAC is similar to a rehab hosp but with some vents, etc. You won't even have the challenges of a fast paced tele/med/surg because the parts are 'long-term'. Therefore you have a BIG advantage b/c you know everything about their hx. (b/c they are 'long-term' stay pts you've had before you aren't thrown a lot of curve balls.) And they are stable in that their conditions are not usually expected to improve much.

If you can get hired on a tele/med/surg unit you'll have ever changing pts. That's the experience you should seek. I often d/c and get 2 to 3 new admits out of my total load of 7 pts/per shift. I'm challenged daily b/c they aren't long-term, every shift has new pts with new problems I must assess quickly. After 6 mos in tele/med/surg you'll be able apply for a spot in ICU at the hospital. Several previous RN's on my unit have gone that route and then on to apply to NA school.