Give LTC a chance, or get out now?

  1. Recently licensed ADN graduate in Illinois, I took the first job offered to me after being rejected from some big hospitals. RN position in a LTC facility, started on the vent floor. Was overwhelmed by how many patients there are, the physical condition of them, the resources available at the facility, and the professionalism of the staff. Now I 'understand how things work' a little better but that doesn't mean I like it.

    I'm also still recovering from an ORIF of my proximal tibia from last August, and the 12 hour shifts [really 13 hour when you count hand-off and catching up on unfinished tasks/charting] add up, especially on the vent unit where most of my time is spent passing meds to my 13+ patients, all of whom are on ventilators and have g-tubes, most of whom are comatose. It's a lot of work and my knee throbs after a shift. Compression socks have helped.

    I told the DON I'm going to quit because they were consistently scheduling me for 4 day weeks [with a bonus 5 day week] after promising alternating 3 and 4 day weeks. It was too much for my knee and didn't feel like a good fit. They offered me a consistent 3 days a week, and a position on a calmer LTC floor with more independent and medically stable patients [granted, it's about 20 residents now and one nurse, two CNAs]. Still a lot of meds to pass but much less clinical problem solving. Currently I'm going back and forth between this floor and the vent unit, still doing twelve hour shifts. On the next schedule I'll mostly be on the calmer floor.

    People are telling me to stick with it because it's good experience and if I stay six months I can be considered for positions in hospitals. I'm honestly afraid that I'm not going to learn anything at this facility unless I take the initiative and come in having studied my residents conditions and medications at home. I just want to get out and look anywhere but LTC, but it seems like that's all that's really available to me at this point with my unimpressive resume. They also seem to have taken back the hiring bonus they promised me, because I threatened to quit. Nobody's said anything but I can't think of another reason. Just another thorn.

    What's your experience with a first job in LTC? Are you glad you stayed, or glad you left?

    Sorry if this is all over the place. I feel so conflicted about what to do. Some things are shady.
  2. Visit mc-escher profile page

    About mc-escher, RN

    Joined: Oct '15; Posts: 16; Likes: 12
    Nursing student; from IL , US

    19 Comments

  3. by   gees_rn
    I am glad I left. I worked LTC for abouI 1 month total. I was lucky because this facility was giving me a long orientation, which I know just new LTC nurses don't get, but I left one shift shy of my first day on my own.

    I wanted a job so I'd taken the first one offered but knew it wasn't the right fit from the get-go. I am glad I left; the work was challenging and I actually enjoyed it but I felt like I was learning a skill set that was really only specific to THAT facility and that as a brand new nurse that didn't seem like the best option for me career wise. I regretted wasting their time, but it was the right descision.

    Stay till ya find something else, but don't stay long. I actually think that's what someone at that first facility told me :-)
  4. by   Buckeye.nurse
    I worked as a CNA in a long term care facility during nursing school. We were able to sit for the LPN boards prior to the last semester of our nursing program. As it was a pay raise at the facility I already worked at, it seemed a no brainer to me.

    I learned a lot--mostly pharmacology, time management, and prioritizing tasks. I also cried many days when I was going home because I felt like I wasn't able to give quality care to the 20-30 patients I was assigned. I don't regret that position per se, but I'm very, very glad those days are behind me.
  5. by   Emergent
    If you think you don't have anything to learn, you most definitely don't know what you don't know!
  6. by   Wuzzie
    Quote from mc-escher
    I'm honestly afraid that I'm not going to learn anything at this facility unless I take the initiative and come in having studied my residents conditions and medications at home.
    Good nurses are always, always taking the initiative to learn about their patient's disease processes and medications. I'm 31 years in and learn knew things every. single. day. It matters not what unit or facility you are in. Once you graduate from nursing school you alone are responsible for your professional growth. LTC patients encompass almost every disease process known to man. How could you NOT learn from taking care of them?
  7. by   Orion81RN
    Not sure where in Illinois you are, but could you PM me regarding this facility? It actually sounds like something I'd be highly interested in. I've done post-acute short stay rehab, regular LTC/SNF and currently vents in home care. PM me, please if you get the chance!
  8. by   mc-escher
    Ooh definitely don't mean to imply that I'm not interested in learning things! I've already been studying up on vents, catheter care [I've seen some... interesting foleys here], pharmacology, and I'm starting to go back to my med surg book for in-depth reviews of common patient conditions. I love learning!

    My concern is that my facility isn't taking any interest in my progress here. My perspective is that to them, I'm a warm body to pass meds and be responsible for residents. They're not interested in helping me get certifications or giving me the time to really get to know my patients. My stress comes from feeling like it's all on me and that my facility doesn't care one way or another.
  9. by   Emergent
    Your facility needs a nurse. They are interested in retaining you as evidenced by their response to your complaint about schedule. They want you to become competent at the job they hired you for, as evidenced by your solid orientation period.

    No, their primary goal is not to nurture and nourish your budding career.

    You accepted the job voluntarily. Why don't you do the stand up, professional thing and give them a year before you move on. No, LTC is not the high status, hot shot specialty that you may be seeing your classmates start out with, but you will definitely get solid experience that you can take anywhere!
  10. by   BlinkyPinky
    Quote from Emergent
    Your facility needs a nurse. They are interested in retaining you as evidenced by their response to your complaint about schedule. They want you to become competent at the job they hired you for, as evidenced by your solid orientation period.

    No, their primary goal is not to nurture and nourish your budding career.

    You accepted the job voluntarily. Why don't you do the stand up, professional thing and give them a year before you move on. No, LTC is not the high status, hot shot specialty that you may be seeing your classmates start out with, but you will definitely get solid experience that you can take anywhere!
    *****
    THIS ^^^^^^
  11. by   Wuzzie
    Quote from mc-escher
    Ooh definitely don't mean to imply that I'm not interested in learning things! I've already been studying up on vents, catheter care [I've seen some... interesting foleys here], pharmacology, and I'm starting to go back to my med surg book for in-depth reviews of common patient conditions. I love learning!

    My concern is that my facility isn't taking any interest in my progress here. My perspective is that to them, I'm a warm body to pass meds and be responsible for residents. They're not interested in helping me get certifications or giving me the time to really get to know my patients. My stress comes from feeling like it's all on me and that my facility doesn't care one way or another.
    That's really good to hear and if it makes you feel better I have worked at several large, nationally known hospitals and although they say they support their nurses' professional growth the truth is they never really backed up their words with any action. Sure they offer educational opportunities...that none of us can attend because...patients. Keep your chin up, your eyes/ears open and a positive attitude and you will go far.
  12. by   OrganizedChaos
    You're a new nurse, in a new speciality so of course you're going to be stressed and overwhelmed. No matter where you go you will be challenged, it will just be in a different way. Just because the nurseatient ratio sounds lower, doesn't mean it's easier, you'll be on your feet less or get out earlier. You haven't developed a routine yet so no matter where you go, you will have long shifts and feel overwhelmed.

    I have worked both LTC & hospital, they are both challenging. I was on my feet the whole shift at both the nursing home & hospital & I had 12+ hour shifts in both LTC & acute care. So how you're feeling will dissipate with time.
  13. by   heron
    Quote from Emergent
    If you think you don't have anything to learn, you most definitely don't know what you don't know!
    Really! If you work it right, at the end of a year or two you'll have some pretty impressive skills, I would think.
  14. by   fibroblast
    Quote from mc-escher
    Recently licensed ADN graduate in Illinois, I took the first job offered to me after being rejected from some big hospitals. RN position in a LTC facility, started on the vent floor. Was overwhelmed by how many patients there are, the physical condition of them, the resources available at the facility, and the professionalism of the staff. Now I 'understand how things work' a little better but that doesn't mean I like it.

    I'm also still recovering from an ORIF of my proximal tibia from last August, and the 12 hour shifts [really 13 hour when you count hand-off and catching up on unfinished tasks/charting] add up, especially on the vent unit where most of my time is spent passing meds to my 13+ patients, all of whom are on ventilators and have g-tubes, most of whom are comatose. It's a lot of work and my knee throbs after a shift. Compression socks have helped.

    I told the DON I'm going to quit because they were consistently scheduling me for 4 day weeks [with a bonus 5 day week] after promising alternating 3 and 4 day weeks. It was too much for my knee and didn't feel like a good fit. They offered me a consistent 3 days a week, and a position on a calmer LTC floor with more independent and medically stable patients [granted, it's about 20 residents now and one nurse, two CNAs]. Still a lot of meds to pass but much less clinical problem solving. Currently I'm going back and forth between this floor and the vent unit, still doing twelve hour shifts. On the next schedule I'll mostly be on the calmer floor.

    People are telling me to stick with it because it's good experience and if I stay six months I can be considered for positions in hospitals. I'm honestly afraid that I'm not going to learn anything at this facility unless I take the initiative and come in having studied my residents conditions and medications at home. I just want to get out and look anywhere but LTC, but it seems like that's all that's really available to me at this point with my unimpressive resume. They also seem to have taken back the hiring bonus they promised me, because I threatened to quit. Nobody's said anything but I can't think of another reason. Just another thorn.

    What's your experience with a first job in LTC? Are you glad you stayed, or glad you left?

    Sorry if this is all over the place. I feel so conflicted about what to do. Some things are shady.
    Get out now from this hellhole. That 20 patients you are 'promised', will turn in to 'we don't have staff' for you to have that unit. Then that 20 patients will be all trachs, 15 feeding tubes, all needing sched II meds, with colostomies.
    Last edit by fibroblast on Jun 14

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