Forever a LTC/Rehab Nurse?

Published

Over a year ago, my first job on a cardiac progressive care unit ended after an unsuccessful orientation. Then, with the recommendation of the nursing placement office as well as others, I started a job at a local skilled nursing facility. While I have encountered more than I would have imagined at this job, it was never my intent to make it a permanent position.

So, after 15 months of working there, I have started putting out applications, including ones to the organization that I lost my first nursing position with, in addition to other organizations. I have applied to a variety of areas, from hospital floors to clinics to outpatient services to public health. I had an interview with the public health position; however, with 11 other applicants and no experience in public health, it doesn't seem likely I will obtain that position. Additionally, I was already rejected from a supplemental flu clinic position. None of the other positions that I have applied for have made any contact or shown any interest.

Obviously, if I don't get a different position, it is not in my best interest to leave my current job. However, it was never my intent to be a LTC nurse. I am wondering, though, that with my past, and with no one else currently pursuing me, am I forever a LTC/Rehab Nurse? What can I do so that other areas of nursing will be interested in me?

Up Vote Up Vote ×
Specializes in ICU, LTACH, Internal Medicine.

1. When you transfer patient to acute, be very friedly and very useful with ER staff.

2. Do the same with "outside" nurses who go into your LTC. Dialysis is one popular example, as HD companies constantly hire and after going everywhere for a year one can easily get enough connections for securing a spot in any realm, plus tons of useful skills. Let them know, after you become comfortable with each other, that you might like a change.

3. Get BLS, ACLS and basic ECG/arrythmia course done and keep them updated.

4. Move to more "acute" LTC, for example one with vent unit or transitional care.

5. Try LTACH if you live near one. Just make sure it is not "acute" one to begin with, as patients there are very sick. Rehab LTACHs are a bit more stable, and nurses with only LTC experience are usually comfortable there once they get on with tele.

6. See what you can do where you are. Wound care certificate, case management, chart audits, ID control, IVs/lines (including PICC placement if your facility has enough of such patients) are only a few options. Speak with your DON and let the Powers know that you are interested in advancement. If you do not know what you want except that you better get the heck out of pushing that cart ASAP, ask for shadowing different people one day a week on your time off. Look at things which tends to fall through the cracks (I know, most of them do but that just gives you more choices) and become a person who makes a difference AND uses the results in her own interests. Just keep quiet about the last part for a while :)

Your goal is to get skills which would push you above the crowd and make sure they sound right in your CV.

Good luck! You are NOT stuck there to the end of your career, trust me.

Up Vote Up Vote ×
Specializes in Med/Surg, Tele, Dialysis, Hospice.

Have you considered hospice nursing? I specialize in hospice and am a certified hospice nurse. I think they would consider you since LTC facilities often have residents who are on hospice and you definitely have geriatric experience and no doubt experience with life ending illness. Not that hospice is all geriatric patients, it is a wide mix and I know so many nurses who fell into it sort of "accidentally", because they couldn't get into acute care or whatever, who love, love, love it and would never do anything else.

Just my $.02. I worked acute care for many years and have family members who still do and you couldn't give it to me on a silver platter these days. Too many government regulations and interferences and too many really sick people whose acuity is not taken into consideration when staffing is done.

Up Vote Up Vote ×
1. When you transfer patient to acute, be very friedly and very useful with ER staff.

2. Do the same with "outside" nurses who go into your LTC. Dialysis is one popular example, as HD companies constantly hire and after going everywhere for a year one can easily get enough connections for securing a spot in any realm, plus tons of useful skills. Let them know, after you become comfortable with each other, that you might like a change.

3. Get BLS, ACLS and basic ECG/arrythmia course done and keep them updated.

4. Move to more "acute" LTC, for example one with vent unit or transitional care.

5. Try LTACH if you live near one. Just make sure it is not "acute" one to begin with, as patients there are very sick. Rehab LTACHs are a bit more stable, and nurses with only LTC experience are usually comfortable there once they get on with tele.

6. See what you can do where you are. Wound care certificate, case management, chart audits, ID control, IVs/lines (including PICC placement if your facility has enough of such patients) are only a few options. Speak with your DON and let the Powers know that you are interested in advancement. If you do not know what you want except that you better get the heck out of pushing that cart ASAP, ask for shadowing different people one day a week on your time off. Look at things which tends to fall through the cracks (I know, most of them do but that just gives you more choices) and become a person who makes a difference AND uses the results in her own interests. Just keep quiet about the last part for a while :)

Your goal is to get skills which would push you above the crowd and make sure they sound right in your CV.

Good luck! You are NOT stuck there to the end of your career, trust me.

Thank you. I am not sure if there are any LTACHs where I live, but there are definitely more skills to learn at the place I currently work. I work evenings usually, so I don't always see everything but maybe picking up a day shift here and there can expose me to more situations and skills.

Up Vote Up Vote ×
Have you considered hospice nursing? I specialize in hospice and am a certified hospice nurse. I think they would consider you since LTC facilities often have residents who are on hospice and you definitely have geriatric experience and no doubt experience with life ending illness. Not that hospice is all geriatric patients, it is a wide mix and I know so many nurses who fell into it sort of "accidentally", because they couldn't get into acute care or whatever, who love, love, love it and would never do anything else.

Just my $.02. I worked acute care for many years and have family members who still do and you couldn't give it to me on a silver platter these days. Too many government regulations and interferences and too many really sick people whose acuity is not taken into consideration when staffing is done.

Hmm, that is something to consider since we do take on quite a few hospice patients.

Up Vote Up Vote ×

Thank you for your responses. At this point, I am just going to have to continuously send out applications until someone shows interest.

Up Vote Up Vote ×
Specializes in Education, Administration, Magnet.

Apply for internships. That is the best way to get into another hospital specialty.

Up Vote Up Vote ×

Being a Nurse with 30+ years varied experience, I love LTC Nursing,but admitting,I HATE the working conditions that CONSTANTLY seems to prevail!!!

1 Nurse /20 Residents ,3 CNA's (millennials)

Some how,you're to complete a 20 bed med pass, treatments, supervision of the CNAs (their assignment is split among 40 Residents), monitor those Residents that are High Fall Risks,p/u orders(God forbid there's a fall,Transfer to the ER or incoming Admission) Documentation and report...and yet,you're EXPECTED to do all and leave on time....

I'm 57,is this it?!!

It's the RESIDENTS who ultimately end up with the "**** end" of the stick,and that's NOT FAIR!!!

And that's why there's such a HUGE STAFFING TURN-OVER, MANDATORY OVER TIME in LTC.

I'm mad,frustrated and at this point,IF I could retire I would...but not po$$ible.

Up Vote Up Vote ×
Specializes in Progressive Care, Sub-Acute, Hospice, Geriatrics.

Hey OP how are you doing? Are you still working in LTC?

Up Vote Up Vote ×
+ Join the Discussion