acute care vs. long term care

[Ashana]

I have been thinking a lot about LTC and was wondering if I can get some feedback on it. I graduated nursing school a year ago and have since been working in med/surg, a field that I hate. I love learning about the all these different diagnosis and how to treat them. But I hate how insanely fast pace it is and that the patients are constantly changing. My impression of long term is that it's fast pace without being too fast pace. In addition, the patients are usually the same for a while. However, it does change enough so that you can keep learning and developing your skills. The downside to LTC is 5 day work weeks and a lesser pay (though overtime is always available).

I am also afraid that eventually I will want to try something new in nursing and going into LTC will make it harder for me to change than med/surg will.

How accurate is my impression and what are the pros/cons of LTC and acute care?

[TheRegisteredMurse]

Hi Ashana!

I enjoyed your post and I hear what your saying about the fast paced environment. Just keep in mind that the experience that you are building is amazing on the floor that your on and will make you a better nurse in the long run. I see you have been an RN for a little over a year or so, and I'm going on my third year and I sometimes cant stand the fast paced environment but the learning capacity like I said it valuable.

Now to touch on your idea of LTC....I have a per diem job at a sub acute rehab unit and its fantastic. Your pt load is higher but you dont get you IV meds and your acute care shenanigans. You just have heavier med passes. It is by no means slower, its busier in different aspects. I know this is short but I hope you found this useful.

[KatieMI, BSN, MSN, RN]

I've been in both and honestly can say that either field has its own quirks and demands. You don't enjoy patients changing quickly; would you rather like to be a personal servant that LDOL from XXX pushing her button every 5 min every working shift for months in a row? Or if you can't just hope for that new Adams Family to walk out of there before you come back next time?

If you want to try LTC, there are agencies where you can work a few shifts a month for $$$ to get the taste of it. There are also acute rehabs and LTACHs where your med/surg skills will be welcomed but patients stay longer, although overall tempo may be even worse than in med/surg.

[RainMom]

Not all LTCs do 8 hr shifts. At least a few near me do 12s & one has starting pay the same as what I make now after 5 yrs experience in a hospital (but less in the benefits dept). Agree with above to also look at rehab & LTACH.

[Cvepo]

I agree with LTACs and SARs. Be careful with your state laws and facility policy as an RN vs LPN, though. We have a large acute rehab center in our hospital system with LPNs and RNs. LPNs are not allowed to do ANY IV meds at all. Nothing! So the RN has his or her own assignment and then has to go do IV antibiotics and routine PICC flushes for all the other patients with lines on top of everything else. A friend of mine worked there and hated it, because she was given the same patient load but was expected to do even more. Many RNs is LTC take managerial roles, but LTAC, MRU and SAR is usually different.

[Cvepo]

I've been in both and honestly can say that either field has its own quirks and demands. You don't enjoy patients changing quickly; would you rather like to be a personal servant that LDOL from XXX pushing her button every 5 min every working shift for months in a row? Or if you can't just hope for that new Adams Family to walk out of there before you come back next time?

Ok what is LDOL? I feel stupid, haha.

I agree with this part about possible difficult patients/families being gone. Eventually those difficult ones do leave. Chronics get stuck in ever facet in healthcare, but LTC is literally all chronics all the time. Acute care you can at least expect them to leave eventually...

[KatieMI, BSN, MSN, RN]

Ok what is LDOL? .

Little Demented Old Lady. A type who is frequently looking very frail and benign but in reality extremely difficult to manage due to long list of medical and mental conditions aggravated by extreme polypharmacy, dementia and often being quite spry and aggressive as well.