LTC as Rn experience..

Nurses General Nursing

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Just wondering if Rn experience working in long term care hurts a person when they try to apply for hospital, clinic or home health jobs? also experience level, how many years are employers looking at and expecting? . Are they also picking a BSN over associate degree RNs?

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Specializes in private-duty, hospital, LTC, clinic.

There is so much that can be learned in LTC, knowledge that is invaluable to a nurse in ANY setting !! Hospital nurses that don't have LTC experience, from my experiences, often lack intervention skills r/t skin integrity, safety, mobility, and psycho-social issues. Many other reasons as well, but I'll let another person address why else LTC is beneficial. This is just one of my opinions, I have LTC and hospital experience, as well as clinic and private-duty. All nursing experience is advantageous !!

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Specializes in adult ICU.

No experience hurts, but hospitals prefer acute care experience. In the almost 6 years I've been at my facility, I haven't heard of a single new hire that came from LTC on my unit or on other wards. I know my manager won't consider them at all, but I am in critical care which is a pretty different skill set. She is only hiring RNs with critical care experience right now because the market allows her to. My hospital is also BSN preferred but you know how that goes -- they still hire ADN RNs all the time.

I disagree with the previous poster that said hospital RNs lack intervention skills regarding skin integrity, psychosocial issues, etc. I don't think that's true at all. You get that experience plus a whole lot more in almost any med/surg acute care setting.

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Specializes in private-duty, hospital, LTC, clinic.

My comment regarding lack of intervention skills in the hospital setting is because of the condition that some elderly return to the nursing home in. Having fallen or obtained an open area on their coccyx or heels/elbows. Skin integrity and safety are a big issue in the geriatric population. It's offensive to me, the opinion that a nurse that has been working in LTC isn't a worthy candidate to be trained in acute care. Hiring policies are different, depending on where you are. I was hired for the medical/oncology unit with only LTC and clinic experience. For me, I felt that to be an advantage.

One of the things that I like about this forum is the opportunity to hear the differing opinions :) And, as the previous poster stated, "No experience hurts"

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My comment regarding lack of intervention skills in the hospital setting is because of the condition that some elderly return to the nursing home in. Having fallen or obtained an open area on their coccyx or heels/elbows.

The problem in acute care is that the patients come to the hospital so ill that sometimes their condition doesn't allow them to be turned. Shifting them to the right or left, or attempting to offload them from their coccyx in any way may cause respiratory distress. Antibiotics can cause frequent diarrhea, which may cause coccyx breakdown. Patients become agitated in the hospital setting because it disrupts their routine, and rub their heels and elbows on the mattress, causing shearing injuries. While it's possible to get specialty mattresses in the acute care setting to prevent these things, when a patient is so ill that you can't appropriately offload them, the last thing you can do is switch their mattress.

Patients cry out in pain, so we medicate their pain. Patients become hypoxic from pneumonia. Patients are admitted for urinary tract infections, which as we all know, cause massive changes in the elderly. Any of these could, in turn cause confusion. Patients then get out of bed, despite the acute care nurse's best efforts to remind them that they have to stay in bed. We don't get to bed alarms on time, and the patients fall. It's not for lack of intervention skills, it's because the patient condition in the hospital is vastly different from LTC, when they are at home.

You send them to the hospital because their medical condition is such that you can't manage them in a sub-acute setting anymore, and sometimes, that condition or the treatment for the condition causes adverse effects. Sometimes, the acute care focus has to be only on keeping the patient alive, skin condition be darned.

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And to the OP, I think that in the coming months and years, unit directors will be more lenient when they see LTC experience. They will have to understand that the job market was tight and that LTC was all of the work some new grads could get. Plus, as other posters have pointed out, you gather valuable experience with time management, medication administration, skin assessments and management of wounds, and patient/family relations. There are far worse things you could do than go to LTC.

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Specializes in LTC, Med-SURG,STICU.

As a nurse who started out in a hospital, then went to LTC, and is now going back to the hospital setting. LTC has been nothing but benifical to me as a nurse. While I was on the search for new job in acute care I did run into a few managers that did not like my LTC experience and I could tell that when I interviewed with them (still not sure WHY they interviewed me). I decided that they were ignorant and decided that I would not want to work with someone who would look down on me for that wonderful experience.

Where I am going now I interviewed with a nurse who worked in LTC and could see what a great assest I would be to their unit. That is when I knew that this place would be a good place to work.

I can manage 30+ residents healthcare needs on a dly basis, manage their acute needs as they arise, do mountains of paperwork, keep 30+ residents' family members happy (somewhat), and still manage to get out of work somewhat on time everyday. How wouldn't all of this not be an assest?

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Specializes in Geriatrics, Med- Surg.

Hi! I worked in LTC as a new grad ADN for 8 months and I was recently hired at a hospital on a med/ surg unit. They are giving me a 8 week orientation before I go on my own. But during my interview my DON said she started off in a nusing home 30+ years ago because back then hospital jobs were hard to get for new grads as well. She said I must have developed excellent time management skills. So I think it depends on who is interviewing you as far as there opinion on LTC experience. I loved working in LTC & miss my residents everyday! :) Good luck with your job search.

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The problem in acute care is that the patients come to the hospital so ill that sometimes their condition doesn't allow them to be turned. Shifting them to the right or left, or attempting to offload them from their coccyx in any way may cause respiratory distress. Antibiotics can cause frequent diarrhea, which may cause coccyx breakdown. Patients become agitated in the hospital setting because it disrupts their routine, and rub their heels and elbows on the mattress, causing shearing injuries. While it's possible to get specialty mattresses in the acute care setting to prevent these things, when a patient is so ill that you can't appropriately offload them, the last thing you can do is switch their mattress.

Patients cry out in pain, so we medicate their pain. Patients become hypoxic from pneumonia. Patients are admitted for urinary tract infections, which as we all know, cause massive changes in the elderly. Any of these could, in turn cause confusion. Patients then get out of bed, despite the acute care nurse's best efforts to remind them that they have to stay in bed. We don't get to bed alarms on time, and the patients fall. It's not for lack of intervention skills, it's because the patient condition in the hospital is vastly different from LTC, when they are at home.

You send them to the hospital because their medical condition is such that you can't manage them in a sub-acute setting anymore, and sometimes, that condition or the treatment for the condition causes adverse effects. Sometimes, the acute care focus has to be only on keeping the patient alive, skin condition be darned.

I work in ltc and always felt that that hospital RN's have different problems to focus on...you wrote an excellent response!!

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I gotten the impression that many employers frown on ltc experience. Worked in it for 2 1/2 yrs so far.. and I often get told that I have no experience. I often feel like ltc is hurting me my chances of getting a different job.

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I am facing the same fear as you are. I am a new Grad in May and graduated with my BSN. In my area there are few jobs and you are lucky to get into a hospital as a new grad. I took a position in a LTC facility about 2 months ago hoping that it would give me some experience to one day get into the acute hospital setting where I always thought I would go straight out of college. Now it scares me that I made the wrong decision and it could effect me negatively. I had to make the decision of driving an hour to work in as a nurse tech in a hospital that did not have a position for me, or take a nursing position, but in a facility I never thought I would work?

Also, I have another question.. Is hospice care experience that will be looked at by acute hospital employers as good experience? or is it in the same level as LTC?

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