LTC vs. Hospital, good move or not?

Nurses General Nursing

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Specializes in M/S, Travel Nursing, Pulmonary.

I see a lot of posts by LTC nurses about how bad the conditions are. I see some too who say they are happy with where they are, but not nearly as many.

I've come to the conclusion that I don't get along with night shift. In my current position at a hospital, not much opportunity to change to days and/or evenings. Day shift nurses are being called off a lot due to census still and every position that posts internally is for nights. So, unless I am willing to move on, I'm stuck with nights here.

I am considering doing LTC nursing because I already know of two places I could basically be hired at right off the bat if I wanted. And, they are days. I've always said I would never do nursing home but............to get away from nights I might.

Good move or no?

More importantly: What do I look for as I go to places to see where I might get hired? Any tell tale signs of a good vs. a bad situation at a nursing home?

It'd be a big move for me, but I think a lot of things would improve for me if I go to nights.

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Specializes in Gerontological Nursing, Acute Rehab.

As a nurse that has spent the majority of her career in LTC, the most important piece of advice I can give you is to STAY AWAY from for-profit orginizations. They are an absolute nightmare, IMHO.

You can also google "Nursing Home watch list", and it will give you a website where you can look up nursing homes in your area and their survey results. When I moved to a new state, that was the first thing I did before even setting up interviews. Nothing impresses/scares a prospective employeer more than when you ask them about their status on the Nursing Home Watch List.

I love gerontology and I feel I'm able to practice with a lot of autonomy in this setting. I sometimes do miss hospital nursing, but I probably would not go back to it. There is also more opportunity to advance, if that's something you would be interested in down the road. Just do your research before deciding on a place to work.

Hope this helps!

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I have worked in both hospital and LTC, and my advice would be to look up the facility's rating by Medicare. Also, it would be a good idea to be very apprehensive about a facility that a.) hires you on the spot or b.) claims they have recently "cleaned house" as these can both be signs of a facility in trouble.

If you haven't worked in LTC before, maybe you should consider part time or PRN there first, that way you could get a feel for whether or not it is a good fit for you before you make a commitment to full time

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Specializes in LTC, Acute Care.
I have worked in both hospital and LTC, and my advice would be to look up the facility's rating by Medicare. Also, it would be a good idea to be very apprehensive about a facility that a.) hires you on the spot or b.) claims they have recently "cleaned house" as these can both be signs of a facility in trouble.

If you haven't worked in LTC before, maybe you should consider part time or PRN there first, that way you could get a feel for whether or not it is a good fit for you before you make a commitment to full time

I was in a situation like that (hired on the spot) once. Scared me half to death; I left the building and never returned.

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Test the waters and you'll find out. I especially love it when you walk in for a tour of a facility and almost every single nurse has been working there just under a few months. Why? Because the facility has a revolving door of staff members and they ALWAYS have room for a warm body because someone is always quitting! :uhoh3:

Good luck with your decision and do what you feel is necessary to do.

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I would look at the Residents, are they clean, do they look uncomfortable in their wheel chairs, (sleeping, slooped over,) does the facility smell, is the staff friendly when you are touring, or do they not even acknowledge you?

LTC can be very overwhelming in the beginning, but give it 3 months and it gets alot better, give it 6 months and you will deff. know if this will be a long term career choice.

I was actually hired on the spot at the place I work, was told by several staff members, that in the 8 years that the DON had worked there, that she had never hired anyone on the spot, and I believe that. I think that she just recognized right away that I would be a good fit with the rest of the staff on my unit, and she was right.

We have very little drama, and everyone does their job, and helps out if one gets behind.

Good luck in your decision

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Specializes in Cardiac Care, Palliative Care.

I agree with one of the above posts that suggested you go prn at the nursing home of your choice 1st before totally quitting your hospital job.

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Specializes in LTC, Med-SURG,STICU.

I wouldn't make the switch. Speeking as someone who has been there done that. LTC is a whole different beast and yes I mean beast! The work load is impossible on a good day and on a bad day I feel like I am going out of my mind. This is coming from someone who likes LTC and I work in a ok facility.

It is very difficult to maintain high standards of care. Very difficult. The aides I work with are the best, but many of them are ready to walkout at any given time due to the HEAVY pt load. Of course if I did not care and they did not care what kind of care the residents are getting we would all be better off. However the residents would suffer.

Any c/o fall on deaf ears or they say well what do you want to do about it. When I suggest more staffing they tell me how this is impossible. Riiiiight! Therefore the staff that gives two sh**s about the residents continue to burn themselve out. I felt like a use up dish rag after about 6 months and I continue to feel that way.

Ok some positives. I truely enjoy my residents, even to old grouch that can do nothing but c/o, the spitter, the hitter, and even the yeller. I get to form some of the best professional relationships ever with the residents and their families. When I come back from vacation my residents will say how much they missed me and how glad they are that I am back and they have to catch me up on every little thing that happened in the last week or so because they are just sure that I need to know. I have assisted some of the best people I know to have the most dignified and comfortable death possible.

Good luck with your decision.

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I also suggest you do part time for some time before you make your decision. You could be swayed either way, but at least you would have more information to base your decision on.

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I'd recommend asking to shadow a nurse for a shift and ask plenty of questions. If they're trying to hide something, you'll know.

Problems with LTC arise when management tries to save money, and forgets that there are people involved in the equation -- patients/residents and staff. If you find a facility that looks at more than just numbers on a page, and considers needs of patients and staff, you should be ok.

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Specializes in M/S, Travel Nursing, Pulmonary.
As a nurse that has spent the majority of her career in LTC, the most important piece of advice I can give you is to STAY AWAY from for-profit orginizations. They are an absolute nightmare, IMHO.

You can also google "Nursing Home watch list", and it will give you a website where you can look up nursing homes in your area and their survey results. When I moved to a new state, that was the first thing I did before even setting up interviews. Nothing impresses/scares a prospective employeer more than when you ask them about their status on the Nursing Home Watch List.

I love gerontology and I feel I'm able to practice with a lot of autonomy in this setting. I sometimes do miss hospital nursing, but I probably would not go back to it. There is also more opportunity to advance, if that's something you would be interested in down the road. Just do your research before deciding on a place to work.

Hope this helps!

As I check these local places out on the web, is there a definite way to tell if a place is "for profit" or not?

A few people (away from my current job) suggested going part time at wherever it is I am considering too. I guess that makes sense. It'll be hard though working full time nights at the hospital then days/evenings at the nursing home. But, a few weeks worth of getting to see the place should be enough.

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Specializes in Home Health.

I cannot say whether or not it will hurt YOUR career (or any others) if you decide to go into LTC and then down the road want to get into hospital work. All I can say is it has made it difficult for me to get into hospital work. A lot of hospitals now want 2 years recent acute care experience to work in a hospital, which you won't get in LTC. I have 3 years LTC experience and a nurse recruiter at a local hospital told me not to bother to apply for any jobs there because I "don't have any skills we need." In this economy limited job options are really bad.

I was able to get a job at a geriatric hospital where I am currently getting those 2 years of acute care the hospitals are demanding of their applicants.

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