How to sell my LTACH experience for interview

[Clovery]

I've been working at an LTACH for 7 months and it's been my only nursing experience since graduating with an ADN last December. I was so excited and hopeful to start my first nursing job but unfortunately my experience there has been pretty bad. I love the patients, love the work, love the staff... corporate and management is awful, though. Before I started I read about LTACHs and so many people say "do not pass go, run the other way, dangerous conditions" etc. I hoped it would be different for me but sadly this is the advice I would pass on to anyone else looking at an LTACH.

When I hit the 6 months mark, I started to apply for jobs at the local hospitals. The stars seem to have been aligned... I was cancelled off work today, went back to bed and a nursing recruiter called (and woke me up) about a position on a unit that I did a clinical rotation on. We talked for about 30 minutes and I guess I did okay because now I have an interview next week with the person I spoke with on the phone. She wasn't aware of my workplace and I really had to explain what an LTACH was because she wasn't familiar with them. I really had to convince her it wasn't "long term care" as she knew it.

I need some advice for my interview next week. The unit is med-surg, the patients are a bit of a mix. I spent half a semester there and the patients seemed to be mostly post-abdominal surgeries. At my LTACH I work on a med-surg/telemetry unit where we get a good mix or combination of vents, wound care, dialysis, bariatric, and psych patients.

Any advice would be appreciated as I really really want to leave my current job. They have a horrible retention rate of all the new grads they have hired and I feel like I'm the scapegoat for all of them since I'm the only one who's still left.

[Esme12, ASN, BSN, RN]

explain your typical patient.....remind them that LTACH are accredited and licensed as acute care facilities.....for long term patients.

Tell them that LTACH's care for acutely ill and critical patients. Usually several facilities dump...I mean send their medically complex.....difficult, complicated failure to heal/wean patients and they are all under one roof. There are usually several vented, trached patients with multiple co-morbities on the general floors. The will have chest tubes, and complex care/meds/wounds. I have seen halo traction on the general floors. These nurses care for these patient son the general units and will have a few vents per nurse.

There are telemetry units and ICU units where these patient have drips and lines just like any other "acute care patient" In the ICU they are monitored like any ICU patient and the hospitals send them to the LTAC when the have "run out of acute days" intubated with lines and drips. These facilities are licensed as Acute Care facilities (just like the hospitals) and can perform simple surgical procedures like PEG tube insertions and tracheotomies. Many have labs on site and they have their own x-ray departments. They do this with half the staff of a "real" hospital.

These patients are a collection of the sickest of the sick from several contributing hospitals and they are all under one roof. Many nurses, if not a majority, have no clue what a LTACH really is...tell them a LTAC is a long-term acute care hospital for patients with medically complex conditions that require a physician’s care each day.

[Clovery]

Thanks, Esme. Those are some good points. I had forgotten about the accreditation as an acute care facility. I did tell her that we have gotten several admissions from their hospital's ICU and our patients were those who had run out of acute care days on their insurance but were still too critically ill to go to a SNF, rehab, or LTC. She said she had never heard of an LTACH but it seemed like a good thing and she could see how there would be a demand for it. I will also emphasize they require a physician's care every day and use that point to hopefully play up my "effective communication" techniques. Thanks again for the advice :)