I'm so conflicted..HELP!

Since you prefer LTC I would suggest you consider working at a long term care hospital. This is a specialty hospital that takes care of acutely ill patients for many months. These patients are too ill for simply a nursing home and require specialty wound care or have traches and are vented.

This would give you the best of both worlds a chance to use your RN skills while maintaining a connection with the patients as they are not short stay like regular hospitals. Of course, the work is intense, more so than simply a nursing home, but the ratio's are obviously much less.

Most nursing homes use RN's as supervisors simply because it is more cost effective than using them on the floor. LPN's cost less and now some places are uses CNA's as med aides to hand out the pills. It is all about the money!

Where I live, they reserve the RN's for the rehab section of the nursing home and you may have 14 patients! They are acutely ill similar to the regular hospital, but your staffing ratio is double a hospital. I've heard they may have only one RN in the building working in rehab, but technically available for the NH side for IV's etc.

In my area, it's common to staff an RN on the floor in a SNF for the noc shift.

In long term acute care facilities you will have some really sick patients. It is a viable option to work the floor as you desire. Patients are there for months at a time. Some are there to be weaned from a vent, others need specialized wound care.

If you want and like your current facility you could go back to bedside there.

Good luck in making your decision.

Actually, I would say it's the good LTC facilities that DO hire RNs, not don't.

Maybe focus on learning or specializing in wound care. LTC always need wound care nurses plus it gives you a specialty.

Stick with what you love. Good Luck.

Thanks everyone! I have been applying to local LTC facilities who hire RNs to work the floor as a staff nurse. Fingers crossed!

You say you would love to go back to working the floor where you work now but you are afraid of people asking questions. Well...so what if they ask questions? If you voluntarily return to bedside care because you miss interacting with the residents, then why is that a bad thing? You really don't have to explain yourself, but if you feel inclined to do so, then simply say, "Well, I thought I would love that position but it turns out that I missed the residents too much so I asked to go back to working here on the floor and they said yes. I'm so happy!" That's no big deal.

I work in a busy outpatient dialysis clinic. If you think that you would get a lot of time with your patients in that type of job setting, I can tell you first hand that you probably wouldn't, because as an RN you would be buried under an avalanche of government mandated paperwork like you have never seen. I get a few minutes with my patients when I do their initial assessment before each treatment and then I'm lucky if I get to talk to them much at all unless it is their turn to have their long care plan done that day or if their BP crashes and a nurse is needed chairside. It's not all fun and games, and it sure isn't easy. I have worked ICU, ER, LTC, and hospice, and outpatient dialysis is the most challenging and frustrating job I've ever had.