Interview Tues, leaving ICU for LTC

[kimmersRN]

Hey guys. It's been awhile since I've been on this forum. I wanted to just stop by. I live in NC. I've done all aspects and realms of acute care nursing that I can bare anymore. I've worked peds hem/onc, general peds, labor and delivery, newborn nursery, postpartum, observation med/surg, I've cared for psych pts, drunk patients, and my last stent has been in an ICU. And, I think....it's me. I'm burnt out. I've been a nurse for 6 years and I'm so tired of charting every poop and burp and itch and scratch I just don't know what to do. I need to continue to work weekend nights because I have 2 small children at home and my husband is a stay at home dad. He makes sure I get to sleep ALLLLLL weekend. And, we are both with the kids Mon-Fri. It's awesome. But, I'm at the point where I hate going to work, I loathe extra stuff and I'm just so tired of caring for people who don't want to be cared for. I'd much rather be involved in QUALITY of care and that's why I'm excited about my interview on Tuesday. I'm hoping that I'll be able to find that eustress. And, I'm looking forward to having the same patients. I'm excited about activities and not stressing so much. Don't get me wrong, I DEFINITELY think it's going to be stressful...and that I'll be trading one stress for another. But, I just feel like I would rather spend more time doing patient care things instead of all my time behind a computer charting normal findings all the time. And, if something happens and the patients get sick, etc, they go to the hospital. I just feel so much of a load on my shoulders to "SAVE" everybody and that responsibility is exhausting. I thought I was an adrenaline junkie and I would love this ICU stuff. But, I think I'm too much of a routine-type person. Has anyone else gone from ICU and acute care to Longterm care/Rehab lately? How has it worked for you? Any advice?

Thanks a ton!

Kim

PS--I wonder how much of a paycut I should expect? I'm not making all that great now! I'm in NC. Any fellow North Carolinians?

[mazy]

Not to burst your bubble, and I, for one, like it when nurses with experiences elsewhere come to a skilled facility, but.......

you'll have just as much charting to do in a SNF, just as many nasty,unrealistic, annoying family members, MORE regulations to deal with, less staff, the dreaded DPH, and a slew of other things.

What you also will have is knowing that you made a difference in someone's life every day.

Erm, yeah. Not sure why anyone exeriencing burnout would want to go to LTC. It is a seriously stressful environment, especially if you are the kind of nurse who is dedicated to providing high quality care.

You will be dealing with heavy, unmanageable patient loads (anywhere from 15 per nurse up to 60), you will be dealing with some very complex and acute patients, with no resources for adequate care, you will be dealing with paper charting, an administration that functions on the basis of bonuses earned for every dollar saved -- which means you will not have the supplies or support you need, and you will meet a wall of resistance everytime you want to address a quality of care issue, there will be crazy family members, patients who should be in psych facilities but who are wandering around free to assault or abuse anyone who gets in their way, a lot of mandatory overtime, supervisory duties that make no sense, little orientation, etc. etc. etc.

Don't get me wrong, there are some amazing things about working LTC and personally I love it, I've worked in many different areas of nursing and keep coming back to LTC, but please be cautious about your expectations that it is somehow going to be less stressful than acute level care.

LTC has it's own, very unique set of challenges. It's not for the faint of heart.

[Katie5]

You only weekend nights and spend the rest of the time with family, and you don't like that.

You honestly truly believe LTC would be much better?

[reeveslpn]

I think LTC is just as stressful. I think you may want to consider homecare or hospice.

[CoffeeRTC, BSN, RN]

Try it with an open mind. I have to agree with Capecod and a few that followed. One of the differences in LTC vs acute is that you get to know the residents over a period of time. Still busy, lotsa charting and some places have a good bit of highly skilled res.

[kimmersRN]

Wow you guys, thanks for all the input. Just a few things. I will be still working weekend nights. I'll be doing 2 16 hour shifts plus 1 8hour shift every other week. Also, the LTC/Rehab is owned by a reputable hospital so benefits/ time off are the same as if I worked for the hospital. I'm not thinking it's going to be "less work" but I'm thinking it's going to be less "acute" and more longterm. I'm not thinking that it's going to be EASY. I didn't mean to imply that. However, I do think it will be different. And, the ICU that I work in right now doesn't have an intensivist on call weekend nights. We have a pulmonologist that hates being called at night and usually we all have to work together to keep a few people alive every shift until morning. So, I'm used to not having a physician. I'm also used to taking care of psychotic pts, pts withdrawing from meds and wanting to beat me. I'm used to them being hooked up to monitors and IVs. It would be a little easier if they weren't. You're right. I'm not used to 15 patients, 30 patients, or 50 patients as one person said. I'm not. But, I'm ready to care for RELATIVELY stable patients. I'm ready to chart and reassess plans and paperchart. Are you kidding me? I'd rather document on paper. It's easier. It's nicer and easier to figure out what the heck is going on! I'm sure there are caveats with all fields of nursing. I really kindof hoped everyone would sugarcoat things a little more. But, that's okay. I appreciate the honesty. I have the interview Tuesday and will find out more about the facility and my responsibilities as a staff nurse there. I will have to let you guys know how it goes.

Take care and thanks for the blessings.

I do intend to pray about it.

Much love,

Kimmers

[kimmersRN]

Well I got the job! She said it may not be until next week to hear from HR so she wanted me to know that I got the job. Now I'm just hoping that the pay will be decent. I'm expecting it to be less. Sure would be a nice surprise for it to be better. But, my husband is more than willing to get a part time job so I'll be working somewhere I"m happy. What a relief. There are 2 med passes that are big...she said I would get it down in no time and she said that the CNAs and other RNs are awesome, that they hold each other accountable and don't need to be reminded of their jobs. That's AWESOME.

I'm really looking forward to it.

Thanks for all the support.

Kimmers

[tyvin, BSN, RN]

Well I got the job! She said it may not be until next week to hear from HR so she wanted me to know that I got the job. Now I'm just hoping that the pay will be decent. I'm expecting it to be less. Sure would be a nice surprise for it to be better. But, my husband is more than willing to get a part time job so I'll be working somewhere I"m happy. What a relief. There are 2 med passes that are big...she said I would get it down in no time and she said that the CNAs and other RNs are awesome, that they hold each other accountable and don't need to be reminded of their jobs. That's AWESOME.

I'm really looking forward to it.

Thanks for all the support.

Kimmers

I'm just a little confused here ... you don't know how much you will be making? You didn't discuss salary? If you didn't; why didn't you ask what the pay was?

[kimmersRN]

To clarify :)

The director interviewed me for the position. HR is the one who offers the job and discusses salary.

I've been told that it's unprofessional to discuss salary during the interview. The director told me that my salary would be based on years of experience and that I would hear from someone from HR within the next week or so.

I haven't accepted the position yet because it hasn't been OFFERED by HR.

Hope that helps :)

Kimmers