Is it really "easier" working in a hospital after you have worked in a nursing home?

LVN2RNMom, ASN, BSN, LVN · Dec 2, 2012

I went from working at a psych facility for 7 mths to a hospital. Sure I am familiar with things but I need to learn "the hospitals" way of doing things. Documentation, med dispensing, patient care and protocol are all different. No matter where you work you will need to learn their policies & procedures. We as nurses need to be flexible & be able to adapt. This is the best advice I can give but I say go for it! It was the best decision I ever made.

evolvingrn, BSN, RN · Dec 2, 2012

I will bite.... The answer is it depends. For some who work snf they struggle with the fact these pts are acute.....pain ,gt need to be immediate and you need to be able to act on things that arise Immediately thus the lower ratios. Some make that transition seamlessly ....others it's more of a challenge

Seas · Dec 2, 2012

I think people confuse that acute care and long term care nurses have way different type of stress. Hospital (acute care) is unexpected with quick condition changes on patients. You can't have as many patients as you have in LTC, because you have to monitor your patients very closely. Frequent vital signs on each of them with more interventions depending on the case. Frequent crisis situations, codes, condition changes, priotizing, etc. It really challenges your critical thinking skills.

LTC is more of routine. As it is called, it is "home". Those aren't patients, they are "residents"; they live there. You give them their daily, routine meds and treatments. You don't continuously watch their O2 sat or heart rhythm, or whatever you do at the hospital.

If you did the same duties at the hospital as you did at the nursing home, hospital job would be a cake, since there would be 3-7 patients.

So, definitely not. Hospital isn't easier than LTC. There is a reason some employers don't even count LTC experience as nursing experience. Think about it.

Esme12, ASN, BSN, RN · Dec 2, 2012

I think it is like comparing apples and oranges. They are completely different roles. I have worked in some very bust emergency departments in the inner city in some tough neighbor hoods......but I would rather stab my eyes out than work in LTC.....I find the aspect of being responsible for 30+ patients over whelming.....and I think they would find my emergency room mind numbing and over whelming.

They each have completely different responsibilities and areas of focus for the day. Heck I'd be hard pressed to feel confident working the floor after 35 years in critical care.

I think we need to respect each others area of expertise....and until you actually walk in the other persons shoes, it's impossible to know exactly what their responsibilities are but we need to be respectful of each other at all times.

OP ......I think the first year after graduation is the hardest.....regardless of where you work. You will have another orientation and peroid of adjustment moving to acute care becasue your focus is completely different.

I wish you the best.

Born_2BRN · Dec 2, 2012

I speak from experience as I had worked at LTC before and now at hospital. I wouldn't want it the other way. Although Stress still there most days, you are more respected at hospital and gain more valuable skills. I was like you when worked at LTC. I barely had time to eat anything. The stress was so high even higher dealing with the administrative and evil colleagues who would kill to see you fall. I cried and dreadful before headed to work. There were lack of support, inadequate orientation everyone was to protect themselves and would be glad to throw you in the bus. I got written up twice for minor stuff and threaten to get fired after 3 months. I did them a favor I resigned. I had come to a conclusion time to go when I realized I would not grow there. I was a sinking ship so to save myself I left. Anyway, if you want to pass meds all day stay but if you want to expand and grow leave.

somenurse · Dec 2, 2012

I have been working in a SNF for about 9 months now. Other days are okay, but overall stress level is high because of nurse/patient ratio. I barely even get to eat during my 8 hour shift, although I bring my bottled water with me on my medcart when I go around passing meds and stuff.But lately I have been thinking of applying in hospitals again (tried that as a new grad,no luck) maybe having nursing experience of almost a year might help.
Is it really easier in a sense working in a hospital when you've had nursing home experience because of having less patients now?

haven't' read the other replies,

but, for me, i'd say YES YES YES. Of course, each nurse is an individual, with her own strengths and weaknesses,

but, me, the bulk of my career was in ICU or E.R., and many years of floor nursing as well,

and later, I tried ECF nursing, and i was blown outa the water by how hard THAT is, wowza, that is some hard hard nursing!! I say, if you can rock at ECF nursing, and if you are interested in hospital nursing,

you can do it, and you'd probably be amazed at how much easier it is (it's NOT easy, but easieR) than ECF nursing, imo.

yes, ANY new job, ANY new type of patient population,

you have to learn new things. Well, we all learn new things every week, or, at least, we should.

You will be clumsy at first, on your new unit, yes, you will. You will have to learn a new body of knowledge for the routines of your new unit.

for example, say you went for a med/surg unit, you will INITIALLY be weak at being adept at the organizational skills req'd to send that patient off to surgery, or, to receive him back onto your unit. Yes, you will probably bite at that, AT FIRST.

but, if you can learn the organizational skills to care for 20, 30 or 40 patients,

you can learn how to do whatever it is you will need to know to rock at caring for the 4 or 6 patients on whatever unit you are sent to. There is almost always a mentoring deal, for first howevermanyweeks.

I SAY, GO FOR IT, and see how much easier it is, imo.

BrandonLPN, LPN · Dec 3, 2012

Many comrades in LTC-Land will likely beg to differ, but once you learn the residents and routine of a nursing home, it becomes way, way easier. Once this level of familiarity is achieved in LTC, I would venture to say it becomes notably "easier" than acute care. The problem is, too many nurses give up on LTC before they can develop that level of comfort.

Kittypower123, BSN, RN · Dec 3, 2012

I work in LTC. As another poster noted, there is a familiarity with the residents. I like the continuity. I know my residents. I know what they like and dislike, how they take their medications, whose blood sugars vary considerably and whose are more stable, how to deal with the residents when they get agitated, and what is normal for them. Maybe I don't have all the skills an acute care nurse has, but I do perform assessments daily and I do deal with crises and condition changes. I have run codes, used critical thinking, and developed time management and prioritization skills. I love my job and have no desire to work in a hospital. Do what you love, not what someone else thinks you should.

OnlybyHisgraceRN, ASN, RN · Dec 3, 2012

I've worked in LTC and ICU. I agree with ESME, you are trying to compare apples and oranges. Both jobs are stressful. I've had days when I worked harder with my two sick patients than I ever did with my 30 "residents" in the nursing home.

It truly depends on the specialty and the person. Some say hospital work is harder some say LTC is harder. On another note, I've always made more money in a nursing home than a hospital job.

Kmcdaniel · Dec 3, 2012

Ive had the pleasure of doing both. I started out in the hospital, and while going back to school had to move to LTC so I could have a more flexible schedule. To me there is really no comparison with one another, both places being a great experience. You mentioned not getting a lunch break or even time to stop and get a drink, that happens in both areas, its called Nursing!! LTC is made for certain people just like ICU, OB, ER, and so on. If its not your thing, try something different. You do have a higher nurse to patient ratio in LTC, but it is mandated by the state on how many pts you can have just like the hospital, the acuity is different. LTC is not based on acute care, but chronic so you don't have the daily lab, non-invasive procedures, respiratory, or PT. My main point is no matter what field you go into, there are gonna be hectic days, you may have more hectic days in some areas more than others, but overall its just what you prefer in a career path. I don't think one is any better than the other, it depends on what you "click" with. Once you have that feeling O this is me, I feel comfortable here, and I do my best working here, then I think thats the right field for you. At this point in my nursing career, Im not sure if LTC is where I need to be, but right now I feel comfortable there, and I try my best to make a difference when Im there. Good Luck to you, and I hope you find your spot that "clicks" with you!!

DSkelton711 · Dec 3, 2012

To me, there is no "easy" nursing. No matter what unit or environment you work there is always going to be stress. But, if you love what you are doing then that can make the difference. I think everyone should have some hospital experience, because even in SNF "residents" are coming in sicker and needing higher levels of care.