Leaving my comfy throne to go into LTC, comfort vs skills

[MzLopez4real]

I'm leaving my job as a floor nurse in mental health/Special needs because I was offered a LTC job in a better location and It suits my needs currently. Mainly, I need more skills. I have been here almost a year and I can't even get a peg tube, much less an injection. ( yup you guess it. The staff is med cert) So I need more skills, and more of a challenge I believe so i can keep growing as a nurse. Sooo I wanted to ask for those of you who left your comfy high paying job for a more challenging one which involved a pay cut 😦 ..Do you think you made the right choice? I am scared to leave my comfort zone. I am having second thoughts. i will have 30 patients at the new job doing 7p- 730a and its NOTHING LIKE what Im doing now. My job is a piece of cake But I AM NOT GETTING SKILLS. Any advice on this??? 😢

[caffeinatednurse, BSN, RN]

There is a learning curve with LTC, just like with any other type of nursing. You'll become more independent, mostly because you have no choice but to. There's not a doctor there to ask questions to. You'll probably have an on-call provider service, but those providers have probably never even been to the facility or seen that patient. They're relying 100% on your assessment skills. After I had been there for a while and the providers knew me by name, they would just ask me what I wanted. Did I want an order to send them out? Okay. An order for an x-ray or labs? Sure, why not.

Don't be surprised if it's you doing all of the meds, treatments, discharges and admissions on your unit. You might get lucky and have help of another nurse, but don't rely on it - someone could call out, and that other nurse could be pulled to another unit at any point. Discharges are less likely to happen on night shift, but admissions can arrive at any point. If you're on a rehab unit, your census will depend on the hospital and whatever admin feels like dealing with. I've had detox patients, patients with hip/joint replacements, patients with new pacemakers, psych patients, patients on isolation precautions, wound vacs, Foleys, nephrostomy tubes, PICC lines, JP drains, IV antibiotics and maintenance fluids, basically anything that you might see on a medical-surgical unit. The only difference is that there's a lot more of them and only one of me. Their pain level is still a 10 while they're playing on their phone. They still need PRN pain medication. Their families still find things to complain about. They can still code. At one point, I had more pts that were full code than DNR on my unit. You will become adept at recognizing "normal" and "abnormal" by just walking in the room, looking at your patient and assessing them. You will become really, really good at wound care. You will learn what dressings work best with certain types of wounds. You will learn how to do everything 10x faster than you're used to doing it. It will be challenging, but depending on what you're looking for and your career goals, it very well may be a valuable experience for you.

[Kooky Korky, BSN, RN]

Skills are overrated in my opinion.

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[sotelo.dixie]

Molly, your psyche experience is a big plus in anywhere, acute, SNF, no added skills needed. But if you want to have more choices, change that LPN to RN and a wider world will be openedv. If current employer is offering tuition reimbursement, take it. You even have option online.

[MzLopez4real]

Update: Thanks to all of the advice! I started orientation today at a beautiful ltc facility. Haven't had a tour yet on my floor so we will see. I'm staying positive and hoping for the best. I figure I owe it to myself to at least explore this new opportunity because I know at the end of the day I'll learn something new. So Im gonna just ride this wave and see where it takes me. I am definitely going to go back to school too. Anyways Wish me luck!!!