what's it like to work in an ltach?

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hi,

i'd like to hear feedback from those of you who work in long term acute care facilities. i've been working in a neuro icu at a large metropolitan hospital for almost a year. i started there as a new grad, it's been a great learning experience, but after my year is up (and my tuition assistance commitment is done) i am going to consider other options. there is a 56 bed ltach just 2 miles from my home. it's a "free standing" facility, that is part of a snf/rehab complex which is owned by the hospital system i work for (so taking a job there would be a simple intersystem transfer).

i've read some very general articles online describing ltach nursing as a great way to keep up with icu skills without the frantic pace of a primary hospital setting (this sounds ideal to me!!). however, my sister recently took a job as a nurse liasion for an ltach company (not in my state), and describes the nurse's work as "very heavy", and that she "wouldn't want to work there".

i enjoy the complexities of caring for icu patients, but the lack of assisting personnel (no cta's in our unit, and a charge nurse who always has an assignment), the never ending road trips to ct, neuro angio and mri/mra, and a 50 minute drive to work are all factors in my desire to "look around".

so i'd like to hear from you ltach nurses, as much detail as possible, good and bad aspects of the job . . .the whole scoop!

thanks!!

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LTACH is a very busy place, very noisy at times and can be very dirty, due to mrsa, c. diff, esbl, vre, etc. I work in a coronary care unit and do per diem in an LTACH. CCU is easy compared to LTACH. Patients generally stay 30 plus or minus days, some improve and get weaned from vents, some don't. Some get discharged only to die within weeks, others heal and lead productive lives. Families in CCU have hope to cling to most of the time; families in LTACH realize how bad things are going and are weary, and at times mean. Other families become like your own family and want you there at the time of their loved ones death. They also tend to pick favorites from the staff and aren't very pleased when their loved one is assigned to one of their least favorite nurses.

The LTACH I work in has PT, OT, and pharmacist there on day shift. RT is there 24/7, which makes it nice for the nurses; a little less to do regarding trach changes, etc. We also had one or two nurses aides to help with beds, baths, turning, etc. Most of the patients need help moving and most need help from more than one nurse.

Good luck with your decision. Is there any way possible for you to work a few per diem shifts before you make a decision? That might help you understand the environment a bit better and perhaps help you make a more educated decision.

Melissa

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Thanks for the input so far! Hope there are more LTACH nurses out there to hear from!!

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