Umm...again, how many weeks of orientation?

[jrsRN07]

I had the opportunity to take a critical care RN position at a LTAC (long term acute care) hospital. The nurse manager gave me pause when she told me that I would get 2 weeks of orientation. Hunh? Eventhough I am an experienced telemetry RN (6 years), I was a little put off by such a short orientation for changing from my specialty to such a high acuity specialty. Two of my colleagues told me that I should have taken it but to me that would have been putting my license and more importantly, patients in jeopardy due to my inexperience.

If you were me, would you have taken the position?

[Esme12, ASN, BSN, RN]

Don't know where you live of course, bur where I am I couldn't count on moving on easily after that year or so experience. None of the hospitals in my area count LTC as experience, when experience is listed as a position requirement it is "acute care" they are looking for. Maybe different where you are? Or maybe having the LTAC connected to the hospital makes that count as hospital experience? Sorry for the questions but we don't have any long-term units connected to the hospitals close to me.

An LTACH is NOT LTC. These are medically complex and medically fragile patients that have multi-system complications that are being removed from "acute care" because they have "run out of days". You have in one building every complex "heavy" medical patient on one floor and in one building. Many/most LTACH's have intensive care units that have patient on complex multiple IV drips, vents and invasive monitoring.

These are medically acute patients with a goal of being weaned from gtts and vents to go home or at least rehab. These patients are treated like any hospital patients there is an in house hospitalist 24/7 to deal with issues and full time respiratory therapy for vents.

Because people have NO CLUE what LTACH's are and that includes hospitals who actually sent the patient there the OP will have to do some explaining what a LTACH is and what experience they got there...but experience the will get.

[SquishyRN, BSN, RN]

Because people have NO CLUE what LTACH's are and that includes hospitals who actually sent the patient there the OP will have to do some explaining what a LTACH is and what experience they got there...but experience the will get.

This is very true. I'm an LVN in an RN program currently working in an LTACH and have even had to explain to my clinical instructor several times that it is an acute setting. As Esme mentioned, we have an ICU, in house MD 24/7, and have some surgeries performed in house as well. I cannot seem to get it through to her that no, the patients we get aren't more stable than the ones we have at my clinical site. In fact, they're less stable because they couldn't get well enough to be transferred to a lower level of care while at the hospital... like our clinical hospital, which is one of the feeder hospitals for my LTACH.

The floor nurses at my clinical site, however, know the patient population we get at the LTACH and automatically gave me props when I tell them I work there :)

[boogalina, ADN, ASN, BSN, MSN, LPN]

LTAC = stepdown on steroids. This was how some of my nurses described it to an agency nurse who was rather frustrated by the poor description of his assignment by his agency. He could hang, just wasn't prepared for having 2 trach vent patients with 3 other relatively high acuity folks.

LTAC is hard, but if you can survive working in one, you can work anywhere!

My CNA2 clinicals more than adequately prepared me for working in an ICU!

[xoemmylouox, ASN, RN]

I worked an LTAC before. They are tough! Mine was VERY poorly ran, and I ended up quitting when they started asking staff to completely redo documentation and lie. You will gain a ton of experience as those patients are super complex. My most challenging were the very obese (500#) post flesh eating bacteria patient, and the guy who survived his aortic aneurysm burst.

[Lizkostel]

In my LTAH they gave us 6 weeks orientations