LTAC experience.....?

Norimakke · Aug 1, 2012

I worked LTAC for just over a year after working general medical floor my first year out of nursing school. LTAC was definitely more challenging! I cared for patients on vents, with cardiac issues, and A LOT of major wound and ostomy patients. A 5:1 ratio is going to be very challening for new grad, believe me. I loved LTAC because my patients were generally there for weeks (if not months) at a time and I really got to know them.

I used my LTAC experience to go on and work in the ER. Depending on how good the orientation and mentoring is at your LTAC, it might be a great jumping off place for you. However, if they plan (like mine did!) on throwing you in at the deep end, you might be better off elsewhere for your first post nursing school position.

Good luck!

carnatlast · Aug 1, 2012

Thanks for the info! I am very interested in LTAC as a springboard. I think it would give me a lot of experience and I like the idea of having a pt for a longer period.

I've just heard that some hospital nurse managers don't consider LTAC to be sufficient experience, but from the sounds of it, I would think so?

Hmmm....

Norimakke · Aug 2, 2012

Honestly, I don't know how LTAC is viewed by managers elsewhere. But I think if you go in and say, "LTAC - these were the typical types of patients I cared for," and explain the accuity and your responsibilities, you can get them to understand exactly how challenging it is.

My main concern, if I were you, would be to make sure the LTAC you're considering has a good orientation program in place for new grads. If so, I think you might really like LTAC.

nursingilove · Aug 2, 2012

What is a good orientation period? 3-4 months would that be sufficient?

Esme12, ASN, BSN, RN · Aug 15, 2012

Hi there! I just graduated this past May and have not been too aggressive about applying (enjoying summer with my kiddos!) but have managed to get into a few hospitals to turn in resume/cover letter in addition to applying online for positions.
I am turning in a resume to a LTAC facility and am wondering how this will fare in 6 months to go into an acute care setting in a hospital?
The nurse pt ratio in the LTAC is the same as in the hospital - 5:1
The pt population is definately more complex than a regular LTC facility, so I am hoping that - should I be hired - it will still be credible experience for my goal of obtaining a position in a hospital.
Just wondering what any experienced nurses or nurse managers have to say about this.
Thank you in advance!
:) carn

LTAC's are a unique combination of very sick patients in a LTC setting. These people are the SICKEST of the sick AND they have had complicated hospital course. A 4:1 ratio may not seem like very much but in an ICU setting in an LTAC are the failure to weans so you will have 4 vented patients. Most will have multiple lines including PA Catheter's/Swan , including pressors and IV's.

Any LTAC I have seen or worked in is a tough environment. These patients are SICK!!! They have just "run out" of acute days and are sent to the LTAC. These patients are the ICU patients that remain critically ill but have run out of "paid days" on insurance/medicare. You will see a ton of stuff.......everyone else's failure to discharge home. Open hearts with complicated post op courses, trauma's with Halo traction, many unique disease process with complicated recoveries, open wounds, chest tubes, vac dressings, wound irrigation's. You will give TPN, blood, do labs...your IV skill will make you valuable to them. These patients are mostly full codes and every attempt is made to get them home.....but with a fraction of the nursing staff in an acute care setting.

The LTAC I am familiar with had an ICU and these patients were not DNR's, they were vented, with lines and drips. They are a collection of the most medically complex patients that have suffered complications and rough hospital courses due to comorbidities. The floor patients can be vented, multi lumen lines, feeding tubes, IVF, antibiotics with complicated wounds still receiving aggressive treatment to get them well enough to got to a rehab, SNF or home.

The nurses perform like any other "acute care nurse" and more "acute care" nurses and hospitals/administrators need to respect what these nurses do with little to NO help. They process labs, drugs, give blood, pass meds. I have seen HALO traction many times on the elderly who have fallen. There are a ton of young trauma victims that are not doing well as well as the complicated open hearts on telemetry. They will seen neurological diseases like ALS and weird meningitis like listeria.

Any nurse will work very hard....I think a new grad who is bright and a go getter with a thirst for knowledge and confidence is a good candidate. They usually have extensive orientation programs and are will to invest i the nurses education....but you will work very hard. The patient load is double...example most ICU patients are 1:1's or 2:1's when they leave the hospital....they are 3:1, 4:1 at the LTAC.

The opportunity is there to learn a TON.

You will gain a TON of experience and at least they do have great orientations. I wish you every bit of good fortune and luck in your new journey.

If you have any other questions about and LTAC....PM me.:heartbeat

StinkMomBomb · Nov 17, 2012

Wow, I posted a LTAC thread under my state of MI because I din't think to look here first. I am a new grad LPN and got hired at an LTAC. I was very excited to be able to work with more complex cases but I am getting a little anxiety over it. I am you tubing and googling whatever I can before I get on the floor! I think it's going to be a wonderful place to gain experience and hone my skills. The LTAC I'm at has excellent equipment and seems to spare no expense when it comes to taking care of the patient and the nurse. This is my first experience though.

So, I plan on taking full advantage of the orientation, but I've already been told that I am no longer a student and I collect a check like everyone else, so if you have anything that will help me become a prudent nurse, I will take it.

Didn't really realize I was getting into a "specialty", what a blessing this is!!!:)

nursingilove · Nov 17, 2012

i have been working at my LTAC for 2 months and I have learned a tremendous amount of nursing experience, I definitely have a lot more but this is a good start. yes alot of the pts are heavy but you get to see alot. i am also learning to manage and prioritize my time. happy to be a nurse!

ChrissySnowRN · Nov 20, 2012

I am also starting as a new grad, at a LTC facility in a few weeks. But I have to say.... alot of the posts I've read are scaring me; dirty facilities, non-compassionate care, rushed to complete med pass and errors, high nurse patient ratios, patients not receiving proper care, I could go on and on. So, as excited as I am to start my nursing career, I'm having nighmares about all that I'm hearing. Esme12's post gave me a glimmer of hope that this can be a great experience for me, but still have that worry in the back of my mind

StinkMomBomb · Nov 20, 2012

I am also starting as a new grad, at a LTC facility in a few weeks. But I have to say.... alot of the posts I've read are scaring me; dirty facilities, non-compassionate care, rushed to complete med pass and errors, high nurse patient ratios, patients not receiving proper care, I could go on and on. So, as excited as I am to start my nursing career, I'm having nighmares about all that I'm hearing. Esme12's post gave me a glimmer of hope that this can be a great experience for me, but still have that worry in the back of my mind

ChrissySnowRN, are you at an LTC or a LTAC?... huge difference.

ChrissySnowRN · Nov 27, 2012

ChrissySnowRN, are you at an LTC or a LTAC?... huge difference.

Sorry, should have clarified, I'll be starting at a Long term care facility.

rn_abbey · Jan 2, 2013

I; dirty facilities, non-compassionate care, rushed to complete med pass and errors, high nurse patient ratios, patients not receiving proper care, I could go on and on.

Sadly, this is the case all too-often. Great facilities exist, but I've also seen the ugly side of things. That being said, getting passionate RNs into programs that are suffering can only serve too improve conditions!