LTAC ICU

Here.I.Stand, BSN, RN · May 21, 2014

It's a good opportunity for sure! You'll learn a ton; these people are SICK. You'll get some good experience w/ vents, cardiac monitoring (the facility I worked for had monitors at the bedside and at the desk--we watched our own rather than tele where a monitor tech watches them from a central location), drips...my facility even took pts w/ LVADs.

A couple things to be aware of when someone has been so sick for so long. First, their courses are complicated. New onset diabetes, pneumonias, sepsis, pressure ulcers, you name it--you can Google "chronic critical illness" if you'd like more info. Second, they and their families have been through the ringer. They are extremely stressed. Sometimes they're appreciative, and sometimes the RN is the one available to voice their frustrations to...or at. They need to be heard and know their concerns are being addressed.

Congrats on the job offer!

tina8314 · May 22, 2014

Thank you for so much useful info. It makes me even excited about the offer:-)

I will grasp every opportunity to learn. I'm sure it is going to be hard work, but payback will be great too. As to frustrated family members, I always think in their ways, they are frustrated because their loved ones are suffering. All I do is try my best to offer care, help and companion. I think I will be fine in that way.

It's a good opportunity for sure! You'll learn a ton; these people are SICK. You'll get some good experience w/ vents, cardiac monitoring (the facility I worked for had monitors at the bedside and at the desk--we watched our own rather than tele where a monitor tech watches them from a central location), drips...my facility even took pts w/ LVADs.
A couple things to be aware of when someone has been so sick for so long. First, their courses are complicated. New onset diabetes, pneumonias, sepsis, pressure ulcers, you name it--you can Google "chronic critical illness" if you'd like more info. Second, they and their families have been through the ringer. They are extremely stressed. Sometimes they're appreciative, and sometimes the RN is the one available to voice their frustrations to...or at. They need to be heard and know their concerns are being addressed.
Congrats on the job offer!

Here.I.Stand, BSN, RN · May 23, 2014

Glad I could help. :) That's the exact mindset you need to have. These people have been SO sick (or hurt--we got traumas and burns in our facility too) for so long that lots of times they're at their wits end. They need some good nursing along w/ the one in the hospital bad! Sounds like you'll be good for them.

Esme12, ASN, BSN, RN · May 23, 2014

I am going to tell you that working an LTACH ICU is a tough job. Most of these ICU have very sick patients. You WILL see PA lines(swan ganz) titrated pressors. These patients are sick with multiple co-morbidities intubated with lines and complex drsgs. This ICU has a collection of all the other facilities rejects/failure to weans. The LTACH I know recieves open hearts with chest tubes and only a few days post op before they "run out of days" at the "acute" facility so they continue a profit.

LTACH's are licensed as an acute care hospital. Although they only get LTC/acute rehab reimbursement. They will have radiology and do labs as well as simple surgical procedures like G-tubes.

Contrary to popular belief these are real ICU's with real ICU patients. These patients have the intention of going home or to rehab. They are FULL codes with an in house MD/NP. You will give blood and titrate drips. You will have 3 patients on days and probably 4 at night. Your patients acuity will be as high, if not higher, as many "softer" ICU's.

I too did not know what an LTACH was until I was supervisor at one. Why "acute" hospitals don't know what they do still amazes me for they sure do know where to send these complicated patients when they run out of money or ideas.

This is an amazing opportunity to learn. Good luck!

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