LTC CNA to Hospital PCT?

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I'm wondering how hard it has been for some of you to get on with a hospital?

I've been a CNA since Decemember, however, I started out as a nursing staff coordinator for an entire LTC facility. I also did all of the ancillary tasks like ordering and stocking central supply, med rooms, carts, and all of the billing. I went back to the floor in January when I was told they could only pay me CNA wage to do all that work :eek:. Anyway, I have been on the floor of a rehab unit for a few months now and it's very similar to a hospital with the constant admits/discharges, lights, pace, ect. I have my time management down and I want to move on to a hospital so I can have more exposure to different patients but also exposure to different careers in healthcare.

Could anyone share experience with me? How hard was it for you to get on with a hospital and what qualities do you feel helped you the most? how long are PCTs orientated? What's the biggest difference? Is the patient ratio any better than it is in LTC?

Specializes in Med/Surg, Float Pool, MICU, CTICU.

I have less than 3 months under my belt working in a hospital, so I hope I am qualified to answer your question lol. I started off working in LTC in late August last year up until that December when I got a job offer in a hospital. Best decision career wise as a cna. The work environment and co-workers in LTC was too toxic for me. Hospitals like hiring people with experience and who intend on furthering their career in that field. Employee retention is a key goal on whether they will hire you. They want to keep you for the long run. Since I am a pre-nursing student, I was able to share my experience on why I wanted to become a nurse and then my background as a cna for those 5 months helped me get the job. Hospitals love nursing students!!! Apply in December or in May. Those are the times when nursing students on the unit graduate from the nursing program and take their exams to become nurses. Once they pass, they can no longer be a cna/pct so there will be job openings.

In a hospital, everything is pretty much fast pace, but you will get the hang of things once you have the routine down. You will go through orientation for about 3 weeks and if you need more time, don't be afraid to ask. Time management is a must to keep up. I suggest carrying a notebook with you and writing down the times and what activities you are doing with your aide at “X” time so you can set your pace. It is very easy to fall behind on getting vitals and charting when you have two new admits during the first set of vitals and still having “x” amount of pt to attend to. Always hit the ground running and get report from the pct/cna and your nurses within the first 30mins to 45mins if possible. If your nurses are still getting report from the nurses on the previous shift, either finish writing on the boards or start your blood sugars and get report afterwards so you don’t fall behind. Always get report from your nurses as well, because the pct/cna may not have all the information.

It is definitely a new experience at first and you may feel overwhelm, but don’t let that get to you because everybody goes through it. The transition was a little easier for me since I came from a LTC background and had some of the skills already down. I am always constantly moving which helps. The greatest thing about working in the hospital is that you develop critical skills and respond more rapidly. You will learn sooo much in a hospital especially if you are taking pathology and pharmacology, you can see the real life applications. For ex. if a patient is has their call light on and is having trouble breathing, you would grabbed the vital machine check their O2 SAT and if they are already on O2 and their SAT is in the low 80s, notify the nurse and if measures need be, the nurse would called for a Rapid Response and the RR team will come and treat the patient, if the pt is still failing, then we would transfer the patient to the ICU. Same thing with Blood Sugars. If a patients BS is hitting the low 30’s notify the nurse and have grape juice, honey, cheese and crackers on standby. They will use the grape juice and honey to raise their glucose levels up if they are able to swallow without aspirating. If not, they will administer glucose through an IV or glucose gel tablets sublingually. Then once the pt is within the normal levels, they will give the pt cheese and crackers to stabilize the glucose level. The protein in the cheese helps prevent the glucose from dropping quickly since it takes a while for protein to digest.

The biggest difference is you are able to do more in a hospital and the routine is different. You will learn to take vitals Q4, Q8, post-op, etc; take BS F&2PC, AS and HS, or even Q6, transfer patients to different units (mainly to the CICU for me), learn how to respond during a RR, and much more. After 3 months at my hospital I can float to different unit within my hospital or float to another hospital if our census is low. I’m so exicited, I can’t wait!!! I really want to see more of the hospital. Also, if you need assistants with a pt, THERE IS HELP AVAILABLE!! In LTC, I had such a hard time with a two person assist since none of the aids wanted to help with it. The aides and nurses on my unit are wonderful, a complete contrast form LTC!

The only downside is the patient load if we don’t have enough aides on the floor and can’t pull from resource. I had up to 18 pts one time. I think a good pt load is 12 or under; anything above that can get hectic especially with the call lights going off, changes in status of pt, or getting a new admin from the ER.

Overall, I’ve really enjoyed my experience working in a hospital. You do have 12 shifts (night/days) but only have to work three days in a week. Good luck. Like I said, I am only less than 3 months working in my unit and I am already orientating two new pct, so you will get the hang of it.

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