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I work nights and have 46 residents, 15 of those being skilled at the moment. If the night is quiet, and half the hall doesn't want a PRN, and no one falls or exacerbates, and the planets line up just so, I might have some down time. It's rare. Very rare. Even on a "good" night I stay pretty busy just doing what needs to be done on my shift. Add (insert event here) to the mix and I need roller skates to finish on time. In other words, I wouldn't expect any down time in a LTC regardless of shift.
I don't work third, but in my facility if you were studying on the clock, that would definitely get you walked out the door. Whether you can find the time or not, it wouldn't be tolerated. Don't want to sound like a jerk, just a thought that even if you "have" time, it might not be wise to use it. Do you really not have any time to study other than when you're at work? The experience might be good for you, more action as a new nurse than your current position. Doesn't sound you're getting a whole lot of nursing care experience, so depending on what your goals are, a more active job might be good.
I'm guessing what a LTC equates to a med-surg floor is their transitional care unit. 25 patients in transitional care is heavy. Hospitals really like to d/c some real train wrecks to TCU because they know we'll try to treat and keep them in house before sending back to the hospital. For the most part you'll be running your butt off all night.
When it comes to experience. TCU is where you'll get a lot of experience. You'll see and do A LOT. From what I understand private duty patient's can be very complex, but for the most part they are stable.
In TCU you'll see IVs, central lines, various types of wound care including wound vacs, feeding tubes, new ostomys, hospice, drains and so on. Patient diagnosis range like crazy.
I worked 11-7 on a rehab hall. While the nurses on the LTC halls had time to surf facebook on their ipads or read novels (not all night but in hour-long spurts throughout the shift), I never had time for anything like that, due to the difference in the types of pts I had. Also, I wouldn't start my med passes early for anything, worried that state would walk in any second (hey, you never know!) and it was common practice by more seasoned nurses to start 2 or more hours early in order to get everything done early (ex. starting med pass at 4 am for 6 am meds).
cazach0122
47 Posts
I'm having a bit of a dilemma. I currently work 3rd shift full time as a private duty RN. I was just offered a job at a nursing home on what they equate to a med-surg floor. I'm a relatively new RN (been working for 6 months) so at first I was excited about the opportunity to increase my nursing skills... but now I'm concerned about how much (if any) time I'll have to do homework/study. As you can imagine I have plenty of free time working overnight in my current position and have more than enough time to get work done. I always hear LTC is extremely busy and hectic, even during 3rd shift. I know the nurse to patient ratio at this facility is 1:25 (give or take)... which is horrifying to me... but again, I realize that is the norm.
Is it ridiculous to think I'll get any study time at this new job? I'm going to school full time to get my BSN and I should be done in December.
Also... my ultimate goal is to land a job in the ICU, so any advice regarding the pros/cons of working in LTC vs. private duty would be great as well.
Thanks for your help!