LTC to Med-Surg

[JB2007, ASN, RN]

I have finally obtained a Med-Surg position after working in a LTC facility for over 2.5 years. I am very happy to be getting back into the hospital environment. I really did not think that I would find an position. I am cutting back to PRN and every other weekend at the LTC facility because the hospital is only PRN. Here is some back ground info on my past employment.

Upon graduation from nursing school I took a new grad position on a busy, chronically short staffed cardiac unit. I worked there for about five months before I could not stand how short staffed we always was and left to work at my current facility. I have been been at this facility for about 3 years as a full time staff nurse. I am use to doing the tx, meds, updating the doctors, taking off the new orders, you name it I did it for about 30 residents. At one time out of that 30, 9 of the residents were skilled. I at times have residents with PICC lines, colostomies, feeding tubes, surgical wounds, ect. I am very anal about my pt care and I need to know what is wrong with each of my pts and understand the disease process.

The position that I will be taking is on nights which is what I wanted. A little slower paced so I will have a chance to understand how things are ran at this hospital and get used to the different environment. My question is this have any of you went from the LTC environment to the hospital? If so how did you do when you 1st started? Was it an easy transition?

[rnlately]

I can't offer any advice because I am in the identical situation as you. As a matter of fact seems like I could have written your post...lol. I am currently in the process of transferring to a med/surg unit from LTC after about 3 yrs. I start in 2 wks on night shift also and am looking forward to the slow pace and frankly I just function better at night. My new unit appears to be very conducive to learning and I like that although I am a little nervous. However, I think the both of us will be just fine. Best of wishes to you.

[JB2007, ASN, RN]

I am starting in 2 weeks also and on nights too. I usually start perking up around 9 pm when I should be getting ready for bed so that part should be fine for me also. However, I do dread the hours between 3am and 5am. That is the only time that I feel bad while working nights. You will have to keep me updated on how you are doing. I wish you luck.

[haley4]

Well I am in the same position as well. I just started nights on a med=surg floor. I previously worked in LTC for the last two and a half years. I do like it so far. It is alot to learn, but very interesting at the same time.

[NooNieNursie]

Good for you :) You give me hope that I can land a hospital position one day. I did LTC for about a year and a few months.... I've been doing subacute/rehab for the rest (I will have 2 yrs nursing experience in october).

The LTC's were sometimes skilled, but my subacutes are almost always skilled with surgical wounds (cardiac surgery, ortho surgery), PICC lines, TLCs, IV abx, TPN, many PEG and colostomies, trach once in awhile...etc. We get some "normal" subs who are just there for PT/OT or LTC placement... but most of our subs are skilled care patients... pretty much semi-stable acute care patients who would have been in a hospital if this were several decades ago.

I'm very afraid that being in rehab/subacute will mean I will never land a hospital job, which is unfortunate because the work I'm doing now is not all that different from what is done in a hospital on a med surg floor. Thanks for giving me some hope.

[JB2007, ASN, RN]

Good for you :) You give me hope that I can land a hospital position one day. I did LTC for about a year and a few months.... I've been doing subacute/rehab for the rest (I will have 2 yrs nursing experience in october).

The LTC's were sometimes skilled, but my subacutes are almost always skilled with surgical wounds (cardiac surgery, ortho surgery), PICC lines, TLCs, IV abx, TPN, many PEG and colostomies, trach once in awhile...etc. We get some "normal" subs who are just there for PT/OT or LTC placement... but most of our subs are skilled care patients... pretty much semi-stable acute care patients who would have been in a hospital if this were several decades ago.

I'm very afraid that being in rehab/subacute will mean I will never land a hospital job, which is unfortunate because the work I'm doing now is not all that different from what is done in a hospital on a med surg floor. Thanks for giving me some hope.

Well do not give up. I do not know how many jobs I applied for before I finally was offered a job that felt right. I was offered jobs before, but some of the managers seemed not right or the unit just gave off the wrong vibe. I wanted to be sure when I went to work somewhere this time it was the right place for me.

[Scarlette Wings]

i was able to transition from ltc back to the medical floor with little difficulty. after doing a med pass on my cart for 20-30 patients and their 10 million meds, not to mention dressing changes and helping do feeds, it seemed like heaven to go to having 6 patients on a cart. of course once i got back on the med/surg floor i clearly remembered why i became burned out and left it. lol. but it shouldn't really be that hard for you. you should actually be prepared more than most. good luck.

[VivaLasViejas, ASN, RN]

My experience was a lot like CheyFire's. In fact, I've made that transition twice, and gone back to LTC again both times when I got burned out on M/S. It can be done, it's just more intense and the patients are much sicker than in the average LTC unit, although subacute is extremely challenging in its own way AND there are more patients!

Best of luck to you. You'll do fine, I'm sure!

[JB2007, ASN, RN]

Thank you both that is just what I needed to hear. I just get a little bit nervous sometimes that I have been out of the hospital setting for too long. I am sure the time spent in LTC will help me a lot. Thanks all for your kind responses.