LTC or Med/surg Thoughts????

msdobson · May 23, 2007

I graduated form nursing school May 2006, my first job was on a medical floor with overflow of mother/baby and pediatrics working 7p-7a. Well needless to say nights are not for me. Started have terrible problems with anxiety(panic attacks and everything) Wanted to move to 7a-7p but unfortunately there were no openings available. So I went to a LTC facility which I have been at for 7 months now. Hoping and waiting for a position to come open on the surgical floor at local hosp. I am finally comfortable at my current job (still have some residual anxiety though) and a position has been offered to me on the medical unit at local hosp. Not surgical like I had hoped, but close enough. My question is I'm not sure how the transition will be going from LTC to medical unit.
My current resident load is 30 working 3p-11p. I do all med, treatments, orders, admissions...everything. I love my residents and their families but I miss using my skills. Haven't even started a foley in 7 months. Needless to say I am scared to death to go back to hosp environment:uhoh3:, but hosp ratio is 6:1. Any comments or suggestions are welcome. If anyone has made this transition from LTC to hosp your experience is greatly welcomed.
Thanks for reading sorry soooo long but it's been a tough year

First you need to seek treatment for your anxiety, THEN you can answer this question. Anyone, especially a nurse, with that kind of debilitating illness needs to address it imediately, before it causes unforseen problems on the floor.

Best of luck to you.

Dolce, RN · May 23, 2007

I made the transition from LTC (my first nursing job) to a hospital with relatively little difficulty. If working in a hospital is what you would like to be doing in the future than I would suggest taking the opportunity at the hospital soon. One thing that I realized about my stint in LTC was that I had developed some killer time management skills. Many people say that the 30 people that you take care of now are "easy patients" and the 6 patients in the hospital are the very complex ones. Well, when I worked in LTC some of the patients were easy, but scattered among the easy ones were the 6 or so that were really complex. One of the very important keys to a good med/surg nurse is time management. You probably are a pro at that by now. I actually think that the medical floor would be a good place for you now.

kellyskitties · May 23, 2007

If you have anxiety, medical nursing may be very hard for you. Harder than normal. Cause people will yell at you once in awhile. You have to be calm when others lose control. There's often a very fast pace (especially early in my shifts - if I'm lucky they slow enough at the end to catch up).

I've observed other nurses running down the hall crying. I've heard of one sitting in the break room crying. Had one explode at me over something not even logical she thought I did. One was found in the med room sitting in floor crying. You may need to handle the anxiety first.

What triggers your anxiety? Maybe you could consider another area of nursing - there's a lot more than LTC and med/surg.

Trauma Columnist · May 23, 2007

Hi there and welcome. I too would want to address the anxiety issue first. However, changing jobs if this is what you want to do, then shouldn't be a problem. Good luck with whatever you choose.

Daytonite, BSN, RN · May 23, 2007

take the job. seven months out isn't that long. it'll come back to you. the fact is that the longer you stay away from the hospital the less likely it will be that a facility is going to be willing to give you an opportunity to go back. so, i say take the opportunity you've been given and question it not.

i went to a hospital medical unit after doing a year in ltc and, get this, 2 years of private duty nursing (one patient at a time only!). [jeez! i make it sound like a prison term, don't i?] after every shift at my new hospital medical unit job i went home and was hitting my books for an hour or two to refresh my memory on something that had come up at work that day, but i was determined to keep up and keep that job. i was also real quiet (not me at all if you knew me) for fear that opening my mouth and saying something would reveal some inadvertent ignorance on my part. i still remember the first time i heard a nurse use the word "obtunded" during a change of shift report to describe a patient's mental state. i honestly didn't know what it meant. after a few months i didn't have to hit the books every day, just every once in a while. now, no one can shut me up and i think i'm an expert on everything. ha! ha! it's amazing how confidence or uncertainty will change your behavior.

if, knock on wood, the job doesn't work out, ltc will take you back in a new york minute. but, i'll tell you this. . .you learned how to organize and prioritize in ltc. it won't be long before you'll be rolling your eyes at people who complain about taking care of 6 patients and thinking, "you should have to pass meds to 30". you'll see what i mean when you get to that medical unit.

i'm very prejudiced about ltc because i started there too and i often worked part time jobs there as well and as my health declined i spent my last working years as a nurse in ltc because it was physically easier for me. i believe that everyone should work in ltc for a year or two. there is a daily routine there and you need that kind of stability when you are a new grad. it's good training where you learn about providing basic fundamental nursing with attention to adl assistance and some exposure to acute care nursing (fevers, an infection here or there, some dressings, a little oxygen assistance, and the occasional patient that goes bad and needs transfer to the er).

hope you kept your textbooks and notes from school because you'll probably want to pull them out for reference. don't forget there are some good resources on the nursing student, critical care, med savvy and patient education resources forums of allnurses to help you as well. you can do this. nursing school only armed you with the basics. you still have to practice at them to become a master of them. and, now you've gotten your chance. go for it.

st4wb3rr33sh0rtc4k3 · Jun 1, 2007

Too funny. I am in the opposite boat. LTC was my start in nursing. I loved it. My superiors would comment that at least one year of Med/Surg would increase my head-to-toe assessment skills. I left LTC after a year, to gain some Med/Surg experience. Work seems the same, no matter how many patients you have.

The hospital I worked with offered me a great training, but the floor suddenly closed and they couldn't offer me the hours I needed to pay the bills. Benefits weren't that great, my hours were dropped dramatically and I was being floated to floors without being able to get into the computer to pass out meds until hours later. Something that just didn't happen to me at my old LTC facility. Supervisors are readily available and I was able to pass out meds without a need of a password.

My old LTC facility doesn't have hours available for me at this time and the DON wasn't happy that I left in the first place, leaving me to start over again. I have been applying to other LTC facilities and will have to do temporary nursing until I find a home.

After my experience with the hospital I don't think I would go back. I am a single mother who pays a mortgage and I don't have time to play with my hours being cut down, due to census. It could be very detrimental to my credit.