LTC verses hospital

swee2000 · Nov 4, 2007

hi. i am also an lpn and i work on a med/surg unit at a hospital. for me, i love my job, where i work, and what i do. seriously!! i don't mean or intend to offend anyone with this, but i could never work in ltc. it's just not for me. the hospital is fast-paced, always keeps you moving, a constant learning experience, never a dull moment, no two days are ever the same, and there's more of a variety of things to do. if you intend to further your education and become an rn down the road, i would suggest working in a hospital(on any unit) vs ltc. in my honest opinion, you'll learn a whole lot more and it will come in handy during school.

now, the things an lpn can/cannot do in a hospital depend on the individual state's bon regulations/nurses act and the facility's policy & procedures. at my hospital, i can administer all meds(incl ivpb) except for iv push, 1st dose of ivpb antibiotics, and chemo, to name a few. i cannot set up pcas, nor hang blood; however, i can be a second verifier of dose changes in pcas &/or the hanging of blood, as well

as monitor the vital signs required of both. i can start ivs with or w/o the use of lidocaine. i can do picc/central line dressing changes, but i cannot d/c either or access one that is capped in order to administer meds, including flushes. i can do "simple" dressing changes, but the more complex, packing wound type changes have to be done by an rn. i can d/c ngs, but i can't put one in. i can "data collect", which is the same as an rn doing an assessment, but i can't do the initial assessment on a new admission or post-op. i can gather info from a patient for their admission database & enter it in the computer. i can also enter discharge instructions for a patient in the computer, but i cannot verbally discuss or review them with a patient because it's considered teaching. speaking of teaching, at my hospital i cannot give the initial education to a patient about meds, procedures, etc(although i'm sure i do it every day w/o realizing it); what i can do is reinforce whatever teaching the rns have already done. i cannot do any med reconciliations for take home meds or meds being prescribed at discharge. i cannot take any orders from doctors/pas, nor sign them off. i also cannot do anything with care plans. i can primary up to 3 patients under the supervision of an rn, which means i am doing both the nursing & the cna job responsibilities. this is how my manager wants me to function/be utilitzed every time i work. however, it doesn't happen a majority of the time because of one &/or two reasons: 1)the rns that i'm assigned with do not let me primary because they don't want to do the cna work(exact words out of some rns mouths) and/or 2)the rns do not want the extra work of having to verify my "data collection" & charting. my manager is aware of these issues, but one-and-a-half years later nothing has changed. so i usually just help w/meds and do the cna work. on the flip side, there are a few other rns on my unit who can't wait to split the group and let me primary.

so, as you can see, there are good & bad things about being an lpn in the hospital setting. from what i hear from friends who are also lpns and work in the ltc setting, they do the same thing, day in & day out. some of them love it, others hate it. as i said before, i love my job, even if i don't get to function like a true lpn 100% of the time. i'm getting more of an education working in this environment and it helped me when i was in school(for the lpn) and will continue to help me when i eventually go back to finish the rn program. but everyone's interests are different and deciding where to work is not something that anyone, other than yourself, can decide for you. hopefully the varying opinoins are helpful, though.

LakesideRN · Sep 23, 2008

I have worked 13 yrs in the hospital and 5 mos in LTC. I think you learn a lot more in the hospital. I prefer hospital. The NH I work at is some of the most challenging work I have ever done. I've worked med-surg, ER ICU, IMC, PP, amb care, stress lab, home health, and hospice.