Med surg or LTAC?

[guest1143647]

Which one will I see a greater variety of patients without being overwhelmed?
 

I already worked with vents,trachs,feeding tubes, and the occasional IV,all in home care for 15 plus years. I’m trying to expand my skill set. I was offered a NOC med surg position in a hospital down the street from me. I was also offered a NOC position in a LTAC unit located in a different hospital about 30 minutes from my house.  The LTAC facility has vents,CVC, and telemetry. The med surg position is just regular med surg floor,no telemetry. 

I am worried because I am used to one on one nursing. I am worried I won’t know which IV meds can be given at the same time or piggyback. I am also worried about reading telemetry monitors and figuring out when the patient is having an arrhythmia. I am fine with vents and trachs,and I don’t want to lose those skills. I don’t know how I will function under pressure in new environments, because besides a 4 yr stint in LTC in the early 2000s,we did not have IVs or electronic charting. 
 

[lovingtheunloved, ASN, RN]

I worked in an LTAC for several years. One thing to consider is the nurse to patient ratio, because these patients are SICK. I frequently had multiple multiple patients on pressors and/or cardiac gtts, trach/vents, HD, PD, lots of wounds, on TF or TPN, most of them are quite debilitated, and very needy. I was fortunate to work for one that staffed appropriately. Many don’t. If you are looking at one with good staffing, I’d go for the LTAC. I saw all kinds of things. Cardiac, GI, neuro, ortho, pulmonary, surgical…it was a great experience and I learned a lot. My two cents! ? 

[Dani_Mila, BSN, RN]

I wonder which unit did you choose? and how are you faring?