Med-surg vs. LTC (new LPN needs advice!)

Fiona59 · Dec 10, 2004

Lots of factors to consider. Are u happy in LTC? There are LTC RN's who specialize in Geriatrics.

Skills do need to be used.

But ultimately the choice is yours. I'd probably stay put. Travelling time eats into study time.

Good Luck

FocusRN · Dec 10, 2004

I know what you mean. I am a CNA, and I worked in LTC. As you said all LPN's do is pass meds, do accu-checks, and do wound care or dressings if they are any to do. I worked the 11-7 shift and most of the nurses were usually either sleeping on the unit, or they would come in clock in and leave until around 4:30am, when it was time to start getting people up, so they could pass meds.

Usually being a LPN at an LTC is a pretty easy and laid back job, but it does show in the pay. But since you are going back to school I would ecommend staying put until your last semester inschool. I say that because, you won't get too worn out at work so studying shouldn't be a problem when it comes to school, but as soon as you get into your last semester, you can go somewhere else and gain some real experience in those last 4 months. And that will benefit you in more ways than one:

#1 Your new employer will see, that you are likely to stay around for a while

#2 You gain experience

#3 You'll be okay and not burnt out while going through school

Hope I Helped

Blackcat99 · Dec 10, 2004

That's a hard decision to make. I think I would stay put since it is only a 5 minutes drive. I am an LPN who works nights in a LTC and I am running all night long. We have "plenty" of stuff to keep us busy all night. Nurses at LTC should not be sleeping on the unit. Nurses should not clock in and then leave until 4:30am. What if there is a "medical emergency" at 3:00am? Please notify your director of nurses about those nurses. Sleeping on a job and not being on your unit when you are clocked in should cause those nurses to be fired. Nurses like that are a disgrace to the nursing profession. :angryfire

Fiona59 · Dec 10, 2004

I'd love to find a LTC where "all the LPN's do on 11-7 is sleep"!!!:angryfire The level of care in that facility must be very low or not done at all.

I've worked all three shifts in LTC and they can be brutal. I've worked Acute and all i've "done is passed meds, done accuchecks, and changed dressings", on a busy surgical unit.

The poster that made these comments has never worked in LTC and perhaps doesnt realize the duties that fall on the night LPN. Med stock refills, MAR checks on every client, transfer papers to be prepared and checked for the next day.... The list goes on and on. Trust me, management can find a lot of things to keep the night crew busy, and don't forget the joys of getting patients up at 5am so that the work load for days is slightly reduced. And there are people to be toiletted and changed all night, the guys who worked night shift all their lives and need company, the list goes on and on. Until you've experienced the job you don't know the duties...

FocusRN · Dec 10, 2004

Whether I am a nurse or not, I know what was done in my facility. The nurses didn't change anyone during that night, that was done by CNA's. And I have worked the floor by myself a many of times in a locked Alzhiemer's unit with 40 rooms, and all of them full, (full meaning 2 patients each room), when then nurse would not get off of her a**, to help me change these people doing rounds on patients that A. were not in my section and B. that I did not get paid for. The nurses didn't do med re-stocks, the ward clerk would do that when she came in a 6. The nurses didn't get patients, up at 5am unless they had to give them meds, CNA's did that. I can honestly say that I worked harder than all of the nurses in my LTC, esp. on 11-7. I was six months pregnant, changing a 320 man every night, and getting him up in his wheelchair every morning. And did the nurse see fit to help? No. She was too busy watching the 5 o'clock news. You need to understand that every hospital and LTC is different, and just b/c you may be a hard working nurse at your place of employment doen't mean that all are. And just off the top of my head I can give you a list of about 40 LPN's and Rn's, that don't do anything but sit around, and direct there work to others during their shift. Just because I am not a nurse doesn't mean that I don't know what nurses do, and it doesn't mean that I don't know what hard work is. It is my personal opinion from what I have seen that nurses that work in LTC esp the night shift have it easy, and until I see different for myself that is all I will ever believe.

As for the other post up there, the ADON and DON don't care that the nurses sleep, as long as they have a body on the unit. How do I know this? Becasue I heard my ADON tell a PRN nurse that she should come in eventhough she had to get sleep for an exam, because she could sleep on the unit. One of my nurses was asleep on the unit when a patient unlocked the door in front of her face and got out. Did she get fired? NO! So I don't work there any more, I couldn't take it. And when state would come it was a joke. The didn't do anything either.

debinohio · Dec 11, 2004

I gotta tell you that I have been an lpn for 15 years. I have done home care, agency nursing, nursing homes, veteran's hospital, camp nursing and also was in the military for awhile and I currently work in a local community hospital and have been there for 10 years. While the hospital is scary sometimes, you do not lose your skills like you might in a nursing home. When I worked in a LTC, I felt like I was the drug pusher and treatment lady for the evening and I hoped that the night went smoothly because I had too many patients to look after to have that happen. I also worked as a nurses aid for 8 years before I became a nurse. I guess you could say I have been around. I still feel like sometimes I have forgotten to do something when I get home from work you know? Thanks for listening, sometimes just talking or typing helps:p

Long Term Care Columnist / Guide · Dec 11, 2004

Wow........I'm still shaking my head over those night-shift nurses who sleep on the job. Where I come from, that's a firing offense, not to mention against the Nurse Practice Act, no matter whether you're an LPN, RN, or CNA! I worked nocs in LTC for 2 years, and only once did I even take a nap.....and that was when I hemorrhaged at work and there was another nurse to take up the slack for me while I tried to get a little strength back. The rest of the time, I was too busy doing meds, treatments, and administrative work.......and that was when I wasn't picking someone up off the floor, refereeing arguments between staff members, dealing with emergencies, chasing wanderers, and answering calls from the nearby retirement village, whose residents always seemed to have difficulties locating their dog, their keys, or their spouse at two AM. :uhoh3:

kaseysmom, LPN · Dec 11, 2004

Wow........I'm still shaking my head over those night-shift nurses who sleep on the job. Where I come from, that's a firing offense, not to mention against the Nurse Practice Act, no matter whether you're an LPN, RN, or CNA! I worked nocs in LTC for 2 years, and only once did I even take a nap.....and that was when I hemorrhaged at work and there was another nurse to take up the slack for me while I tried to get a little strength back. The rest of the time, I was too busy doing meds, treatments, and administrative work.......and that was when I wasn't picking someone up off the floor, refereeing arguments between staff members, dealing with emergencies, chasing wanderers, and answering calls from the nearby retirement village, whose residents always seemed to have difficulties locating their dog, their keys, or their spouse at two AM.

At the LTC facilities here, as soon as a nurse or CNA is found sleeping on the job, they are automatically fired. My mother is a head nurse and gets called in at whatever time it is that they are found asleep. Also, I think that people should refrain from saying "all that LPNs do". LPNs do A LOT. The BIG difference between LPNs and RNs is management. RNs do more management then we do because that's a large part of their education. LPNs tend to do less in a LTC facility because people perceive it that way. Just because an LPN isn't doing many clinical skills (tube feeds, meds or whatever the case may be) doesn't mean that she/he isn't doing important things like calling the doctors, making judgement calls when a patient is going down hill..those are all clinical skills, as well. =) Sometimes I think that we (as LPNs) perpetuate the problem as far as being labeled "just LPNs" because we have a tendancy to downgrade ourselves. Be proud that you've gone through a long and tedious course to become a nurse... =)

Blackcat99 · Dec 11, 2004

That's very sad to hear that the bosses know the nurses are sleeping and they don't care. I've worked in places like that in the past so unfortunately I know that places like that do exist. I'm glad to hear that you don't work at that place anymore. I bet the state board would be interested as to what goes on at that place during the night.

KaroSnowQueen, RN · Dec 11, 2004

I have been an LPN nearly 21 years. I have worked hospital maybe 4 or 5 years of it and the rest LTC.

Truthfully, I despised LTC but it paid much more than hospital work for many years, until I got my experience level up.

I have been full time on a med surg telemetry floor since Summer 2001, and I do not regret it a bit. I am now making $3 an hour more than I made at my last LTC job, and only $1 an hour less than I was making agency. I learned more in three months on med surg than I learned the entire time I was in LTC.

Don't let the commute be much of a factor. I worked LTC 10 minutes away, and 45 minutes away. I now work hospital 1 hour away but wouldn't trade it for anything.

DO check into the pay scales and see how they compare. Unless of course, you have a rich husband and money doesn't factor into the equation (don't I wish I had one of those!!!!!! :rolleyes: )

BKRN · Dec 12, 2004

Michelle,

I graduated in August and started working in Oct also. I am working on a Med/Surg floor and have learned so much! I picked Med/Surg because I am also doing my RN online through Excelsior. As far as getting experience on night shift-you will get plenty! I work 7PM-7AM and you would be surprised how little people actually sleep in the hospital! The best thing about nights is not having the Docs around so much-if you need them you call them. Good luck with your decision-hope this helps a little.

BKLPN