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

truebluenurse · Dec 30, 2004

I have been an LPN since 98. I am currently in LTC. I started out in LTC and felt the same way. So i went to a hospital for 2 years. It was the best thing for me. U learn so much more! But i missed the LTC. So i went back and signed on with 2 nursing agencies were i go to work in hospital and stayed on at the hospital prn. That way i could keep up my skills. I do believe that there are always new skills to learn predominately that u learn in the hospital setting and that u dont learn in the LTC facilties unless it is from other nurses advice or stories. I have always encouraged all my friends that have become nurses to go to a hospital for their experience but if ended up else where to stay prn @ hospitlas or go to them thru agency. U get to learn so much more! I continue to do the same.

proud2BLPN · Jan 8, 2005

I have worked both and personally I am able to work full scope in the LTC facility. We have one RN team leader on during the day, and the LPN's do everything ( meeds, drsg's, contact Dr.'s, take orders, assessments etc...

The med/surg floor I worked on the LPN's werent allowed to do half the stuff, and our scope of what we could do is slowly diminishing (d/t anti LPN nurse manager, but that is another subject :angryfire ) I would suggest doing some research..talk to some of the LPN's on the med/surg unit, find out what their policy is. I did gain alot of knowledge on the med/surg unit I worked on just not alot of hands on experience.

Hello everyone.:) I'm new here and I need some advice!
I graduated from PN school in August, and since October I have worked at a LTC. From what I understand from speaking to some of the veteran nurses who have worked everywhere, this home is one of the best in the area as far as working conditions for nurses go. I like my job and my co-workers, and have grown to love my residents.
The problem is, I feel like I am not utilizing 1/10th of what I learned in PN school. I pass meds (I have a couple of GT's), do wound care, and that's about it. And since I am going to start pursing my RN online this winter, I am thinking that I should get some med-surg experience. I have been offered a job in a med-surg unit (liver transplant) of one of the best teaching hospitals in the country. I am torn though, because I would be making $4.00 less per hour in the hospital, and it is also an additional 30 minute commute each way (my current commute is 5 minutes!). Also, the hospital job is 11-7. Would I get *enough* med-surg experience overnight, or would it be perfect way for a new graduate to get their feet wet in med surg?
Please help me! Any advice or perspective would be much appreciated.
Michelle

Chel · Jan 10, 2005

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.

Yep. This LTC facility sounds more like the one I just left. One side had 36 residents, the other had 56. You didn't stop on the larger side. You didn't run as much on the side with 36 residents, but there was always plenty to keep you busy. I ran my not so little tail off getting the required work done. ....which includes answering lights and alarms. If the doc was there that day there was tons of chart checks to be done, labs to be written, etc. And there's always the little alzheimers pt who won't go to bed and has to stay right there with you, setting off his personal alarm every five or 10 minutes. I can't begin to imagine sleeping, let alone LEAVING the facility.

nursemelly · Jan 15, 2005

I just started working on a med/surg ward. I love it so far. Ive been able to utilize alot of skills that I have learned. I graduated in Sept. Theres so much to learn and its so fast paced the only down fall for me is I cant give out meds on this ward.Good luck on making your decision

Silverhawk · Jan 16, 2005

I have only worked in long-term care. The first place I worked was totally unorganized. Nurses wrote orders and faxed them in to the Doc for approval. This made me uncomfortable, and blew my mind! I didn't know enough to be put in that situation. The DON and ADON were let go, I quit just prior to this. However, I went from 30 residents on my hall, skilled care, to 50 intermediate care, with one to two CNA's, usually two. I am getting burned out, no breaks, 5 min lunches. Thinking of going to a hospital for better working conditions. Any thought on this? I can see why there is a nursing shortage! Thanks!

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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