i miss ltc i think

Selene006, BSN, LPN · Jun 24, 2010

That's hilarious! I currently work on a LTC/ subacute unit and just accepted a job at an acute care hospital--hoping to get away from LTC's 2 nurses to 30 patients ratio! I'm not sure what's going on, but our facility USED TO have beds filled with grandmas and grandpas. Now, the beds are filled with alchohol detox patients (for whom we only babysit anyways), homeless patients with severe wound issues and terribly rude demeanors, purely psych patients, and cardiac patients who are transferred out to the hospital every other week because the LTC facility needs to fill every bed, even if it's with a patient who is clinically unstable and needs more attention than 2 nurses can spare! I'm so fed up with it that I gave my 2 weeks notice last week! I loved taking care of grandpas and grandmas, but there's only a handful of them left on the unit! :lol2:

I love LTC nurses and I've admire their dedication, despite the fact that the patients being admitted in have more complex comorbidities and need more medical attention. But I don't think I'll be romanticizing LTC any time soon!

ez2000 · Jun 24, 2010

wow this topic is just so perfect and i can't complain more about the timing. i am contemplating in moving to the hospital. i always think that hospital med surg is easier than ltc w/ grandma's and grandpa's. right now i am taking care of 36 pt and i thought it is already hard. what can be harder than this? i mean in the hospital you only have 6 pts. and you work 3 days in a week whereas in the ltc...you work 5 days/wk. did i just read the topic right "i miss ltc i think" or it just happens to a few? because based from what i read...most nurses in the ltc can't wait to get out of ltc and work in the hospital. can somebody enlighten me as well... :uhoh3:

Doc Lori, R.N. · Jun 24, 2010

I think LTC gets into your blood! I've worked several specialties and to date my favorite was a 93 bed skilled nursing facility. The work was hard, but rewarding to say the least. You really felt as though you were able to give compassionate care. Of course, the admin and the DON were top notch, and I think that made all the difference as well.

Ohh the fun we would have. After dinner, we'd take the residents back to their units. On the LTC unit, they would all sit in their wheelchairs at the nurses station, one by one they were taken for their evening showers, PM care, etc..we would sing songs, tell stories. Ohh those people were precious! They had every level of dementia you could imagine. They would take about the war, and sometimes they would fight! The spirit in these residents is amazing :)

I think it's easy to get burned out on LTC, then you think, hey..I am going to work in an acute care setting. Sometimes you find that you are happy you left, most often you find that it's not always greener on the other side of the fence :)

From another perspective though, it is always good to have at least 2 solid years of med/surg on your resume.

When you take care of residents, not patients..it feels less like a job and more like a privilege. If I ever went back into active nursing, that's where I'd be :) Just follow your heart, your feet won't be far behind! Best wishes!

makes needs known · Jun 24, 2010

The grass is always greener on the other side ?:)

jjjoy, LPN · Jun 24, 2010

Of course, the admin and the DON were top notch, and I think that made all the difference as well.

That makes a BIG difference and can't be left out of the equation. Some places the nurse practically needs rollerskates to be able to get the bare minimum done.

makes needs known · Jun 24, 2010

Our patients used to be called residents, but now we are to call them patients. And our superiors, used to be someone you could go to with a problem and they would try to fix it. Now what we hear is "too bad, so sorry, deal with it, can't do it", and the #1 topper we hear is "work harder and smarter and you won't have so many problems." We have too few nurses, too many patients, and not enough supplies. Our pharmacy does not send us meds when we order them, our doctors do not send scripts to pharmacy for narcotics, our dietary department does not send us the nutritional supplements we need even after I requested them 3 times. Is the grass greener? Probably not, our grass is pretty green with all the manure I see every day.

kathy313 · Jun 24, 2010

I think the continuity of the care, knowing your patients or residents, is what makes LTC special for some people. Not only that, but the routine....it's easier when you have a "normal" routine. I had 30 residents and it kept me busy, but it was predictable.

Now I work Med/Surg with 5 or 6 patients, but by the end of the day 3 or 4 have been d/c'd to various places and I have 4 admissions. We have a very rapid turn-over on our floor. We are always on our toes.

Schmoo1022 · Jun 25, 2010

I love, love, love long term care. I truly enjoy working with the elderly. That being sad....we have very few residents that are even considered Seniors these days. All psych and dependency issues. We have several residents under 50...all psych issues.

I have thought many times of trying Med/Surg. Mostly to learn more hands on skills and benefits. If my place had better benefits...I can honestly say I would be there until I retired. Which is 30 years away lol.

It's hard, I have 30 residents with a med tech. So, yeah sometimes 5-8 patients sounds good to me. I know they are more acute and require more assessment, but it would be nice to get the pay, differental and other benefits that hospitals offer. I make a decent salary, but everything else Blahhhhh.

I love the way I can go in any given day and my residents all call me by name, ask how my weekend was and tell me what is going on with them. I love that (usually) you can tell if something is off with a resident right away.

SuesquatchRN, BSN, RN · Jun 25, 2010

If you get into a place with a subacute unit you'll get lots of IVs, etc., as well as wounds, rehab post-op for fx, etc. You'll be pretty marketable, but those units are insane with paperwork - admits and discharges - with no more nurses or aides.

Don't buy the line that you don't learn clinical skills in LTC. I'm a manager but we've been short so I've had a cart most days the past month. And right now 7 of our 44 have PN and I caught every single one and got them all started on tx without having to send them out.

Today I had my end-stage COPD lady satting at 80 - she's usually 98. The doc, as usual, didn't show up on schedule. I threw everything I had at her - PRN Xanax, neds, Tessalon, cough syrup, pain meds - and got her to sleep and by 3 pm, at the end of my shift and when the doc deigned to appear, her sats were back up to 93. Still low for her, but better. Then, yes, I stayed over to get coumadin orders entered.

I'm a nurse. If you want LTC go for it. I love it. I'd like an effective DON but we can't have everything.