Moving from LTC to the hospital

Sour Lemon · Mar 14, 2019

My last employer started hiring six LTC nurses a year instead of six new grads. They did great.

lovingtheunloved, ASN, RN · Mar 14, 2019

I went from LTC to home health to acute care. It was a rough transition, not gonna lie. When you’ve spent 12 years out of the hospital it’s really hard to try to learn to think that way and to learn all the equipment and technology that you just didn’t have before. I was lucky to have a great team and manager who were patient with me and had my back. It honestly took me a solid year to feel confindent as a hospital nurse. Pretty much like a new grad I would say. I had good experience with certain things that were an asset, but the hospital was a whole new ball game for me.

Davey Do · Mar 14, 2019

I say "Amen!" to Sour Lemon's post.

Competent LTC nurses seem to have their priorities in interventions and time management down to an art.

Now, I'm speaking predominately from a geriatric psych perspective, but for the nurses I've worked with who have had LTC experience, geriatric psych is a cakewalk.

Having had some acute care medical experience, I can also say the same.

Good luck, Lovejday!

allnurses Guide · Mar 14, 2019

Every manager I have ever worked for had their mind firmly closed to nurses whose experience history is in LTC - most likely because of the issues the above poster had. They need a longer than average orientation period but don't generally qualify for the "new grad" residencies/internships. I think it is a shame, to be honest.

WittySarcasm, BSN · Mar 14, 2019

I began my nursing career in LTC, I was usually on the skilled floors except through agency which would put me anywhere. Anyways I finally decided to make the acute jump about 5 years ago. I went into acute inpatient rehab and yes it was a scary jump but at the same time I had so many skills (except for IV starts I will never get that skill I swear) already from being on the skilled side of LTC that I just had to learn the hospital rules for patient care. I’ve been floated to ortho and wound and med/surf and there’s been stuff I’ve encountered but I asked and learned. Yes it has been hard at times but also the time management usually has me finishing my stuff so early. Even if I go slow and take my time. Haha.

Golden_RN, MSN · Mar 14, 2019

I worked with several LTC RNs that went to acute floors (same company owned the LTC and acute facilities) and thrived.

Golden_RN, MSN · Mar 14, 2019

5 hours ago, Davey Do said:
I say "Amen!" to Sour Lemon's post.
Competent LTC nurses seem to have their priorities in interventions and time management down to an art.
Now, I'm speaking predominately from a geriatric psych perspective, but for the nurses I've worked with who have had LTC experience, geriatric psych is a cakewalk.
Having had some acute care medical experience, I can also say the same.
Good luck, Lovejday!

Geropsych is something I would love to try someday.

Ruby Vee, BSN · Mar 17, 2019

I've never worked in a nursing home, but I have precepted (ICU) many nurses who came to us from a nursing home. They all did great.

A nurse who worked in a nursing home has the ability to know when a patient is deteriorating without looking at all of our fancy monitors and technology, and often before the technology flags a change. They have time management down pat, and they know a wide range of medications -- use, dose, side effects, toxic effects and interactions. They already know how to conduct a quick, focused assessment while introducing themselves and fluffing some pillows. They know how to talk to patients, families and physicians. They already know about the night shift, weekend and holiday requirements so we don't get a lot of silly pushback on that, and they already know how to think critically. (Or have commons sense, which isn't so common.)

Some of my valued colleagues started out in a nursing home.

Long Term Care Columnist / Guide · Mar 19, 2019

I've been from LTC/SNF to acute care and back again. Frankly, I think both have good points and bad. I loved Med/Surg for awhile and became certified during my years in the hospital, but the floor was disorganized and clique-ish, and I always seemed to be the odd (wo)man out. Still, it was varied and fulfilling...until it wasn't. I ended up leaving because of one assistant department manager who for some reason disliked me and did her best to make my work life miserable.

In LTC, I was in my element and I had friends with whom I'm still in contact, though I haven't worked there since 2013. I had mad time management skills and still had enough left in the tank at the end of the shift to make sure my CNAs had done their room tidies and do my own rounds on 38 residents just before shift change. No matter how chaotic my LTC shift had been, it still beat the average hospital shift by a mile. But that's just me.

Advanced Practice Columnist / Guide · Mar 19, 2019

I went from working in acute care as a nurse in a foreign country to LTC when I immigrated to the US. That was the only option I had at the time but I stayed for about three years until I could transition back to a telemetry unit. This was in the 90's. It was tough getting used to the 12-hr shift but I didn't have a hard time managing my time since I actually had less patients than in LTC. I also felt that some of the nurses underestimated my abilities and focused on my recent LTC experience until they realized I worked as a nurse in a hospital in a foreign country where I was proficient in starting IV's.