Need advice!

Not to be discouraging, but it sounds like you're describing acute care med/surg, too. The ratio is lower, and that's the one positive thing, but the patients also have acute issues which can create quite a bit more work.

In fact, where do you send your patients when they become too sick or injured to be cared for at the SNF? They're climbing out of their beds and even more agitated when you put them in an unfamiliar place.

You should purse whatever you'd like, but just don't romanticize acute care. You'll have plenty of anxiety there, too. ?

I think the anxiety and the feeling of being overwhelmed comes not only from the staffing issue but also because I’m taking care of so many people. The unit I work on is a mixture of acute patients (some have trachs, gtubes, catheters), and residents who are just there to live (LTC) and need someone to just administer medications to them. My problem/issue is not acuity. I know med surg is no walk in the park - I have done school clinicals and have witnessed these floors. Like I mentioned no nursing job is easy... but I feel as though LTC is just WAY too much, especially for a brand new nurse who still needs to develop skills. I sometimes feel like I don’t even have time to think because I need to accomplish SO much in an 8 hr period. I also work the floor alone - I do have a supervisor but she rarely will help with orders, labs and won’t touch meds. I have no other nurse that I can work alongside. There’s no teamwork, no communication, no consistency. Acuity is not my problem. I can learn in a fast paced environment and could utilize and build on the skills I learned in nursing school if I had 1/2 the patients I’m taking care of now.

On 1/1/2020 at 8:00 PM, jennsrn said:

I think the anxiety and the feeling of being overwhelmed comes not only from the staffing issue but also because I’m taking care of so many people. The unit I work on is a mixture of acute patients (some have trachs, gtubes, catheters), and residents who are just there to live (LTC) and need someone to just administer medications to them. My problem/issue is not acuity. I know med surg is no walk in the park - I have done school clinicals and have witnessed these floors. Like I mentioned no nursing job is easy... but I feel as though LTC is just WAY too much, especially for a brand new nurse who still needs to develop skills. I sometimes feel like I don’t even have time to think because I need to accomplish SO much in an 8 hr period. I also work the floor alone - I do have a supervisor but she rarely will help with orders, labs and won’t touch meds. I have no other nurse that I can work alongside. There’s no teamwork, no communication, no consistency. Acuity is not my problem. I can learn in a fast paced environment and could utilize and build on the skills I learned in nursing school if I had 1/2 the patients I’m taking care of now.

Sounds like my current job atm. I work on the sub-acute/rehab floor. I have mix patients as well with 27 patient:1 nurse ratio. I work night shift. It was overwhelming at first, but you get to know their medications and you will get hand of it. I know most of my patients and I get an admission once in a blue moon. Unfortunately, most LTC are gonna be like this. Nurses are forced to do a 2 nurses job, while having high patient ratio to take care of, while dealing with CNAs and management, and other nursing duties. I am starting to not like LTC, but it is an easy way to get into, temp job, while looking elsewhere for a more stable job.

get out now before you become stereotyped to LTC. long term care is just a nice term for nursing home only patients are sicker and need more attention. the enviornment you are in is there to stay and only get worse.

i am an LVN with 26 years of LTC/SNF and trying to get another job out of this area is nearly impossible because most employers think "nursing home" and think you dont know anything. i dont know where you live but a brand new grad should be able to get a good job anywhere. it may pay less but a lighter load may be worth it. there is a hospital in the city where i live is offering a $15000.00 sign on bonuse for RNs.

I have read a lot of posts here with Nurses stating that they ban not find jobs that pay the same or more as the LTC's.

I have also heard that for new grads that work for a LTC/SNF get stuck there after 6 to 12 months. In other words hospitals etc... just will not hire them. (I do not know if this was true or not).

That’s how I felt when I was a new grad in a nursing home, I didn’t want to be a nurse anymore. Don’t be discouraged and continue to apply everywhere. Try long term acute care facilities (LTACH), hospitals, etc. When I got out I went to an LTACH, then moved on to acute care. The hospital setting is definitely better, in my opinion. You will have your good and bad days in the hospital too but I find that I have less bad days in the hospital. Don’t give up, good luck!

I would try to get on at a hospital, work med surg for a year and then decide if you want a change. I've worked both areas and they're both equally difficult and stressful.

My first post-licensing job was also LTC/SNF. I had a load of up to 38 patients. It was hell. I never gave any one patient fair attention and became a task-master based on pure survival. There were some good moments and I did like most of the residents and came to really care about some but mostly it was awful.

Now I'm med-tele. Not a lot of difference in the patients or the procedures. Still running my *** off in the morning and playing catch-up all afternoon.

BUT...I have no more than 6 patients, hopefully only 5. I have many other nurses on the floor from whom to draw advice, opinions, assistance, etc. There is a charge nurse that takes care of time sucking admin stuff like arguing with pharmacy or tracking down a doctor that can't be found. So it is better than LTC/SNF in a lot of ways with a lot of similarities in others.

Work at getting into LTAC or acute care immediately though. Once stuck in sub-acute it can be hard to get out.

If you want good staffing try a NICU. I've worked in 4 civilian ones and there have been VERY few times when I thought staffing was inappropriate. Yes, there are shifts that are crazy busy but the good thing is your patients aren't very heavy. And they're usually closer to each other so not as much running around.