New Grad Rn In Ltc?

surfnbeagle · Mar 1, 2005

Hi, I am an RN in long term care and work as a staff nurse, you don't have to go into management. I have seen RNs who have gone straight into management (like my DON) and they dont seem to have a clue about the realities of patient care, the acuity nowadays, etc.. And besides she doesnt have the respect of the staff. The drawback into going into LTC right away is that there is usually poor orientation and they want you to hit the floor right away. There are exceptions though, ask them during the interview. As there are exceptions, about going right into management. Go where your heart is, you may find you will have to seek out learning experiences on your own. stay in touch

CoffeeRTC, BSN, RN · Mar 1, 2005

I think you can do it!! RN functions vary. Our staff RNs do the same as the LPNs but aslo are the supervisors. As far as going in to management...get your feet wet first.

stidget99 · Mar 1, 2005

I will be graduating in May 2005. I really enjoy working with the geriatric population, and rehab patients. would an LTC/REHAB facility be a good place to begin my career? What would an RN do in LTC other than management?
I am in Texas. Any info or advice would help!!

My two cents worth....I think all new grads should start in the hosp setting. I made the mistake (12 yrs ago) of starting work in a long term care setting for the developmentally disabled. I lost 99% of my nursing skills. When I did decide to move to the hosp setting, I needed an extra amount of time for orientation because I was "worse than a new grad" (i.e. didn't even have the benefit of recent clinical experience). I re-learned things very fast but I would have felt more comfortable had I had some hosp experience. And, as far as working w/ the elderly....you have the opportunity to work w/ the geriatric population on any med/surg floor.

edeverges · Mar 1, 2005

i too have worked in long term care. i feel like I have maintained many skills, but i think i know what you mean. i would not feel comfortable working icu, ed, etc. i have cared for many residents that have been returned from the ed without aqny care being provided, but whom i felt needed closer supervisiohn than my staff ratio provided. what section of the hospital did you transfer to work?

My two cents worth....I think all new grads should start in the hosp setting. I made the mistake (12 yrs ago) of starting work in a long term care setting for the developmentally disabled. I lost 99% of my nursing skills. When I did decide to move to the hosp setting, I needed an extra amount of time for orientation because I was "worse than a new grad" (i.e. didn't even have the benefit of recent clinical experience). I re-learned things very fast but I would have felt more comfortable had I had some hosp experience. And, as far as working w/ the elderly....you have the opportunity to work w/ the geriatric population on any med/surg floor.

donmomofnine · Mar 1, 2005

I never worked in the hospital, other than L&D. I worked LTC for fifteen years now and have no regrets. I don't think lack of hospital experience hindered me, but I guess that is an individual thing.... I wish you all the best and it does my heart good to hear someone say they want to work LTC. We need all the nurses "with a heart for it" that we can get!:)

snowfreeze, BSN, RN · Mar 1, 2005

LTC used to be the poorly staffed entitiy of nursing, Add hospitals, home care, school nursing and penitentary nursing.

Ask in your interview if you can talk to some people who work there.

Many LTC facilities are now what a med/surg unit in a hospital used to be.

LTC is where the jobs will be in the next 20 years as the babyboomers age even further.

Actually this will be the tsunami of LTC. Such a surge that it will overwhelm a lot of people.

I work in LTC in pennsylvania in a 325 bed facility. I supervise on my weekends and work all the units during the week as a full time nurse. 9 units and 8 are locked for patient safety. Personal care, mid stage demetia and end stage dementia along with long term care, sub-acute and dementia behavior is our range of care.

I worked critical care before coming here, I needed something close to home and with the hours I needed to raise my youngest daughter.

My work does focus around my life, not my life around my work.

stidget99 · Mar 2, 2005

i too have worked in long term care. i feel like I have maintained many skills, but i think i know what you mean. i would not feel comfortable working icu, ed, etc. i have cared for many residents that have been returned from the ed without aqny care being provided, but whom i felt needed closer supervisiohn than my staff ratio provided. what section of the hospital did you transfer to work?

I worked med/surg first then branched out to other areas as my comfort level increased.

Antikigirl, ASN, RN · Mar 2, 2005

I did the med surge thing right out of school, and it was a utter horror story, that is how I wound up in LTC.

Now LTC was far from my thing (still is really), but I do it well and started noticing that I was making connections from hospital to post that were outstanding and really a good move for me! Seeing how folks were treated and released on what meds and treatments, then actually getting to see what these meds/treatments do really helped me to understand things a bit more full circle! So LTC is a really good place for me to hone in on connections that will aide me in other things I wish to do!

In fact, Today I get to study for my ACLS course (I take that to keep my skills up to date, and looks nice on a resume!). I was growling about having to learn all those meds again, all those arrythmias, all those numbers. But I was shocked to find...OH...okay this is like that one patient Mr. So In So who had the slow heart rate secondary to CHF...okay he was on this and this and they started an IV of this.... I made a connection to cause, effect, treatment that I knew all along, but only in the form of an algarhythmn and not from my own experience! WOW, seems simple...but for some reason that light came on and I went through ACLS book yesterday and it was a breeze! I knew these meds, I knew these conditions, I knew what was done pre-transport to ED and after discharge! I felt so great...and remembered the value of working in LTC when you never ment to go there (I was going teen/adult acute care or ED...so LTC was very different for me!).

Alas...I have been job seeking for over a year, and since I went into LTC, I have been told by potential employers, human resourse folk, and interviewers that I am "unskilled" now that I work in LTC, and don't qualify for much. I find that entirely incorrect and shocking to say the least..but something I guess is not uncommon...so that is a good thing to be aware of. It isn't the truth to me, but it is the reality of how others view an LTC nurse sometimes..but this may vary from place to place? (I hope!). So watch for this or consider it in your choice (ask other LTC nurses in your area).

DR2004RN · Mar 2, 2005

I will be graduating in May 2005. I really enjoy working with the geriatric population, and rehab patients. would an LTC/REHAB facility be a good place to begin my career? What would an RN do in LTC other than management?
I am in Texas. Any info or advice would help!!

Boy am I glad that you brought this up!!! I too am thinking of doing LTC, but I wasn't sure if I would get to use my critical thinking skills, as well as some I.V. skills; or get to work with trach/vented patients. I don't want to just be a manager. Nor do I just want to pass pills all day either (no offense meant by that.) I enjoy the geriatric and MR/DD population very much, I know that is where my heart is, but I don't want lose any skills should I ever decide to work in a hospital again. I just got my license in June 04, and have worked in a hospital since. Sorry, I didn't mean to ramble on. I just wanted to let you know that someone else out there agrees with you. Good luck to you.

DR2004RN · Mar 2, 2005

One question I forgot to ask, do the LTC nurses do head-to-toe assessments on all of the residents? I worked as an aide in LTC, and I don't think I ever saw a nurse do an assessment. Blood pressures were only done once a week. Is it pretty much like that everywhere?

CoffeeRTC, BSN, RN · Mar 2, 2005

boy am i glad that you brought this up!!! i too am thinking of doing ltc, but i wasn't sure if i would get to use my critical thinking skills, as well as some i.v. skills; or get to work with trach/vented patients. i don't want to just be a manager. nor do i just want to pass pills all day either (no offense meant by that.) i enjoy the geriatric and mr/dd population very much, i know that is where my heart is, but i don't want lose any skills should i ever decide to work in a hospital again. i just got my license in june 04, and have worked in a hospital since. sorry, i didn't mean to ramble on. i just wanted to let you know that someone else out there agrees with you. good luck to you.

you can do all of this in ltc and more ....critical thinking skills are used everyday. iv, phlebotomy, trach, vents, wound care, teaching....you can see it all. please read other posts on this board..

one question i forgot to ask, do the ltc nurses do head-to-toe assessments on all of the residents? i worked as an aide in ltc, and i don't think i ever saw a nurse do an assessment. blood pressures were only done once a week. is it pretty much like that everywhere?

heck no...if i have 26 or more residents to pass meds on, do treatments,etc...there is no way you can to a full head to toe on them nor do you need to. we do focused assessments. what is the dx? pneumonia....id be doing a complete respiratory assessment. chf...cardiac...look at resident. listen to lungs, heart, feel pulses, check for edema...etc.. you get the picture. most residents are not bed bound...they are up for the day out for activities, therapy etc. hunting them down to get meds or treatments done is hard enough. vital signs are different depending on the facility policy. sometimes just because you aren't laying hands on the resident doesn't always mean i'm not assessing.