Newgrad RN LTC or hospital ?

Specialties Geriatric


I wasnt sure where to post this ( career advise, 1st year rn,ltc etc.) but anyways...

Im a RN new grad who has some job offers & Im not sure what career direction I should go, any advise? I had an interview at a LTC place & was offered a job...I also have another interview this week for a new grad program on a Oncology unit. ( which I might not even get but Im preparing my self)

Ok, I tried to the pros & cons and my Head tells me to take the hospital job because of the" first year experience" & its almost impossible to get a job as a new grad right now & I like oncology. But I dont think the hospital is right for me...clinicals were very stressful& i didnt like the "acuity" factor since I become scattered brained under pressure and Im not a fast thinker.(I know this & its been pointed out to me)

So, is LTC right for me, instead? I like to pass meds, I like routine & repeative work. But my head tells me that I can never get back my first year of "acute care experience/new grad program at the hospital". And, I have a gut feeling that Im not cut out for that kind of stress....would I do better with LTC stress? I dont know because my clinicals were only in a hospital setting, Please Help!

Thanx you guys!;)

Specializes in Step Down.

I'm graduating soon and I'm in the same boat as you. I'm so scared to even apply for hospital jobs because I don't think I'll be able to handle it. I also get really scatter brained under pressure (glad I'm not the only one). Two patients during clinicals was crazy and I didn't even have to deal with everything involved (calling docs, family, etc.) I also haven't experienced the LTC environment, but from what I understand 25-30 patients can get pretty stressful. I'm curious of what people have to say. I really want an outpatient setting eventually, but I know I need "hospital experience" first.

Don't think that LTC is not going to be stressful! It is just a different type of stress. You will likely be passing meds for too many patients, having to supervise CNA's, help with cares and do assessments on patients...all without enough time to complete things.....just my experience in LTC. I too was scared to go into a hospital setting but LTC has it's own stressful experiences. Many times I was the only nurse in the building, so no-one to bounce ideas off of, or get a second opinion, look, whatever you want to call it. I don't regret not working in the hospital. It just wasn't for me.

Specializes in Gerontology, Med surg, Home Health.

There is stress no matter where you work. If you choose LTC and work in a skilled place with short term, sub acute patients the stress will be more than you ever get in the hospital.....20-30 patients...some long term ...some have to have extraordinary time management skills and exceptional assessment skills.'s all on doctors around ...not too many other staff members to help out. I wouldn't work anywhere else. I hated the hospital. Not from the stress but because of how they treated old people.

You'll find your niche. Most people are lucky to find ONE job...any job ...these days. Good luck.

So, is LTC stress more about time management stress with meds and charting?

Heres more about myself:

Bad with time management

I cant make critical/acute care decisions on my own, I still need to bounce ideas of other nurses...

Slow learner/not fast thinker

I like routine& repeative duties&stable patients.

Some of these qualities are " just me" & im sure some if its due to lack of experience.

Since all RN jobs are stressful, i was just looking for adivse on my niche...thanx for the comments thus far.

You really should get some acute care experience before you jump into LTC. I have been a nurse for over 40 years and tried my hand in all areas. It paid off later on when I had small children and wanted to do agency work so I could pick my hours. Everyone required acute care hospital experience. As a new nurse I settled in Labor and Delivery and loved it. Now I am close to retirement and work in LTC. It is a total different aspect of nursing. If you do choose LTC try to keep you newly learned skills up by working in an acute care setting once in a while because you won't use many of them in LTC. Good Luck :nurse:

If you struggle with time management/independent decision making, then I would not start in LTC. I am a new grad RN and I just started a new job in LTC. I am very blessed to have med techs to do my med pass, but my day is completely full with other duties. Yesterday we had 2 falls and a re-admit, even with 3 nurses on the floor, we all stayed an hour late finishing paperwork. We have 2 main doctors, and both of them have thick accents and talk 100mph. I have never met one of them, and the other only visits 2x a week (which I hear is frequent for LTC). I need to be alert to changes in residents condition, because we nurse are their main source of medical care. The doctor only does rounds on them 1x a month, or if they have had a change in condition.

Specializes in Gerontology, Med surg, Home Health.

When I was a staff nurse an a skilled facility, I worked on a sub acute floor. I had 30 patients. In any one day I had 3 trachs, 4 tube feeds, a TPN, 10 IVs with q4 antibiotics, wound vacs, care plans, charting....

Don't tell me you lose your skills in long term all depends on what kind of place you work.

I'm newgrd RN, just got an LTC offer. so nervous!!! I don't have experience in LTC before. Any suggestion? thank you!

Specializes in CNA.

I am still in nursing school, but I work in LTC as an aide. You can get your year experience in LTC just as easily as in an acute setting. In my facility we have residents who are just there because they had surgery and need rehab or had a TIA and need some support (thats med-surg), we have residents with cancer (oncology), we have residents who are actively passing (hospice) and those who just need a place to stay where they aren't alone. Ive seen nurses have to do feeding tubes, NG tubes, catheters, heart monitors, bladder scans, IVs, blood draws, wound care/dressings, the whole shabang. LTC runs the board, you have all ages (our youngest resident is 28)and disease processes going on around you. LTC isn't for everyone though, it IS routine for the most part. It is short staffed with HIGH patient/nurse ratios and only one or two aides per wing. The doctors rarely come in, you have lazy co-workers who think the job is nothing more than babysitting, and it is very stressful at times. But it is so rewarding to see a resident everyday and get to know them and their situation. When you have a resident come in, nervous upset and fearful and you take care of them and they tell you how much they appreciate you, there is nothing else like it. I would suggest LTC because you say you like routine and that you didnt care for the hospital too much in your clinicals, and personally I think the reward factor outweighs everything else. If you go into LTC just remember it IS a specialty, and it IS real nursing and you will gain knowledge over a LOT of different things. Good Luck!!

Specializes in Geriatrics, LTC.

I'm a new registered nurse working in LTC and had the same concerns as you did, actually. I worried about my time management/priority skills, and also find the do best with a lot of routine work. I did find my hospital clinicals interesting, but discouraging because I felt as though I never got to know my patients as people.

As an LTC RN for approximately one month, I can tell you that I've already see a (positive) difference in my management and assessment skills. When I first started, I thought I'd never survive; now, I feel as though I'm finally getting the hang of things. THe job isn't always "routine" as ANYTHING can happen (wounds, falls, people passing away - literally, sometimes out of no where), but I love the fact that I have a sense of familiarity with the residents, their basic treatments and med pass, family members, etc. I'm so glad that I decided to start off in LTC versus hospital nursing.

Hope this helps,


Specializes in Geriatric/Sub Acute, Home Care.

My clinicals were based in a hosptial setting also. I found a hospital too cold and I didnt get to KNOW my patients. I became disillusioned when the Night and day crew were almost fist to cuffs one morning when I walked into report. But this was many moons ago. I eventually went to LTC which I later found out hurt me. My Alma Mater hospital that I went to school and worked in didnt want to hire me. But again, it was years ago. They thought I lost my edge on Nursing which they were wrong. You just dont forget what you have learned over many years. I would say.....Work at the hospital. You cant replace what may get lost afterward. They just dont look at you the same. Ps....Long term care is very stressful also.....a whole different enchilada than hospital work. I have worked with many ICU and hospital nurses who wanted a change in their careers and thought it was a walk in the park working in LTC......THEY QUIT soon after. Because the type of patients are totally different!!! Its a big decision but I am sure you will make the right choice that your heart calls you to.

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