Once you work in acute care you can't go back to LTC?

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I have been a nurse for a couple years. I started out in LTC. When I was a new grad, I and a lot of my class operated under the advice to start in LTC, work there for a year or so, and then move on to acute care. Because acute care would be better all the way around. After working in LTC for around 2 years and acute care (med-surg) for about 8 months, one of they only things I have seen to be better is the pay rate.... and not by very much (after taxes, lol).

Anyways, after some harsh experiences in med-surg, I am feeling like I want to jump ship and go back to LTC. I have interviewed at a few places and they kind of act trepidatious. I'm getting interviews, but no calls back and this makes me wonder if I won't be welcomed back into the world of LTC!

When I was a new grad, the LTCs were all over me. I

Specializes in LTC, assisted living, med-surg, psych.

I went back and forth between acute care and LTC several times. The same was true with management and floor nursing. I don't know if it was just the times, but I never had issues with career mobility. Maybe it's where you live, maybe it's part of a trend. I haven't worked in almost two years, so take what I say with a grain of salt. :-)

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Specializes in Med-Surge; Forensic Nurse.

Maybe you can try Skilled Nursing, which is under the LTC umbrella. I know many nurses that work in skilled nursing/LTC, while they work for acute/M/S units or even specialty units, at a hospital. Many of them work through a staffing agency to get assignments in the skilled unit/LTC.

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Specializes in Med/Surg, Ortho, ASC.
Apprehensive, nervous, filled with trepidation.

OED.

Glad I'm not the only confused one:

The Grammarphobia Blog: Is trepidatious” a word?

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Specializes in Hospice.

Apparently it's a word the way "ain't" is a word-common usage/colloquialism but not "proper English".

Oops, forgot to read the link first-that's what it says.

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Apparently it's a word the way "ain't" is a word-common usage/colloquialism but not "proper English".

Oops, forgot to read the link first-that's what it says.

Ha. It's my understanding that trepidatious is a real word that's made it's way into the dictionary, just not spell-checker. I only use it once in a blue moon. The way some of these interviewers were looking at me and talking to me, it's the first word that came to my mind!

http://www.merriam-webster.com/dictionary/trepidatious

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Specializes in Allergy/ENT, Occ Health, LTC/Skilled.

It's totally how much you will "cost". And depending what state you are in, LPNs can now change PICC line dressings and adminsiter ATBs through them. That law just passed in my state earlier this year and LTC is really scaling back the hiring of experienced RNs unless it's for unit manager, ADON, etc. I see nothing wrong with your previous employement (or "job hopping" its rare to meet a nurse who hasnt switched jobs in the last two year, or here at least it isnt) so unless your really bombing these interviews, your too much money for the suits. They could really care less if you are worth the exrta money your expertise would bring, hell they are always trying ot figure out ways to give us more and more patients without getting in trouble for it.

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Specializes in Allergy/ENT, Occ Health, LTC/Skilled.

I would love to hear more about your experience in acute care though. I will graduate in 18 months with my RN and plan to go to the hospital if able to find employment. After having 25 patients every time I work, 10 of those skilled (many post op), the thought of only having 8-10 patients in med-surg sounds like heaven. Now you have me worried!!

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Specializes in Cardiology, Cardiothoracic Surgical.

Several things come to mind:

1) You're a bit of a flight risk from job-hopping.

2) Your acute care experience shows you can easily leave for another hospital or facility.

3) You'd be too expensive.

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I would love to hear more about your experience in acute care though. I will graduate in 18 months with my RN and plan to go to the hospital if able to find employment. After having 25 patients every time I work, 10 of those skilled (many post op), the thought of only having 8-10 patients in med-surg sounds like heaven. Now you have me worried!!

I work M/S, day shift. There are just a lot of tests (ct scan, mri, surg, endo), changes in condition and plan of care. The many doctors are constantly changing orders. My hospital rides us hard to meet the SKIP documentation specifications. Even rides us to get the doctors prescribing a certain way some times which is an added duty.

At all times, consulted doctors, speech, pt, ot, social work will expect me to know what's going on with any one of my patients. Seems like all day every day is like a whirlwind. I never get too familiar with my patients because I only have them one day, at the most two and then they are off to a SNF, ECF, or home. I have admissions at the same time as discharges. The patients and their families might be impatient about not being my only patient (!)

All I can say is that it's constant chaos compared with the ECFs I've worked at. The SNFs were busier, but where I worked, I had 10 patients who were short stays (like two weeks) for physical therapy or whatnot and the other 10-15 were stable LTC patients.

I don't know if it's like that where you work. This has just been my experience. Not even the floats like my unit because it's so busy and the boss is too picky about charting. Hope this helped ?

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Specializes in Allergy/ENT, Occ Health, LTC/Skilled.

Yes that helps a lot, I can see what you mean now. My patient load was the same as your when you were in SNF (25) but the rehab patients just arent hip replacements there for OT/PT anymore! Otherwise, it wouldn't be so bad. It's G tubes, PICC lines, ATBs, wound vacs, and people who should have never really left the hospital that soon in the first place! But I have a nice understanding boss so that helps. Hope you find the job your looking for!

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Specializes in critical care, ER,ICU, CVSURG, CCU.

I have been sucessful in both, going back and forth....that being said I always found critical care much "sainer" than med surg

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I worked in both Ltc and homecare as a new grad Rn in 2009,but by 2011,Ltc facilities would not hire me.

I finally asked a DON and she said home care nurses might have time management issues.

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