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Pathway from LTC to critical


Specializes in hospice, ortho,clinical review. Has 5 years experience.

What would your advice be for someone in a SNF (very little skills as I found out) to get to a burn unit?

Orig when graduating I thought I'd go from a step down to the BTU. Recession had different plans and maybe I shot myself in the foot when I didnt' pursue a 2-step interview for the med short stay but there would have been only 3 days of orientation.

I work in a lovely LTC facility now, one I thought would be a dream as far as co-workers and atmosphere. For the most part it's true, but I'm not being challanged enough, plus I'm learning juggling 24 people, the never ending med pass, and not feeling I can provide the level of care isn't going to work.

I enjoy the elderly but definately not the sundowning that seems to go along w/these places so I guess I learned geriatrics truly isn't fo me since that's a huge part of it :(

I'm feeling pulled towards my first desire which is burn and I'm told by nurses to not ignore it. (I thought maybe geriatrics would grown on me, I was told you know or not whether it's for you pretty much immediately)

How do I do make the transition? Should I give this a definite year even though I may have 3 people tops that have more acute needs and with that only feeding tubes and "maybe" an IV? We have breathing tx but no trachs, vents.

I want to use my skills, I love to learn even though I have a "fear" at first if I can do something, once I see I can, it's great.

How do I know I can handle the true stress of a critical care environment? I didn't care for the ICU b/c it seems more machines than people but maybe I just had a bad rotation that didn't show the good parts. How do you know you're cut out for the ICU?

I feel ungrateful in this economy that at least I'm working in my desired field, but I don't think LTC is for me, but I wonder if I would regret it if I left for the higher stress atmosphere of the hospital :confused: I don't leave work crying as I hear most new nurses do. I was told the 1st year is similar to nursing school and I feel no where near that stress as far as learning. The med pass and the 24 people juggle is another story.

So should I stick it out for 6mos? a year? see if there's something now? Where should I go in the hospital to get to burn? I have an interest in neuro but the hospital I'm intersted in doesn't have a seperate unit I don't think. Mostly it's cardiac.


Specializes in RN@ooh freeatanding birthing center,home. Has 26 years experience.

So,btdt,my background is in ltc for 17 years as lpn,local hospitals would not hire. I saw an add for a birthing center with midwives,always had a great interest in babies,birth etc.Went to an interview, I showed great interest,willing to learn and all that good stuff.Iwas hired probationary basis,bought 4-5 books on labor,delivery,newborn exam,etc. The cnms trained me,recieved my RN degree, and just recd my lactation certification. Now Ihave been here for 8 years and i can say I really love it. So about you,do they do shadow days where you follow a nurse for the day, or do you like skilled nursing care but want to use the skills you learned?Is there a higher level of care re:chronic care you could move to?Get some books on burns and see if is truly an area you would like?Hope this helps.:nurse: