Pathway from LTC to critical

[Kitty Hawk, ADN, RN]

I'm reposting this here from general as that gets more traffic but moves faster and I'd really like some input. Maybe some of you are in the same position (working LTC but want some other speciality)

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 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.

[HouTx, BSN, MSN, EdD]

Have you thought about transitioning into an LTAC? The environment would provide you with an opportunity to develop more 'high tech' ICU-ish skills - but with a fairly stable patient population. I think it is a great intermediate development opportunity between LTC & acute care.

FYI - I did a stint in an ICU burn unit. Even as a very experienced ICU nurse, I found it extremely stressful & unpleasant -- didn't stay long. The continuous extreme physical & mental suffering of the patients, wearing complete isolation garb at all times. Maybe less acute burn rehab would be better?