Please Bend My Brain: LTC --> Acute Care

[Tozz]

Hey,

I'm a (relatively) New Grad who received an offer for a 10 week New Grad Program at a Community Hospital. I've spent a year in a SNF, split between sub-acute rehab, and LTC. Sub-acute was about 15 patients, with an admission or two per day per nurse; LTC ranged from 20-30 patients, a few of which would typically consume 2-3 hours of your shift.

I've talked to several folks about the difference between LTC and Acute Care, but haven't received much helpful input for the transition. I'm pretty much being told that my last year of experience won't help much. Hey, got it. But why?

Okay, I get it that an acute care hospital is going to be more challenging: the patients more acute, closer attention much be paid, assessments more thorough. But what exactly do I need to get a head start on my new job? What do I need to unlearn. What should I be focussing on?

Many thanks in advance.

[HouTx, BSN, MSN, EdD]

Sorry you haven't gotten more responses. Did you already start your New Grad program?

IMO, the biggest difference is in the rapidly changeable nature of the patient problems you'll be dealing with. This is basically what determines the need for hospitalization, since they are discharged when they "stabilize". The average length of stay is ~ 3 days now. So, everything happens on a compressed timeline. You'll have to constantly prioritize and respond quickly to changing conditions. You'll also be working much more closely with physicians and other disciplines, so communication is very important.

Hospitals also have to meet regulatory requirements that have a huge impact on reimbursement, including patient satisfaction (HCAHPA) and JC Core measures.. so there is a lot of pressure in those areas - which will be covered in your orientation.

Best of luck on your new venture.