BosLav

I worked in pediatric LTC and home health for my first three years as a nurse, and planned on teaching within that field. But I ended up relocating to a new state (and I have no intentions of moving again any time soon), and the town I live in only has one local hospital and one local college (and when I say "local", I mean we are the only hospital for 30+ miles). It's an extremely small town, so my job options are much more limited. Pediatric LTC and pedi home health doesn't even exist up here.

I'm having a bit of a dilemma... Almost 5 months ago, I switched departments within my hospital. I was working on the LTC floor, and loved it. I've been a nurse for nearly 6 years, and have always worked in either LTC or home health (and have loved both). I also graduated with my MSN in nursing education a few years back, and because I've only done LTC, I decided to switch to med surg. I wish I could say that I love med surg, but I don't! I'm learning quickly that I'm totally out of my comfort zone in acute care, and miss working with the same residents every day. I really enjoyed the aspect of getting to REALLY know your patients and their families when caring for them, and I don't feel that sense at all on med surg. We patch our patients up, stabilize them, and send them home. I also just feel like I don't handle the constant changes in care plans or patient load as well as the other nurses (6-7 acute patients is a LOT different than 20+ LTC patients). I know it's only been 5 months, but I absolutely miss my old job, and I'd love to go back (especially since I know that my old night shift position is still open, and I'm worried it might not be if I wait it out). I also live in a very small town, and this is the only local hospital. However, I also don't want to cause any burned bridges within the hospital. The LTC department is also going to moving to another facility in a couple of years, and will no longer be affiliated with the hospital, and I'd rather stay with the hospital (this is why I switched departments in the first place). I'm trying to weigh my options, but am not sure where to begin. I feel like acute care experience is vital, so I'm trying to tough it out, at least for a year or two (especially since I've lost so many of my acute skills since nursing school!). But I miss that feeling of actually looking FORWARD to going into work for the night. I feel like I'm losing my spark and passion. In the meantime, I've also thought about maybe applying somewhere else, and just working MS per diem or part time... There is a college with a ADN program nearby, and they are always looking for nursing instructors. I have that nurse educator MSN, and have thought of maybe applying there. But with only LTC experience under my belt, would it be worth it? What other jobs are good for someone who despises acute care? Any feedback is so appreciated. ❤

I would also be on orientation until July (so I don't think they'd cut me from the schedule until I was at least on my own on the floor), so I don't know if moving my start date would really make much of a difference.

Here is my dilemma... I currently work on a LTC floor at my hospital, and have been there for almost 2 years. I decided to move to the med surg floor to gain some acute care experience, and start there in 3 weeks. However, I'm hearing horror stories about how nurses everywhere are having to be sent home for low census. I live in a very small, rural town, where this is definitely a possibility. Where I work now in LTC, I have guaranteed hours, and pay stability, and am just able to pay off all of my bills/rent with a little extra to throw into savings each week. I'm worried sick that I might end up encountering low census in med surg, and will not bring enough home to make a living. I really wanted this job, and am prettyheartbroken over the realization that I might have to turn it down and stay in my current department (if they will even allow me to, where I've already accepted the position). What is it like in other med surg departments right now? Are nurses seeing drastic cuts to their take home pay/hours? Are you eligible for unemployment if you don't work your full schedule? (I work 36 hours). Are there any other nurses in this same situation right now? And feedback would be much appreciated.

I have been a nurse for just over 6 years, having worked in pediatric LTC and home health for 4 years, and geriatric LTC and hospice for 2 years. I've also always worked night shift, and love it! My local hospital was looking for a FT med surg nurse for night shift, and so I jumped on it, and was hired. I start in 3 weeks, and am SO nervous. Although I've been a nurse for a while and am comfortable in my skillset, this is a whole different realm of nursing for me. I also currently work in an unskilled LTC setting (no IV infusions, no G-tubes, J-tubes, trachs, vents, etc). Most residents are on PO meds, and you may have the occasional dressing change... But no skilled nursing. And so I feel like some of my skills needed for med surg are either non-existent, or really rusty. My new manager is completely aware that I'm coming from an unskilled nursing home, and assured me that I would have 6-8 weeks of orientation, with additional training if needed. But I'm still so nervous! Any tips, pointers (or even just some words of encouragement!) would be much appreciated. Thank you! ?

Thank you so much for the advice! I'll be working night shift (7p-7a - I have always worked nights as a nurse, willingly so!), and I know that after 11pm, we have less available resources within the hospital. Our staffing at night generally consists of three nurses and one aide (I work for a VERY small, rural hospital).

I've been a nurse for 5 years, working mainly in longterm care and home health care. I recently took the plunge and decided to apply to the med surg unit at my hospital (the nursing home I work for is attached to the main hospital). I'm both excited, and really nervous! I have a 2-3 month long orientation, so it's not like I'm being blindly thrown into a new realm of nursing. But I would greatly appreciate any tips or advice from other med surg nurses! What skills should I brush up on? How is handling 5-6 acute patients compared to handling 20-24 relatively stable LTC patients? How is time management utilized differently in med surg compared to LTC? I've also thought about looking into either books or online learning material to brush up on some skills and knowledge that I haven't used since nursing school, or haven't dealt with as frequently in longterm care (I.e. acute disease processes, certain pharmaceuticals, emergency care/treatments, etc). Any recommendations? Thank you kindly! ?

Hello! I am an RN student, and also work as a PCA on the side. I have a resident who wears tight-fitting turtle neck style shirts, and I am responsible for getting her undressed at the end of the night. This may seem like a silly question, but I have trouble getting her shirt off of her sometimes; I feel like there is no true comfortable way to undress her. I generally undress patients starting with one arm, the head, and then the opposite arm; but with this tight of a fit, it seems like there is no way to avoid an arm or head getting stuck in the shirt! Any tips? Has anyone run into this problem before?