Question about job duties as a LTAC RN

JSBoston · Oct 6, 2009

I work in one, and I do frequent IV starts, I used to work in Labor and Delivery and starting IV's on the sick elderly is MUCH harder than healthy pregnant women! But it gets easier. We do have a lot of PICCs and midlines though, which is very nice. LTAC's are great for learning before moving on to acute care (my plan). We also do a LOT of lab draws (off central lines and peripheral sticks) at night when we don't have a lab and we send them off to a nearby hospital to process. Any other questions, just let me know! :)

Spencer2002 · Oct 6, 2009

i just left one for the air force. i can tell you from my experience that these people are very sick with multi co-morbidities. you will see lots of non-healing wounds, vent patients and patients that other hospital just won't take. you must be able to available for codes and you will see a lot of people die. i'm not trying to scare you! we have two new grads working nights and they are doing fine. it all depends on the staff you work with. be organized, get your assessments done, pass meds and chart. other things will fall into place. ltac will make you grow as a new nurse. if you can make it for a year you can work pretty much anywhere

JSBoston · Oct 6, 2009

Oh yes. You will learn a LOT about wounds! LTAC's are also the 'dumping grounds' for the area hospitals. We get people with very large histories and many who really LOVE their pain medications. One night I signed out 30 narcotics for 6 patients and over the weekend was over 50. Even if you have a pt who has been there for weeks and you know them well, make sure you have their full histories written down incase of a code and the doctor asks specifically for all of the details. Most of my patients have respiratory failure, diabetes, wounds, infections, PNA, COPD. Make sure you spend a day or more following an RT and a wound nurse if you have one. Always know what antibiotics the pt is on and why.

3rdcareerRN · Oct 6, 2009

Without hijacking this thread, let me ask:

-How is LTAC in terms of constant interruptions, compared to med/surg?

-How often do you admit/discharge, compared to med/surg?

-Do you have an extra amount of psych/coping/hopelessness/etc. nursing diagnoses, due to the LT nature of the medical conditions?

Thanks.

Spencer2002 · Oct 6, 2009

i typically had 4-5 heavy patients on nights. as soon as i would sit down to chart i would have to get back up and go give a med or flush an abx. a ran non-stop. everyone was on tpn and or tube feeding. we used lpn as well, so if they needed an ivp i would have to do it. most 95% of people had picc's so we had to draw blood in the am as well for our lpns. are aids were lazy and didn't want to work. we are a new ltac so the census would go up and down. and yes every patient was bipolar :) or used pain meds heavily, taking amounts that would kill most people. sorry if i sound bitter. but it was this chaotic environment that drove me to look for another job. i worked for a 1.5 years and lasted longer than most. we have gone through two don and on our second ceo. lots of turn-over in this type in nursing. who has time for care plans and nursing diagnosis? i was lucky to get my meds passed and charting done in 12 hours!

ris_03tdgz · Dec 19, 2009

Hi I'm a new grad currently working in a busy med-surg post-op unit and our ratio is usually 6-7:1. I am planning to resign because it is too fast-paced for me, too many admits and discharges in one shift and I get panic attacks all the time when I'm there. I was even thinking of quitting nursing alogether. However, I thought about giving LTAC a try instead. Is this a good idea? Is it less stressful working in LTACthan in a medsurg unit in a hospital? I have no plans of working in ICU or anything, i just want to work in a less stressful environment. Please share your thoughts on this! Thank you!

Spencer2002 · Dec 20, 2009

I worked in a LTACH for 1.5 years before I quit. We had 5:1. Everyone was on TF, TPN, multi antibiotics and IV push meds every 4 hours and code browns all the time. The grass is not greener on the other side. We also used LPN's and had to do a lot of their work as well. Some nights I felt like I had 10 patients. And on top of all that we had to run are own codes with minimal staff. I heard that 67% of nurses drop out of the profession after the first year. I have been in your shoes many times! Hang in. Home Health is OK, 1 to 1 but doesn't pay well and insurance is ok, not as good at what a hospital can offer.

ris_03tdgz · Dec 30, 2009

Can anyone give me tips on how a new grad like me can survive in LTAC? I already resigned from my job in the hospital (medsurg post-op unit) and want to give LTAC a try. Nurse to patient ratio in LTAC is 1:8 night shift. I really want to give this my best and do not want to think about quitting again=c Any tips/pearls of wisdom from nurses who worked/currently working in LTAC would be greatly appreciated! Thanks!!

Indy, LPN, LVN · Dec 30, 2009

I don't think you should work with a 1:8 ratio. Our loads are 4 to 5 patients nightshift, sometimes 3... It's very hard work and you would not be able to survive long in that environment with eight patients. I'm wondering if I could last a week with that.

ris_03tdgz · Dec 31, 2009

Well this is the only job opportunity I have right now. Thanks for the input, but as much as possible only encouragements and tips on how to survive in LTAC please, i dont need to be discouraged right now. Thanks!