Question to nurses who have worked LTC AND Acute Care

allnurses Guide · Jul 27, 2005

I found that LTC was very routine, same stuff daily, only the human interaction with some of the residents varied. Used a lot of assessment skills, but very little was much of a challenge, hard work, but routine.

Acute care has its own routine, some patients hang around quite a while, and on a cancer floor we got regulars come back periodically for chemo. Always enough turn over to make it a challenge though.

ER now, the only routine is always more patients than beds available, and too often short staffed! Lots more challenging, as you never know what's coming in the door next.

lsyorke, RN · Jul 27, 2005

LTC just wasn't for me. To slow moving, to little change,very repetitive paperwork. I needed more action than that. I also felt my skills weren't being put to use. Just my personal choice.

kthnscr8 · Jul 27, 2005

Fortunately I have been a LTC nurse for a long part of my career. I have found that I enjoy the LTC aspect due to the fact that you get to know your pt's on a individual basis. I also have been a MCR charge nurse in LTC that at times I feel we are running a acute hosp. I work for a facility that takes about anything so I get the advantage from the facility of not being scared to take the individuals that other facilities will not take. We do everything from trachs to bariatrics, psych et so forth. I belive it all depends on the facility et the people you work for (cause I have worked for some bad ones)

I was thinking today of the contrast between LTC and acute. What would you identify as the major differences from a nurses POV?
I'd especially like to hear from nurses who switched from acute to LTC environment. What did you like? What surprised you? What difficulties did you encounter? How did your role and work shift change?

mattsmom81 · Jul 27, 2005

Thanks to all who have responded. I have worked acute most of my career, but found in the past few years I enjoyed the rehab/longer term facilities when I worked occasional shifts there. So I'm considering a change.

I'm older now and don't need the action and high adrenalin...LOL! :)

TracyB,RN, RN · Jul 29, 2005

I've done both & have to say that it totally depends WHERE you are; how is the support staff, management? It really makes a difference.

It's about 50/50 for me. I love the routine & getting to know my patients in LTC, but the constant short-staffing & lack of managerial support send me right back to acute. Honestly, if the benefits were more affordable in LTC, I would probably stay in LTC forever. There are days that I really miss my residents.

mattsmom81 · Jul 29, 2005

I am concerned about the heavy lifting...probably fine when all the CNA's show up...but I can see an awful heavy shift for the nurses if the aides don't show....

My shifts at the rehab facility...the nurses did no physical care. We had our days full doing admissions, asessments, giving meds and the CNA's teamed up for pt care routinely, seldom involving the nurses unless they needed our input. I don't know if this was unusual or not. From some postings here, I wonder if my experience was in an unusually good facility and most are NOT this good.

mattsmom81 · Aug 2, 2005

Sooo..I guess I've asked another question to those of you who have worked both areas.

How do you compare the lifting? Is the physical work harder in LTC or is it harder in primary acute care settings??

After 20 plus in acute primary care, the old bod is ready for a break....ouch.

lsyorke, RN · Aug 2, 2005

I find that acute care has more lifting for me. LTC was more paper pushing than physical care.

DG5 · Aug 2, 2005

I'm thinking I'd like to shift from LTC to a rehab setting. I find LTC great, except its getting SO hectic and short staffed. It never seems we can get enough nurses. It's always great when we get another nurse. You'll really be welcome in LTC from that POV!

mattsmom81 · Aug 2, 2005

I find that acute care has more lifting for me. LTC was more paper pushing than physical care.

Thanks for your input. I guess I will have to ask very bluntly about how much lifting goes on routinely for the nurses as I interview. At this point more paperwork and less lifting is the ticket for me.

Of course I know there will always be SOME lifting...I just don't want it to be my primary responsibility any longer.

dinkymouse · Aug 2, 2005

I found that LTC was very routine, same stuff daily, only the human interaction with some of the residents varied. Used a lot of assessment skills, but very little was much of a challenge, hard work, but routine.
Acute care has its own routine, some patients hang around quite a while, and on a cancer floor we got regulars come back periodically for chemo. Always enough turn over to make it a challenge though.
ER now, the only routine is always more patients than beds available, and too often short staffed! Lots more challenging, as you never know what's coming in the door next.

I have worked LTC, Acute, and Home health. I have found nothing routine about any of them. LTC, which I am doing now, is always a challenge, partly do to the staff difficulties, but also because of the individual resident. I work in a non-profit home and we get some of the sickest, poorest, people. I love dealing with their cares, setting up a plan that meets their needs and is functional. Every shift there is some patient in crisis, a family on a rampage or a doctor who doesn't listen.