seasoned nurses..less stress in ltc or med/surg

beachbutterfly · Jul 16, 2009

I'm not a seasoned nurse,actually I'm a novice nurse but I have heard from several collegues that working in long term care facility is much less stressful,of course the downside of it is that you wont learn as much of medicine as you would do in the regular hospital,by no means the nursing homes are a smooth sail but the patient with acute,unstable conditions are shipped out to the hospitals for care!!!

LesMonsterRN, ADN, RN · Jul 16, 2009

Long term care can definitely be every bit as stressful as hospital nursing, IMO.

beachbutterfly · Jul 16, 2009

Long term care can definitely be every bit as stressful as hospital nursing, IMO.

Not necessary true unless you mean those really s.....nursing homes.I know for a fact that several of my friend went back to nursing home after learning that working in hospital is not so "smooth " as they thought it would be,with that said I'm sure there are many nursing homes that offer terrible conditions.I guess you cant sell yourself short and interview with several different long term care facilities,do not accept an offer just anywhere!

LesMonsterRN, ADN, RN · Jul 16, 2009

Not necessary true unless you mean those really s.....nursing homes.I know for a fact that several of my friend went back to nursing home after learning that working in hospital is not so "smooth " as they thought it would be,with that said I'm sure there are many nursing homes that offer terrible conditions.I guess you cant sell yourself short and interview with several different long term care facilities,do not accept an offer just anywhere!

I've worked in a number of long term care facilities over the years and I would have to say that they're a different environment than a med-surg unit in many ways. That said, you would be surprised at the level of acuity that is often seen in nursing homes these days.

Fiona59 · Jul 16, 2009

Done both. Will never set foot in LTC again.

In Acute Care you have the knowledge that your patient and their nutty family will leave!! You don't have to see them month after month, year after year, until they die or you quit.

It takes a special nurse to work in and enjoy LTC. I give myself credit for knowing that it's not me.

jnrsmommy · Jul 16, 2009

This is kind of like asking which is easier, day shift or night shift. There is no one size fits all answer. Yes, med-surg you have a smaller pt load, you have more acute pts, you get to see interesting procedures, etc. LTC you have a higher pt load, you may or may not have a med-aide to help w/ the med passes, you may have adequate staffing as far as CNAs go, you learn what chronic "stable" conditions look like as opposed to acute. It just depends on you and what your preferences are. I did med-surg for almost 5 years, and got burned out on it. I've been doing LTC for a little over a year now and I really enjoy it. I honestly don't see any difference in the "stress" of the jobs, I just needed a change, so the stress of med-surg became magnified to me.

cariboujenny · Jul 17, 2009

I've worked in a number of long term care facilities over the years and I would have to say that they're a different environment than a med-surg unit in many ways. That said, you would be surprised at the level of acuity that is often seen in nursing homes these days.

Residents come back faster and sicker than ever to my facility. You would be surprised how several post surgery rt and the rest of your group can keep you busy.

TheCommuter, BSN, RN · Jul 17, 2009

I worked on a skilled Medicare rehab unit at a nursing home for the better part of 2 years, but it was structured much like a free-standing rehabilitation hospital. I usually had 15 to 17 of these types of patients during day shift, and about 30 to 34 residents at night. My former workplace liked to separate the rehab Medicare wing from the LTC units, because they did not want the fully alert rehab patients to mix with the demented nursing home residents.

On this particular unit, we dealt with many central lines, IV antibiotics, CPM machines, feeding tubes, suture removal, surgical staple removal, complicated wound care, ostomy appliances, diabetic management, casts, braces, splints, cervical halos, and so forth. I once had a patient who was receiving TPN.

Most of my patients had recently underwent surgical procedures such as laminectomies, knee and hip arthroplasties (joint replacements), kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.

The non-surgical patients were typically admitted to our unit for recovery from CVAs, acute MIs, debility, various cancers, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, generalized weakness, HIV wasting, and other afflictions.

Since this was a nursing home, we did not have adequate staff to care for these higher acuity residents. On most days I had only 1 CNA to bathe, dress, feed, and toilet the 30 people. The attending physician made rounds 3 days per week on Tuesdays, Thursdays, and Saturdays. The residents were highly demanding and their family members were even worse.

I ended up quitting because the stress level resulted in physical symptoms for me such as diarrhea, tachycardia, anxiety, perspiration, headaches, and more.

thekid · Jul 17, 2009

I worked on a skilled Medicare rehab unit at a nursing home for the better part of 2 years, but it was structured much like a free-standing rehabilitation hospital. I usually had 15 to 17 of these types of patients during day shift, and about 30 to 34 residents at night. My former workplace liked to separate the rehab Medicare wing from the LTC units, because they did not want the fully alert rehab patients to mix with the demented nursing home residents.
On this particular unit, we dealt with many central lines, IV antibiotics, CPM machines, feeding tubes, suture removal, surgical staple removal, complicated wound care, ostomy appliances, diabetic management, casts, braces, splints, cervical halos, and so forth. I once had a patient who was receiving TPN.
Most of my patients had recently underwent surgical procedures such as laminectomies, knee and hip arthroplasties (joint replacements), kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.
The non-surgical patients were typically admitted to our unit for recovery from CVAs, acute MIs, debility, various cancers, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, generalized weakness, HIV wasting, and other afflictions.
Since this was a nursing home, we did not have adequate staff to care for these higher acuity residents. On most days I had only 1 CNA to bathe, dress, feed, and toilet the 30 people. The attending physician made rounds 3 days per week on Tuesdays, Thursdays, and Saturdays. The residents were highly demanding and their family members were even worse.
I ended up quitting because the stress level resulted in physical symptoms for me such as diarrhea, tachycardia, anxiety, perspiration, headaches, and more.

That is absolutely positively horrible. How does the state allow these places to continue on? Aren't there routine checks to ensure patient care and safety is being met? Even an non-professional could walk in to one of these places and see that staffing is inadequate. I had similar problems when I was working in ltc back in 1999/2000. I ultimately left the job and the profession..(and here I am busting a nut to get back in to nursing)

thank you for the honest responses

ps I know 'stress' is a tough thing to measure

jnrsmommy · Jul 17, 2009

Since this was a nursing home, we did not have adequate staff to care for these higher acuity residents. On most days I had only 1 CNA to bathe, dress, feed, and toilet the 30 people. The attending physician made rounds 3 days per week on Tuesdays, Thursdays, and Saturdays. The residents were highly demanding and their family members were even worse.
I ended up quitting because the stress level resulted in physical symptoms for me such as diarrhea, tachycardia, anxiety, perspiration, headaches, and more.

That just boggles the mind. So glad you got out of that.

Both facilities that I've worked at (current one included) that had a skilled wing, "this is our money maker. we do whatever we have to to keep these customers happy." Which included overstaffing the aides (although, not the nurses), better equipment, more mgmt presence, etc. In no way am I saying this is right.

Long Term Care Columnist / Guide · Jul 17, 2009

I've done both LTC and med/surg, and I can say with relative certainty that you couldn't pay me enough to work a M/S floor again in this lifetime. My current job is on an ICF unit, but I've also worked the skilled unit enough to know that it's too stressful for my tastes. Give me my dementia patients and my IDDMs and my tube-feeders any day!