I started out in long-term care over five years ago, I've been a charge nurse and supervisor and still work per diem because I really like my coworkers and residents. I transitioned into an acute care med-surg position this past summer and I'm transferring to the ICU in the next month. I've seen many new grads lament that the *only* thing they can find is LTC positions and will that effectively end their career if they start there. I wanted to share to not only let you know that a long-term care position is not only NOT the end of a career, but you shouldn't underestimate the value of the skills that you will develop in that care environment.
When I first started, I had classmates that would apologize to me when I told them where I worked, as if their hospital positions were what I really wanted, but just couldn't get. In reality, the schedule options of LTC worked for me, not a hospital job. Learning how juggle med passes, treatment passes, dealing with families, getting lab and test results, calling MDs, and spending time with patients with a 30 patient assignment was a great way to learn time management. Having many stable patients, not everyone gets daily vitals, I had to develop strong assessment skills to identify patients that had a change in condition (like a non-verbal quadriplegic going into sepsis). On our short term rehab unit we've had probably 20 of the 30 patients that were easily as acute as the patients on my current med-surg floor, IVs, wound vacs, dressing changes, etc. And it's a 4-hour med nurse and the charge, for all 30 patients, with 3 CNAs. Those were some run-your-butt-off shifts, and my hat is off to my coworkers that pull those shifts day in and day out. Point being, the skills of prioritization and assessment are key to success in that environment and those skills are hugely beneficial when faced with a 6-8 patient acute care assignment.
When I started in the med-surg position, I was a little intimidated at first by the change in acuity, would I know when someone was facing a crisis? Could I handle the higher acuity environment? Turns out, the skills I developed in LTC continue to come in handy and my new manager in the ICU even commented that she has found that nurses with similar backgrounds have to have strong assessment skills and when they're given the extra tools of constant monitors in the room, they often find success. I hope that will be the outcome of my story and I'm excited for the new challenge.
I hope that my story helps others considering or currently in long-term care positions that don't feel they're putting themselves in a position to move out. And for those that love LTC and want to stay there, more power to you, we're all nurses and we're all using the skills we learned to make a positive impact on the lives of our patients.
