Similarities/Differences of Hospital vs LTC Nursing

[Drysolong]

For LPN's (especially) and RN's and Techs, can you tell me some of the similarities and differences of the duties when working at a hospital, LTC, doctor's office, clinics, etc.?

I currently work in LTC (my first LPN position) and want to work in a hospital (as LPN and later RN). I'm learning a lot in the LTC environment and I'm wondering if these skills will help or hinder me in another environment.

THANKS in advance

[TheCommuter, BSN, RN]

I am an LVN who has worked in both environments. Hospital nursing, in my honest opinion, is faster-paced than LTCF nursing.

[AuntieRN]

As a tech, hospital nursing is less strenuous and back breaking. It is also more exciting and invigorating. Not the same hum drum routine every night. You never know whats going to happen next. I felt LTC was the same ole same ole every time I went to work. Same patients with the same routine. At least in the hospital your census changes almost daily so it is something new every time you work. It is a much faster pace then LTC also. And I think a lot more learning experiences.

[banditrn]

I feel that the aides get more respect at the hospital, too.

[snowfreeze, BSN, RN]

LTC gives you really good organizational skills and communication skills. Hospital makes you work a lot faster, assess your patients more often, treat changes much quicker with more acute patients. In the hospital you will have fewer patients but more to do and assess.

[TheCommuter, BSN, RN]

LTC gives you really good organizational skills and communication skills.

So true. With the higher patient loads in LTC facilities, superb time management skills are imperative. However, I must also add that LTCF patients tend to be in more stable condition and, therefore, need much less monitoring.

[Drysolong]

Thanks to all of you for your informative and helpful replies

[all4schwa]

i spent 6 years as an aide in long term care in a small town and now as a new RN, i'm working in a great big fancy level 1 trauma center. the place it huge!! the diffence is like night and day. although i'm grateful for every experience i had, i wish i had maybe worked in the hospital as a tech instead of in LTC, because while i know intuitively how to be a nurse, the inner workings of the hospital, icluding everything from equipment to politics, is really confusing to me. plus, i might not have the physical ailments that i have now had i worked in acute care. it's not nearly as back breaking in the hospital because the majority of those patients are sick, don't get fully showered or dressed everyday and a lot of them have foleys and visiting family members. in the nursing home the patients usually go about their ADL's, (including their social life) with us there to assist, where as for the patients in an acute care setting a stay in the hospital is an interuption to their everyday life. as far as nursing goes, the patient load is five times less that what you would have in the nursing home, but you spend five times as much time with each patient. in the nursing home the majority of the patients don't get a head to toe assessment ever, so if it's not a LOC thing that you can see while conversing during your med pass, you have to rely on the aides to notify the nurse of changes...some are very good at this, never miss a beat and are upfront about lack of formal education, such as "i'm not sure what this means, but this is new" or "come look at this" unfortunately you have aides that haven't been in the biz as long and don't know when to speak up. also, in the hospital you deal a lot more with labs (drawing/obtaining of and deciphering) and working with doctors, respiratory therapists, rehab, you end up not wearing as many hats. even the techs do way more that we did as aides in the nursing home (d/c ing i.v.'s and catheters, doing accu-checks, ect.)

however, as an lpn i think you may find yourself with less autonomy and because a lot of hospitals don't hire many lpn you will find nurses that don't know exactly what your scope of practice entails. also, we are taught to not delegate assessments, so you may feel like your abilities are not trusted.

just a few thoughts...

[all4schwa]

after re-reading the op, if you are in lpn to rn and are wanting to work in a hospital after completion, my advice is GET OUT NOW!!

peace,

angel

[Drysolong]

after re-reading the op, if you are in lpn to rn and are wanting to work in a hospital after completion, my advice is GET OUT NOW!!

peace,

angel

I appreciate your advice - I am pursuing employment at hospitals, but I'm still running into lack of nursing experience as an obstacle. I am trying to grow as much as possible in my LTC position and transfer to a hospital asap while pursuing Excelsior for my RN.

[1995botosani2007]

Hi,

This may seem funny to you, but I am a hospital nurse, and I am thinking of trying to get a job at a LTC. Not that I don't like the hosp. job, but sometimes I don't even have time time to think. I was trying to decide if a slower paced environment would be good for me, but I have no clue what RNs do in a nursing home. Maybe one of you can help me with some advice. Thanks.

[TheCommuter, BSN, RN]

Hi,

This may seem funny to you, but I am a hospital nurse, and I am thinking of trying to get a job at a LTC. Not that I don't like the hosp. job, but sometimes I don't even have time time to think. I was trying to decide if a slower paced environment would be good for me, but I have no clue what RNs do in a nursing home. Maybe one of you can help me with some advice. Thanks.

In my area, RNs who choose to work in nursing homes are typically placed in the rehab and subacute units. These patients tend to be higher acuity than the rest of the nursing home residents.

I worked on a rehab unit at a nursing home, but it was structured much like a free-standing rehabilitation hospital. 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.

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, and other afflictions.