So confused , LTC nurses needed!

[healthstar, BSN, RN]

I am a new grad, I was in orientation for about 17 weeks! And I was terminated d/t " not a good fit" for the high acuity unit, which required fast pace. I also know that I was not a good fit, everything was happening so fast, and I was so focused on completing tasks did not have time to stop an think! I want to improve my critical thinking but I can't improve in such a fast pace environment!

So here it goes. The recruiter and the HR told me to look for anything but surgical floors, a lot of people keep saying try LTC-- what is the daily routine for LTC nurses? What do you usually do? If I apply to a LTC facility , will I learn / practice skills and expand my knowledge as a new grad! Will this reflect negatively in my future hospital applications? Does this count as experience when I apply to other hospitals in the future?

I just can't afford to make another mistake by choosing the wrong unit- something that is not a good fit . I want to choose wisely this time.

Thanks , peace & love :)

[Ruas61, BSN, RN]

Where exactly did you have issues? Some more specifics might get better responses because LTC can have a hectic, multi-tasking feel to it too with more heads than a hospital under your care.

[healthstar, BSN, RN]

Frequent multiple admissions, discharges, frequent reports( giving and getting ), frequent new orders d/t new admissions, frequent dressing changes ,frequent pain meds( all pt) , IVP, epidural and PCAs, time management and organization was good when my pt were in the hospital for more than 2-3 days, when I got new admissions and discharges one after another that's when I suffered the most with time management. I found myself more comfortable for my level ( new grad) when pt were stable , I did not get admissions , I could not handle more than one admission from surgery! Pain control was always an issue. I was advised not to apply for post surgical units as a new grad, I need something more stable. I understand that every unit takes care of very sick pt , I am just looking for a unit that takes care of same pt for longer than 1-3 days, non surgical pt, and not the same acuity. I honestly do not know where I belong!

My strengths : assessments, identifying a problem,a change in condition, notifying MD, great communication skills with pt, coworkers, families, doctors. I triple check meds. I am empathetic, and a great listener. I talk less and listen more :)

Weaknesses: critical thinking still at a new grad level- I still need to work on it, I need more time and experience to improve.

Time management and organization when I get new admissions, last minute discharges---- sometimes it's good as sometimes not so good.

[proud nurse, BSN, RN]

You will get admissions, send people out to the hospital, and depending on which shift you work you can get help with paperwork from the nurse manager or unit secretary. Work alongside them until you feel comfortable. You will be able to perfect your assessments. You'll have the same residents day after day, so what you've identified as your strengths will be an asset to you in LTC. You'll learn time management in the nursing home because you need it to survive. Some new nurses are overwhelmed by the number of residents they are responsible for. When I worked night shift I had 51 residents. Some nurses also feel they have so much to do in when they work in LTC, and just go straight into task mode. So that would be something for you to think about also since you had problems before with it. I'm a new RN grad. I was an LPN since 2001. My experience in LTC is probably what helped me get my job in the hospital on medical/oncology floor, so I wouldn't say working LTC reflects negatively on your future chances. I wish you the best of luck.

[healthstar, BSN, RN]

The number of patients scares me the most about LTC! 30+ pts?!! I was taking care of 4-6 post surgical pts and I was drowning !! I could never get out on time because I had so much to document! I understand that LTC also gets admissions and discharges but I am hoping not to get frequent admissions every day or frequent discharges. I am not looking for anything super easy either, I was in a super high acuity floor and I was not terrible but I knew it was way too busy, so many new orders! So now , I am not looking for something super easy, just slightly lower acuity. Now that I found out I was not a good fit for the job... My confidence has hit rock bottom, I don't know if I will ever find another job or if I am going to be good at any other specialty

Thanks for your help guys, I truly appreciate it! Peace & love :)

[Sunny68]

Have you tried working nights? Nights have fewer admits and discharges, new orders unlike days with all the doctors, surgeons, specialists that come through during the daylight hours. Not saying that the beginning of the shifts can not be hectic should the ER if wall to wall patients. That can happen. Working nights can sharpen your critical thinking skills and you can learn how to organize your time more effectivily. I know nights are not for everyone. I have done my share of them and finally went on days. As I have discovered being a introvet in nature I am thinking of wanting back on nights as my life changes will allow me to sleep during the day time hours.

Just another idea for you to think about. I have done LTC and I loved it as a LVN. It is very very busy during the day time hours. You can have a whole wing to yourself for meds to pass. It can become easier as you learn how they like to take meds, thier routines, etc.