Those of you who transitioned from LTC

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What was the biggest hurdle besides actually getting the job?

How did you manage to get your foot in the door?

Many of us who have done LTC / skilled nursing and even semi sub acute are very familiar with complex wound care, wound vacs, IV meds, IV starts, blood draws, NG tubes (including inserts) G tubes, Resp treatments, med passes from hell, family issues, dealing with cranky doctors etc.....sooo how does this experience help?

What do you feel you needed to re-learn?

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Specializes in Med-Surg, Developmental Disorders.

After about three years of working in LTC/SNF, I got a job in Oct 2016 as a night shift RN on an inpatient unit (recovering from surgeries and a few traditional med surg patients directly admitted from an urgent care center or transferred up from our ER. I love it! Smaller patient load, more resources. We often do not have an aide, but this is a smaller surgical specialty hospital, so we are more selective in who we admit than a traditional hospital (or nursing home going through a period of low census and financial difficulties...) would be. My biggest thing is that I am weak with IV starts. But, I am getting better! Lately, I average about one IV start a week (working three days a week), and my last two starts were successful on my first attempt!!! í ½í²ƒí ¼í¿»í ½í¸„í ½í²ªí ¼í¿»í ¼í½¾

As for what I took away from LTC... Time management was a big one. Working with patients who have dementia. Helping patients through anxiety attacks. Surgical wound dressing changes. I started writing the number of staples/sutures on the dressing along with my initials and the date back in my LTC days. At least that way, it would get written somewhere before I got distracted.

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I just got offered a job in MedSurg after 5 months of working transitional rehab. To be honest I'm not sure what I said in the interview that had them offering the job not even an hour after the interview (the 2 people that I spoke to said the process would take a week or two to go to the next step). I'm guessing it was that right now my job title is Charge RN and that I have experience with admits/discharges on top of floor nurse duties (med passes which are usually hellish) and treatment nurse duties as well (I average 8 wound treatments per shift out of 12 patients). They are giving me "new grad" training since I'm less than 6 months experience, but I'll bet they will cut it down from the normal 12 weeks due to the things that I can do already.

I will have to work much harder on IV starts since I am not nearly as successful as I need to or would like to be, I also need to work more on Foley insertion because it is rare that I get to practice that skill. I can't wait to start getting certifications (ACLS especially) and also start working on the 8 or so classes I need to get my BSN (the hospital normally only hires BSN applicants but since I expressed a strong desire to use the tuition reimbursement as soon as possible to get my BSN I think that opened the door for me a bit).

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Specializes in Hospice.

I did 11 years in LTC/SNF before making the move to acute care. Believe it or not, the hardest thing for me to do was SLOW DOWN and not be so task oriented first thing in the morning.

As LTC/SNF nurses, we tend to have 20-30 patients to care for, and have to get everyone medicated in the first two hours of our shift. In acute care, you might have only 4-6 patients who need more than just meds. It was hard for me to relax about having to have everything done before 9 or 10AM.

The skills I developed in LTC / SNF were a big help in acute care, but there were still things I had never done. (heparin and insulin drip management, hanging blood, etc.) Fortunately, I work with some amazing people who are only too happy to help / teach when I run into something new to me.

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