Tips on transitioning from a SNF/LTC to acute care?

[ShortyTheRN]

Hi, all!

I have been working at a pediatric LTC for almost a year now. I recently accepted an offer to work at a pediatric medical unit in my dream hospital and I am so stoked! However, the closer my start date comes, the more nervous I get about being a complete stranger to the acute-care environment. All the experience I have is from clinicals when I went to nursing school almost a year ago, but I don't really count that as experience since I basically had a safety net every step of the way. I have a ton of experience with G-tubes, trachs, and vents and I am able to successfully juggle up to 14 patients at a time (compared to the 4 maximum I'm promised at my new job). However, I am aware that long-term care and acute care are two completely different worlds and I am not so sure how this experience and time-management skills will be of use since everything will be completely different.

I was wondering if I could get some tips, advice, and words of wisdom on how to successful transition to working in an acute care hospital after working in long-term care. Anything that might help ease my stressed out mind will help. Thanks!

[Ruby Vee, BSN]

You will get an orientation to help you transition to acute care -- you'll have a safety net at first. There is a lot different about acute care, but you've already developed the basic nursing skills. You know how to assess a patient, how to talk to a patient, how to ask the right questions and how to pass on pertinent information to a physician when needed. You know how to talk to visitors, when and how to call for help and how to recognize a patient in distress. You have more skills now than you think you do.

You probably know a lot of medications, how to calculate the right dose, what lab values to follow with each medication, etc. Time management will be different, and prioritization may be different. You'll learn that as you go -- we all have to do that. I think you'll do fine.

[Jedrnurse, BSN, RN]

Actually, you may find it "easier" in some ways...

[Ruby Vee, BSN]

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You will actually be able to leave work AT work. And overtime will be paid!

[anewsns]

I find acute care much easier than LTC and acute rehab. In acute care you have to slow your brain down. In LTC were used to jumping from room to room fast but in acute care it helps to stay in the room and finish everything you can before leaving, you never know when your patient will suddenly be tied up forever with testing and doctors and other things. I like to get my assessments done right away so I can catch changes. Charting on time is helpful, sometimes you suddenly have to send your declining patient to another unit or a doctor is somewhere looking At your I And O trying to decide treatment plan and they assume it’s up to date. I also like to go in the room when anyone new goes in whether it be family, doctors, Case manager, therapies. Plans and information change fast and everyone asks you questions all the time. You’ll get a lot more respect from being a hospital nurse: it’s not right but it’s reality. Every unit has a different set of “hard” skills so your new unit may not have some of the things your old unit had. I was nervous about skills when I made the change, everyone is. However you pick up those skills fast.