Transition from ER to LTC

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Specializes in Management, Endocrine, ER, Corrections.

Although I love my job in the ER (and I do Corrections nursing PRN), I am making a career move (due to family needs) to a Long Term Care Facility. I was a CNA prior to becoming a nurse but still... any words of advice? Thanks!

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Specializes in Nephrology, Cardiology, ER, ICU.

I went from a level one trauma center (10 years) to outpt dialysis and it was hard to adjust to the lower acuity.

I realize that LTC and dialysis are different settings; however, they are both much lower acuity than ER.

For me, I had to get used to not having emergency stuff readily available. Ambu bags yep, oxygen, yep but no meds, no ability to intubate, etc.. That for me, took some getting used to.

Good luck - we all make decisions based on the good of our family situation.

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A big part of it is just looking at the different philosophy of care. We have a mix of LTC pts with short stay rehab. The LTC pts are never going home...this is their home. Short term pts are treated more agressively.

Adjusting to the fact that you might need to call the docs more since most places do not have standing orders. (some docs might give you more liberty with things...for example..writing a verbal order for a urine if someone has s/s of uti)

Realize that things are not done stat. STAT in a LTC might mean a couple hrs from now.

Get to know the CNAs that you will work with...They are the backbone of LTC. Without them...well..it just wouldn't happen.

Easy to forget, but look at and treat the patient...not the number. Heck...sometimes there won't even be a number. Supplies and equiptment are often in short supply.

Biggest advice..relax and enjoy or try to get to know your residents and the family. If you find out that LTC isn't for you...get out.

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Specializes in Med-Surg, ICU, ER, Geriatrics.

I also went from working 6 yrs in ICU and 12 yrs in ER to a Skilled Nursing Facility. It was hard at first, thinking more of chronic long term problems rather than acute, emergent ones. Also the lack of equipment, IV's, meds, etc. being right at hand was hard to get used to. But you do get a chance to keep your assessment skills up and you get to know your residents. Talk with them. Some can really open your eyes as to what life was like when they were growing up. I really enjoy it now. It did take me awhile though. And by all means, listen to your CNA's. They are your eyes and ears. They know their residents better than anyone else and they will notice changes in them first. You will get frustrated at times, not enough time, not enough help, etc. But hang in there.! LTC is a great place to work.

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Specializes in ER.

Just bumping the thread....hope to here some more answers!

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Specializes in lots of different areas.

I wonder how many nurses have done the transition? Two very different fields of nursing. I think I'm too scared to think of ER~very happy LTC RN here.

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Specializes in ER.
I wonder how many nurses have done the transition? Two very different fields of nursing. I think I'm too scared to think of ER~very happy LTC RN here.

I am an ER nurse and want to do the transition but I think I'm too scared of LTC!

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Specializes in LTC, MDS Cordnator, Mental Health.

choose your facility wisely. I have worked for a for profit and an non profit... I prefer the non profit.

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I, too, for different circumstances, am considering a move from the ER to LTC. I am a little bit nervous. It sounds like things can get overwhelming and stressful in LTC, and this is already how I feel in the ER. TO the OP, have you made the switch yet? Keep us posted on how it turns out. I am just at the stage where I am considering some interviews at LTC facilities, but have my reservations. I just know that I cannot sustain my enthusiasm for life, work, or patient care in the ER that I am in. Keep us posted!

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Specializes in ER.
I just know that I cannot sustain my enthusiasm for life, work, or patient care in the ER that I am in. Keep us posted!

I feel the same exact way as you! Working ER has been sucking the life out of me. I have a job interview coming up for a skilled nursing unit attached to the acute hospital. If I get the job I will be sure to post my experience. I have no real advice for you now, but just know you are not alone in your thoughts re: the ER. People think I am crazing for wanting out of the ER but it is not the promised land that everyone thinks it is!

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No - it is definitely not the promised land. I loved it when I was in the ER as a tech, but being there as a nurse is a whole new ballgame. I guess deep down, I feel like my gut is telling me that the level of stress really isn't healthy. I have always been a people person, I love helping, I am usually pretty social, and I feel like I have become a whole new person since being in the ER- and it isn't someone I really like.

This discussion here, though, reminds me of one of the many reasons I chose nursing- because there are so many different options out there that I knew I would be able to find my niche. Still looking, but maybe LTC? We'll see. Good luck to the others out there making the switch. Keep us all posted on your experiences!

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