What is harder: Hospital or facility?

[aok7, NP]

I think it depends on your career goals.  I started in nursing home/SNF and learned SO much related to flexibility, interaction, and maintaining high standards in often counterproductive set-up.  I happened to work in a nice setting where I met mentors and wonderful patients and families, it was a good experience.  I went from LPN to ADN to BSN and each step I wanted to increase acuity/experience.  I found in the hospital setting a clarity that nurses who were there as their career goal to be floor nurse or the like were some of the most unhappy people I have ever met.  This was MY view, so unfair broadly, but truly a lot of anger and disdain for the hospital system.  Clearly 12h 3 day shifts was the motivation.  My target was to become a NP, and even when I was interviewing and promoting my early days in outpatient I found MDs more impressed with my hospital work, and how "nice" my time in LTC/SNF/hospice.  I actually do not think I would have gotten the job I have without the high acuity level 1 trauma LOL experience.  Reality, it's the place I learned and developed the least, there are 20 people listening to same same lungs in a period of 12 hours if you know what I mean.  If I were to have stayed RN role I would definitely get out of the hospital and work in a..not facility, but hospice or home health or the like outpatient.  

[Slammylou]

What kind of facility are you talking about? I often refer to hospitals as facilities also.

[Golden_RN, MSN]

When it comes to direct patient care, my opinion is 'pick your poison'.  But also look to the employer that is going to give you the pay/benefits you deserve as well as a tolerable environment day-to-day.

[Golden_RN, MSN]

Just now, Leonardo Del Toro said:

Love that. Yes I work at a facility that is like a family, small and everyone is nice. A true rarity in a ocean of terrible SNIF's all around, it is worth every penny I don't make in a place I don't like.

I worked at a SNF with great coworkers - RNs/LVNs/CNAs and I really was happy there.  If you have great residents/families it can be really hard to leave that environment.

But eventually returned to the hospital for better hours (12 vs. 8), better pay/benefits.

[JBMmom, MSN, NP]

Not sure what you mean by facility. Are you comparing hospitals with long term care facilities? I think that everyone chooses their work environment for a number of reasons and deciding what's worth it is an individual opinion. Some people love long term care, with the opportunity to make more lasting connections with people that rely upon you for care. There are high patient to nurse ratios and often poor staffing plagues these facilities, some have management with potentially suspect motives. Other people love the hospital environment, despite also potentially dealing with short staffing, a potentially more intense patient population from an acuity standpoint, and sometimes also from a family standpoint as family deal with new diagnoses or sudden changes in condition. All work environments have advantages and disadvantages, making a blanket statement of which is harder difficult to say. I have worked in both long-term care and hospital environment, I gained valuable skills in both places, and have had some very good shifts and very challenging shifts, in both.

I think the biggest challenge in long term care is that there is a significant lack of resources by comparison with the hospital. Assessment skills, when you may see a patient for 15 minutes in an eight hour shift, and knowing a doctor will only see them for a few minutes a month, are really a key component of care. You have to rely on your techs to also keep an eye out for changes in patient condition. Lack of supplies is always an issue as well, even moreso than in the hospital. 

[Leonardo Del Toro, RN]

3 minutes ago, Golden_RN said:

When it comes to direct patient care, my opinion is 'pick your poison'.  

Love that. Yes I work at a facility that is like a family, small and everyone is nice. A true rarity in a ocean of terrible SNF's all around, it is worth every penny I don't make in a place I don't like.

[Leonardo Del Toro, RN]

After I graduated in 2010 I could not get a hospital job, not even if I offered my work for free. It felt I was being barred from working in these places. I've tried for years. Eventually I was given a break on a SNF. I've been working there ever since. I am no longer interested in hospital work as I was before. And I'm actually  happy I was not accepted in those environments. I don't think it is a good deal. You work too hard for the pay you get, and the culture nine x out of 10 is terrible. I rather make less money working on a SNF, have way less stress but I'm happy, love my co workers and it's mostly a fun time, we laugh a lot. But anyways I'm 2 years from retiring...