[Sydangle2]

I have worked in a hospital for 13+ years in Cardiovascular med surg..... My 1st job in a hospital lasted 10 years I left because the facility closed down; I've been at my current job for 3 years.

I am now looking toward returning to LTC. I want to know if anyone has any good experiences as far as workload, or conditions or anything. Give me some hope.

I worked in LTC as a CNA; before I became a nurse back in 86-92. I know all to well that it is hard work.

I always wanted to return to LTC~ but am ambivilent.... & wonder~ Is it safe? with the work conditions 1 nurse to 60 + pts etc. etc.

I love Cardiovascular/ med surg nursing what I am doing now. I also have a vision of where I want to go in career. I would like to eventually get into agency type work- for the increased pay/ & being able to make your own schedule/ & just having more control over where you work etc.

But; before that happens, I want to open more doors & opportunities by returning to LTC as a nurse~ I always loved LTC; But am concerned about safety/feeling overwelmed/& not providing the quality care the residents deserve. At the same time I feel moving to LTC is a neccessary step~ & I won't know till I try.

Anyone with any thoughts???

[lam]

Why would you want to go to LTC if your goal is to work agency. Unless you are starting your own agency? I am missing how LTC after all your years in the hospital would be of any benefit, career wise. It is almost impossible to give good care in LTC just because of the way it runs. I don't care who you are unless you have a good management team that knows what they are doing there is a lot that just doesn't get done and you end up prioritzing. There are some facilities that have a management team that is aware of how much can "really" be done and admissions are made accordingly. Then there are facilities that only see the quick buck and fills the facility with any patients and eventually becomes a disaster waiting to happen. So if you value your license and health I would stay away from LTC

[lam]

the only time I saw 1 nurse to 60 patients was on the night shift. I know that DON's for some reason claim that they are the only RN there. The other shift usually has 2 nurse and a few CNA's for 60 residents. Oh well good luck

[nursinghumor]

If you've got acute care experience, you'll have no problem getting a job in LTC.

If you've only got LTC experience, you'd have a hard time finding work, carrying your weight in Med/Surg.

You can find agency work in any type of facility if you have hospital experience.

Compared to an acute care hospital, LTC is a major step down as far as professional ability and pay. You will spend a lot more time on passing medications and charting, a lot less time with your patients.

I've done both and I often tell my wife an ICU nurse that when I work in Nursing Homes or rehab centers, I spend most of my day "pushing pills." It is easier, not entirely stress free and doesn't pay as well. Short staffing is just as common.

The exception is a subacute rehab center. Where you deal with recent total knee replacements, hip surgeries, etc. The patient's are still relatively alert, awake and acute care. Ratios are much better than in long term care.

In terms of professional development and experience, working in LTC won't do a lot for you. You're better off keeping your hospital skills up.

Wish you well whatever decision you make.

Andrew Lopez, RN
http://www.nursinga2z.com

[lam]

[ QUOTE ]
nursinghumor said:
If you've got acute care experience, you'll have no problem getting a job in LTC.

If you've only got LTC experience, you'd have a hard time finding work, carrying your weight in Med/Surg.

You can find agency work in any type of facility if you have hospital experience.
What kind of LTC places have you been working in. I have been doing IV's, all kinds of wound care, they have skilled patients that require constant monitoring and a lot are rehab patients, I have also worked in rehab facilities that try to run it like a LTC facility. I have also worked with hospital nurses that went to LTC and they didn't get the drift of how things were done and that you can't spend as much time with each pt. I have worked in LTC and I do not want to work for an agency especially going into LTC because it is more dangerous than the other way around. According to your philosophy then Psych nursing must be even lower than LTC, would you agree with that.

Compared to an acute care hospital, LTC is a major step down as far as professional ability and pay. You will spend a lot more time on passing medications and charting, a lot less time with your patients.

I've done both and I often tell my wife an ICU nurse that when I work in Nursing Homes or rehab centers, I spend most of my day "pushing pills." It is easier, not entirely stress free and doesn't pay as well. Short staffing is just as common.

The exception is a subacute rehab center. Where you deal with recent total knee replacements, hip surgeries, etc. The patient's are still relatively alert, awake and acute care. Ratios are much better than in long term care.

In terms of professional development and experience, working in LTC won't do a lot for you. You're better off keeping your hospital skills up.

Wish you well whatever decision you make.

Andrew Lopez, RN
http://www.nursinga2z.com

[/ QUOTE ]

[lam]

Yes that is all the agency nurses can do is pass the pills. Because everything else is based on knowing the patients. and the mistakes are many. You really shouldn't put this type of nursing down. and I wouldn't feel comfortable just passing pills to patients that have no arm bands. It sounds like you are the one into nursing for the money.

[nursinghumor]

Aren't we getting a bit defensive. . . . so what else do you do besides pass pills in LTC based on your "knowledge" of the patients?

BTW: When patient's don't have ID bracelets on, nursing assistants, other nurses are great about identifying patients for me.

I stopped relying on bedside nursing for income a long time ago.

Andrew Lopez, RN
http://www.nursinga2z.com

[nursinghumor]

[ QUOTE ]
lam said:
You really shouldn't put this type of nursing down.

[/ QUOTE ]

If you look at the first message in this thread, the question was would "ltc experience" be valuable for career development.

In my opinion, acute care hospital experience is much more valuable career-wise than LTC.

Andrew Lopez, RN
http://www.nursinga2z.com

[lam]

They are 2 different types of nursing. And let me give you a little example. I was new to a facility, no arm bands so I passed meds in the Dining Room, every day that I was on orientation this aide assured me that Mr. Smith was indeed Mr. Smith. Patient answered to Mr. Smith, a week later I went to Mr. Smith addressed him by name as I was about to hand him his pills another aid states "That's not Mr. Smith" My heart dropped to my stomach. Of course I did everything I was supposed to to report it. I was devastated for a long time after.
I am glad that you don't have to do bed side nursing any more, not all of us are so lucky, being the politics that be, If and when they allow me to go back to nursing I will have to take what every one else doesn't want. Have been doing my whole career. Politics as it is and a few nuts in the profession. If I get desperate I may go back or not. They thought if they force me to below poverty I will be forced to be ever so grateful for theier left overs. Funny thing is I don't think they are actually any better than me just nuttier. LOL and no I haven't done anything other than some nut thinks I should be ever so grateful. Maybe they don't like the way I look. Then we get the silly thing like trying to make me work as a LPN LOL. Superviser and all. they are nuts. I have a limp, short and chubby so we will stick me in a nursing home on night shift. LOL

[lam]

If you are looking for clinical skills yes the hospital is the place to be. LTC has case management, DON, ADON, MDS cord. If you want to become a NP specializing in geriatrics LTC is the place to be. I swear I have some nut following me around keeping me from getting anything I want.