LTC verses Hospital

[busy-bee]

Hi everyone,

I am a LPN and work in the same LTC facility since becoming a nurse 5 years ago. I really enjoy my residents and the staff I work with. However, I would like to try a hospital but worried about my skills. I am not sure how I would adjust to a hospital. My workload is very overwhelming. 20 patients or more per 12 hour shifts. The nurses as well, feed in the dining room (some LTC nurses do not actually feed) which breakfast and lunch take at least 4 hours. Then the med pass, admissions, discharges, paperwork, careplans,patient care, must I go on........is sooooo overwhelming. There are rarely days I actually take a lunch and after 12 hours I am absolutely bushed. We have no respiratory therapist, which means nebulizers must be monitored (15 minutes) and currently I have 5 resident on nebs Q.I.D.. I manage my time as well as I can, but my goodness, it never gets better. I wish I would of went to a hospital fresh out of school, but geriactrics was my calling. Now I am afraid to make the move....what do you all think?

[TriageRN]

I worked in an ALF/LTC that had 150 pts, caregivers did med pass and all ADL's (including feeding, some laundry, some cleaning...and frankly WAY too much for one human being to handle with so many patients...they had 12-15 each!!!). The ONE nurse on duty did everything else from clerical work, scheduling, treatments, triage, emegencies, communication with the MD's, setting up appts, getting medications from pharmacy or ordering them mail order (and keeping that all up), Checking the MAR's, 90 day order reviews, audits...you name it!!!! It was exausting..and after 4 years I couldn't take it anymore really...even though I loved my staff and residents!

So I made a change...went back to hospital. But I did it in a cool way! I went agency so that I could see the various hospitals and choose my own schedule while in this transition. Finally I found a hospital that adored me, and I adored them! We negotiated my contract and the hospital got me!

I was terrified frankly when I started this up! What will I remember, what can I do anymore, can I put in an IV anymore, what is their paperwork like, have I lost my skills...will I remember my skills? Oh man...if there was a doubt...I thought of it!

But wow...once I was there, it came back to me or I asked for some help! The hospitals I worked in, except one which I never returned to, helped me out and I was back on that hospital horse in no time!

I think to myself, and giggle...it is funny I was so nervous, but if I wasn't nervous I don't think I would have been in the right mindset to make the change! I cared about my performance for my patients...and well, that worrying is a sign of that!

PLUS...all that running around and hoops you have to jump through in LTC really help with good time management skills, and prioritizing in hospital! LOL! And really, if you do that well you have time to work on the rest .

Good luck to you..and frankly it was the BEST choice I ever made! No way would I ever go back to LTC/ALF...I love and appreciate LTC/ALF/SNF nurses and staff...but I don't ever want to be as underappreciated for my tallents like I was again! And switching to hospital proved I was tallented to everyone including myself!

[busy-bee]

Thanks so much for your advise and good luck wishes. I really do feel underappreciated. The families love me, but many times I feel underappreciated by the facility because there is never an end to the madness. IV therapy is not used often at our facility and I jump on the chance to start one and/or maintain one. My skills are not good enough to go agency, I am sure of that. What I need is a refresher class and some good orientation and training. Surely a hospital would do that, correct? What about pay, I do get paid pretty well.

[Nurse Punkin]

Hello Busy Bee,
If you worked longterm care for five years, you will do well in the hospital. I went from hospital to longterm care. In the hospital if I worked the medical floor.. that's what I dealt with. But in Longterm care you could have a 65 y.o. brittle diabetic, that sustained a fall. Now you're not only dealing with the medical... there might be some neurological things going on if they hit their head. Or maybe a hip is broken (ortho). There is no MD around so you have to rely on your own assessment skills to figure out what is going on. The IV's and differnt equipment they have in the hospital, you will get use to and they will train you for what you need to do. When I first went into longterm care I use to hear that the only nurses that do that are nurses that couldn't get a job anywhere else. But I beg to differ. Find that hospital that you want to work in and make us proud. You can do this!