ICU/CCU Nurse Transitioning to LTC

[Grbrico_RN]

Hi all,

Im new to the forum, and well not so new to LTC. I chose to be a CNA while going through nursing school and worked in LTC. My mind set at the time I chose to do this was: If I can't cut it as a CNA in the worst place (at the time I thought) to be a CNA, then I just can't cut it as a nurse.

You know what... my thinking changed. I LOVED IT!!! My favorite patient population is the elderly. Don't ask me why.. I can't tell you. When I was younger... the elderly scared the crud outta me.... now I find myself sneaking peaks at the old old couples helping each other out of cars.. holding each others hands and they shuffle their way into stores, or talking to complete strangers who are very elderly out in the public.. and having a grand old time..... I just love it... I think my husband thinks I am nuts.

BUT... here is the jist of this post... My specialty has been ICU/CCU nursing I also have a specialty in Cardiac/Pulmonary. I have Rhuematoid Arthritis which has made it increasingly difficult physically for me to do what I love. Then this past August.. my husband and I doing one of our FAVORITE hobbies... FISHING... I got hurt. badly hurt. I was out of work for over two months.

I can no longer work the 12 hour shifts, I can no longer lift, I can no longer do what I did in acute care. So I applied to a LTC center. Everything is so different. I am so used to the state of the art equipment and autonomy.... and when I call a hospital on a patient who has fallen OOB and cracked their noggin to the point where she had blown a pupil... and when I start to go over the neuro check... the ER nurse is like have you ever done a Neuro check before... OMG... do they always treat LTC nurses like that???.... I didn't even get to tell her the results before she interrupted me... had she shut up.. she would have known..lol... but I think she got the point when I was finished giving her the report....

I guess I'm not used to having someone question me like that before.... guess I will have to get used to that... I didn't have time to set the woman straight.. I needed to get my resident out of the building and into the ER.

The documentation is different... I laugh because before our hospital went to magnet.... we did narrative charting.. we haven't done that now in years.. everything is done by computer... which I hated.. and I griped about for a few years.... now I have to go back to endless paperwork, and narrative charting.. and quite frankly... I need to remember how to do it.. LOL Lord help me..lol.....

I didn't have to deal with medicare and medicaid charting and their legalities.... we did acute care... so I will be haunting the LTC forums alot asking questions... and so forth...

I just wanted to clarify... it's not that I think that LTC is less physically demanding.... because I'm finding that its not... It's that our hospital was UNWILLING to allow me to work 8 hour shifts. I'm older.. I know that.. and because it was not a WORK related injury.. they did not have to accomodate me.

I'm back working with my favorite patient population.. but Im finding that being the nurse this time.. is sooooooooooooooooo much different. I want to excel here... I like the LTC facility that I work at... it's not the best, it's not the worst... it needs a lot of organization.. but I can fit here.. I like it there... and it feels like home if that makes any sense....

I know it will take some time to feel comfortable in my role there... I just feel so stupid... when where I was before.... I was looked up to by co-workers and respected by Doctors alike.. because I knew what I was doing..... now in a new town. ( The hospital I worked before was about 40 min from where I live... now I work two streets away from where I live..lol ) .. I dont know the Doctors here... I have to restablish myself again.... I can do that but it will take time.

I'm not really ranting... I'm just vocalizing what I'm thinking.. just not sure where I can go from here..... LOL... oh me... Any suggestions for an easier transition from you seasoned LTC nurses...

Best wishes,
Rae

[cougarnurse]

Rae, unfortunately there are some hospital nurses who 'look down' on LTC nurses. Why? I just don't know. Yes, geriatrics can be depressing....residents who have no family visits (there may be a reason, though!), multiple diagnoses....but I still love the rezzies. We sure can learn alotta things from them.

There is one local hospital that calls the Health Dept. on us fairly regularly. We tend to be vindicated, as we have all copies of transfer sheets, etc., and some of the stuff they call us on is ridiculous. Keep giving good report, and you'll continue to give us LTC'ers a good name.

'Cat'

[AmandaWIRN]

Unfortunately, receiving a thorough and accurate assessment from a LTC nurse sending a pt. to the ER is quite rare. Usually, they don't bother to call us a report at all, and if they do, it's usually not very helpful. For example, if I'm getting a pt. with SOB, and I ask what the O2 sat was or how their lungs sound, 9 times out of 10 they haven't bothered to check.... Or, a few weeks ago, EMS brought a pt. from a nursing home with difficulty breathing. When they got there, the LTC nurse had the pt. hooked up to an oxygen tank, but the tank was empty..... And I'm sure you can imagine how hard it is to assess a pt. sent in for altered mental status when they have dementia and you were never given a report on what their baseline is... So, while I'm sure that you are an excellent nurse, and would love to get a thorough report from a nurse like you who actually bothered to assess her pt. & knows what she's talking about, usually that isn't the case. It's a matter of some poor nurses giving the rest a bad name. If you keep calling accurate & useful reports, however, like Cat said, you'll give you & your cohorts a good name.

[cougarnurse]

To be honest, things seem to happen in clusters, too. Many things going on at once. There are several 'walkie talkies' at my facility who believe that their hang nail takes precedence. :rolleyes: Thus, on occasion, that call to the hospital flies out the window. BTW, Public Health has gotten more than their share of calls due to this, also. Yeesh.