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.
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
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
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.
[ 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.
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.
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
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.
You should work in this state they will whip you up and throw you in a nursing home if you aren't working and they don't care how sick ya might be. Walk on those fx legs. LOL
I have not seen an ounce of gentleness/ kindness from anyone in the 2 1/2 years that I have been in this state. Everything is strictly task oriented. You give to me, no excuses for anything. You sick, your in bed oh well, where's my money. You lied. No one seems to realize that no one has control over any thing. I can't give you money if I am not working, I can't get a job if they are not hiring me, doesn't matter you said you would. LOL Small town, not many jobs, oh well. lol
I think a lot of this not hiring has to do with forcing people to work for them. plus getting bennefits. Fraud yes, and I thought slavery was abolished. But to deliberately fire some one so that they can be forced to work on a farm. seems like this should be a little illegal. Not the only thing this town does.
Well, I work in LTC and I love it. I am just going into RN school. I have been a CNA in LTC for 6 years and I love it. I have been going to school the whole time. I am not resting on my laurels. I am pretty sure I want to stay in LTC. I love that I know my residents. I also really enjoy the fact that they love me, too.
I hear it is career suicide to stay in LTC, but doesn't that depend on the career path you are following? What is whrong with folowing a career path in LTC? Someone has to do it and someone has to care.
I worked in LTC for 14 years as an LPN went on to get the RN so that some day I could eventually become DON. Went to work in a hospital for the experience, had planned on working for a few years there then go back to LTC. Well didn't work out that way.
Yes I did have some good experiences in LTC, worked in a retirement community for 2 years and we had such a great team, there were no decubes at all, the aides just followed my suggestions for prevention and we didn't have any. all three shifts got along for the most part and everything got down we didn't have to demand respect we just gave it and recieved it. another place I worked one nurse on each shift took responcibility for thier shift we talked to each other and divided what could be divided between the shifts. Worked well untill they brought in supervisers. lol Everything went down hill after that. the one good thing the sup had brainwashed the aides so bad that they were forcing fluids on end stage CHF pt's with 4+ pitting edema through out their body, and making them sit up for 2 hours in a chair, I mean a dying patient full of fluid. I would work with a patient for an enire shift to get them where they were calmed down enough to eat, able to bath and to rest, the next day I would come in and this superviser would get all the meds D/C'd and the patient would be so hyper they were out of control and full of skin tears on her arms from staff trying to hold onto her. Uh!
I know this thread is old but I have to respond. I have worked in LTC for 7 years and in a hospital for 5 before that. It was in the hospital that I went to work every day worried about losing my license. I love LTC and plan to continue in the field until I am a patient there. Most hospital nurses do not make it in LTC.Is is not because they are not good nurses. They are geared to the hospital, taking care of people who are sick. When they come to LTC, they FREAK. Yes, the work load is more, 25 to 30 residents to one nurse where I have worked. But, these are stable patients. Or as stable as they can be for their age. Management does make a big difference in LTC. Talk to an ombudsman,(you will find the number in any LTC facility) to find a good facility. All LTC is not created equal. As for arm bands, put them on the elderly and you get skin tears. The facilities where I have worked, we had the patients picture on their MAR and it was kept updated. Hard to make a mistake that way.
LTC is not for everyone. You have to love it. Working LTC does not make me less a nurse. I still take care of patients, give meds, start IV's, and work codes. I also know how to do in depth care plans, coordinate MDS's, supervise and evaluate staff, and go home happy. Who could ask for more?
I can say that yes, I have had good experiences in LTC. I will also say that in recent years the ability to be effective in that area has lessened. I have spent the majority of my 20 years n LTC, usually on the night shift. I have found that there it is possible to give some real from the heart care.
There is plenty to be done at night we don't sit around and talk about soaps and drink coffee all night. There are treatment, pills, and procedures. However, I have found a greater opportunity to be able to really 'be there' for the fearfull, the dying, and the chronically ill. There have been times when I have been able to give true bedside nursing that takes into account the 'whole' person, or the psyche if you will. It has been a place for me to practice a supportive relationship with my residents. Using communication at a level that is more than a nonchalant interaction. Being able to soothe, support, and uplift.
No I will never get rich and have more frequent periods of frustration. But I will never forget all those golden moments when 10 minutes and the smile and the grasp of a hand, be it resident or family seems to wipe away what came before.
So in terms of growth in a career, the goals of it should make your decision.
So the thread is a bit old! We see the patients 'long term', thus the term 'Long term Care'. Yes, I may have been sworn at, scratched and hit, but once my demented residents get 'into' a daily routine, the results are priceless. An example? The deaf WW2 vet who would only let me do his treatment, no matter what shift I worked. The list could go on and on.....
I agree that I may not 'make money' like hospital nurses, but.....
WOW!!!! This is all I can say about this thread. We went from one end of the spectrum to the other. It is refreshing to see some positive attitudes from Misskitty and PattyO. I work in LTC and I love it. I believe your job is what you make it. If you believe all the worst things you hear, you will most definately hate the job. I have worked in two different LTC facilities.One was for profit and one was a county home.Both had their good and bad points. I did have 60 to 1 ratio and I also had 20 to 1 ratio. I always managed with the help of the team and am stronger for it. Right now,after going to school and getting my RN at age 46, I am a Restorative Nurse in LTC,responsible for the restorative programs of approx 340 patients and I love it. I love to see their progress and happiness at being able to perform a skill again thet they had lost. I never regreted choosing LTC. Again, your job,your satisfaction,is what you make it.
Cudos to you too cougarnurse!! There are many rewarding things in LTC as I am sure there are in any kind of nursing. That is why I became a nurse. By the way, in the facility I work now, a regular floor staff nurse makes more than the nurses in the local hospitals. The money is good but for me it is secondary. Check out Nursing 2004 July issue title "When is a table an Umbrella" These are two good experiences that happened to me.
Carol, you are sooo right! I have been at my facility for a little over 7 years; 120 patients. Yes, on 7-3 or 3-11, we have 60 patients to pass meds to. (Not all get meds, of course.) The 11-7 nurse has all 120. I love the job! I have worked at a 'private' faacility, also, with low ratios, and hated it. I say it depends on the bosses, too. 'Cat'
I have worked in LTC for five years now as a LPN. I would assume your skills would be greatly appreciated in a LTC facility. I work 12 hour shifts and my case load is 20 or more residents. At times, I have more if a nurse calls in and they pull a QMA. Staffing isn't the best, and at times down right brutal. I work in one of the better facilities in the state, and we give the best care we can. I am bushed after 12 hours, usually ends up 14 hours.......I would love to try a hospital...but my skills are a concern to me. You could try LTC PRN and test the waters a bit...
