Thinking about switching into long-term care from ICU. What should I expect in that transition?

The LTAC is slower paced and sometimes more work than 1:2, vs 1: 5 or 7pts care. You have lots of names and cases to remember but you can see the pts getting better and leaving facilities to go home which is very rewarding vs sending pts to next step of care after they have been in ICU. pts don't remember ICU nurses in their thankfulness prayers as they dont know us. Mostly because they are unconscious from the serious conditions or post surgery. But in LTAC u get to know these people and know their caregivers. Which feels very good to me. I see the difference in their faces and their state of mind from panic state in ICU. Once a family member got mad at nurses as they were being merry in the nurses station during shift change while their dad was passing away or dying. But most of the new shift nurses didn't know about it because of HIPAA laws and it being new shift. It was a bad feeling. I dont want to work in ICU again it felt very thankless job with high stress and acuity. Plus these sad situations sometimes rubs off on u. If u loose a pt or two in one month after taking care of them for so long and trying so hard to help, its sad when u fight a loosing battle. Sometimes u see that the family is doing the same.

Expect change in patient load as well as severity of illness. In ICU our patient ratios are 1:1 to 1:3 because of the complexity of cases we deal with compared to other specialties. In LTC the patients should not be in the acute state of illness but rather in chronic state or rehab. Think of patients that would be home normally but require extra care such as bathing or therapy. Because of this every patient does not require a high depth of monitoring like you would see in a hospital. Ratios can be 1:15 to 1:30. But keep also in mind you have GNAs to help care for the residents/patients. LTC can be quiet rewarding and you get to know your patients quite well. You have to remember that LTC is not a hospital and vice versa. I work in ICU and use to work LTC.

Fewer "right now" situations but still busy. You have basically the same people to care for with little turn over, unless you work rehab. Fewer machines to monitor. Meds, treatments, paperwork, calls, personal care is generally done by CNAs. Get to visit with those under your care a little more

I would do some prn shifts in the unit. The pace, objectives, skills very different. This way you can see if the change is right for you before committing

It’s more fast paced than LT care. The patients are much sicker and can deteriorate quickly. Your critical thinking skills need to be on point and you have to always be thinking “what could happen” and be prepared to take action. You need to know when to ask for help and if you don’t know something ask. On that point you will learn so much about the human body and NPs and Physicians love to teach, for the most part. If you can take the stress of vey sick, many times dying patients than it should be fine. I did all the above, now I think it’s getting to be too much for me, physically and emotionally. I did ICU as a bedside nurse for many years and now I’m an NP in ICU. Good luck.