CNA: Hospitals vs. LTC

LTCs do rotating weekends too, and first shift is hard to get, because everyone wants it. Most hospitals only want experienced aides, so you have to work in LTC for a year first anyway.

There are like 576759674769 threads about hospital vs LTC jobs. Look back a few pages (maybe even lower down on this page) or do a search and you'll find a ton of posts about it.

It just depends.

I have worked in both, and both have their good and bad points.

Hospitals tend to have better staffing, but they can be incredibly hectic. In my area, LTC pays better, but the opposite is true in some places, as well. The hospital I worked at was better managed, but busier. Teamwork was good there, but the patients tend to be more difficult (and more demanding). A lot of it depends on what unit you work on, too.

Hospital Work:
Good teamwork
Better management
Annoying patients are only there for a short time (compared to LTC)
Better staffing (theoretically)
More acute patients (may require more care)
Demanding patients
Very hectic environment

LTC Environment:
Iffy staffing (sometimes it's good, sometimes its terrible)
Iffy management (I've had good and bad)
More job opportunities
Residents are there long term, allowing you to get a good routine down and really get to know the people you're caring for
Flexible scheduling - tend to need more help so they're more willing to work with you
Might be more incontinent residents than at a hospital (not always the case)
More dementia (which I don't mind, I like dementia residents).


At both hospitals and LTC around here, everyone works every other weekend (until you have a lot of seniority). The hospital I worked at only had 8 hour shifts for CNAs, and I've worked at 2 LTC facilities that had 12 hour shifts, and 2 that had 8 hour shifts.

A big thing though, is that it's really hard to get a job at a hospital as a new CNA. I couldn't get hired at mine until I had a year of experience, and that is a very common thing from what I've heard and read.

My advice to you would be to apply EVERYWHERE you can once you become a CNA. If you get multiple offers, you'll be able to compare them based on things like pay, benefits, and staffing. If you can't get into a hospital, work LTC for a while and then apply. You'll be more attractive to them with some experience under your belt.

I was pretty picky coming out of my CNA course, I wanted to work in a hospital for many reasons.

Like you, I wanted hospital CNA experience because I knew that was where I'd like to work in the future. Yes, the type of work you do in a hospital is different from LTC, how much so depends on the unit. I know because I was an EKG tech before this, working all over a hospital; luckily I now know what goes on inside most units. And after all, if you want to be a nurse in a hospital, being an assistant in a hospital makes sense to me. I'm also a guy, so as far as the difficulties of being a male nurse/CNA, as a tech in a hospital I never found it a problem, but found it greatly magnified in long term care where I did my CNA clinicals. It may have had to do with the different nature of the work, but I believe the patient/resident demographics played a big part as well. Toss in the fact that a hospital usually pays more and has great benefits, and it wasn't much of a decision for me.

But I did have trouble finding a job. The current economy is making hospitals try harder than ever to minimize training costs, by hiring experienced workers or hiring from within the hospital. Almost all of the hospital openings I saw were for a CNA II (meaning you must have experience). But for the openings I could apply to, and wanted to apply to, I managed to get 3 out of 4 interviews. And then, the two that were day shifts expressed that they really, really wanted someone experienced and I probably wouldn't get the job because they were interviewing 4 other people. Ultimately, after two months of job searching, I was offered a job on a night shift. Even though its going to be an awesome unit for me experiencewise, almost no one wants to work 7 pm to 7 am, including me--but that's why it was the only job I was offered. I was alright with that compromise and took the job.

So yes, I'd recommend shooting for a hospital. But it is likely a lot more competitive to get a job there. Of course, your mileage may vary from mine!

It is easier, by far, to get hired at LTC facilities, but better for your nursing career to work in an acute care facility. If you are lucky enough to be hired at a hospital, then you should take that job.