Does this bug you like it does me?

CANRN, MSN, RN · Dec 17, 2001

When I worked in the ER, it seemed as if we had certain times of the month when it was nothing but nursing home residents sent to our ER for "evaluation". Many times I would take report from the LTC nurse and jotted down the signs and symptoms all the while thinking "not another one!" Or "my gosh, can't you nurses take care of these people..." the list goes on.

Well, I have left the ER and acute care setting and guess where I'm working? that's right LTC.

My first few weeks on a skilled unit in LTC was a real eye opener for me. I began using skills I had not seen in the five years I was in actue care....namely, G-tubes, PICC lines, some awesome dressing changes, Vents, trachs. One thing I missed more than anything was my monitors!!! I didnt' have them to help me monitor my patient er... resident. I didn't have the luxury of any of the great new machines and tools that I had available in the hospital. I had to learn the 'basics' all over again. I had to use my wits, I had to follow my gut instincts, I had to learn to watch for the changes in my residents. and the PAPER WORK is unbelievable. But now where in my nursing career have I found greater satisfaction.

It is hard work, just because its' LTC does not make it easy. I am grateful for my acute care experience, I can't imagine working in LTC without it!

Your right, the state requires so much from LTC facilities. So many requirements. We are held ACCOUNTABLE for the care of the residents and must prove everything.

Your so right, every nursing job is important. It makes no difference if your in LTC, ER, ICU or any other acute care setting. I wish some of my former collegues could come to work with me just one shift, they would certainly get their eyes opened and when they take that call from the LTC nurse, I'll bet they would treat her with a lot more respect.

Thanks for your post, it needed to be said.

Jenny P · Dec 17, 2001

Mtgirl and CANRN, I work CV-ICU and have been in critical care for 28 years. I love my work and am still learning every day on the job. I started working in a nursing home feeding pts. when I was 15, then became an aide when I turned 16. I've been an RN for 32 years. I could never work med-surg; the acuity and pace of the average med surg floor actually SCARES me! :eek: But I do hope to someday return to LTC-- and not neccessarily as a resident first! LOL!! I have always enjoyed the geriatric population and have the utmost respect for LTC nurses; just as I respect any other nurse in any area of this profession.

LTC nurses have the ability to bond with their patients as no other nurse does. They care for the resident both while he is well and ill. Helping the resident achieve their optimum state of health and maintaining it for lengthy times- even years! is an awesome job that doesn't deserve to be looked down on. The residents come to rely on the LTC nurse as someone akin to family; only different. Be very proud of what you do; and don't ever let anyone put you down! :)

Teshiee · Dec 17, 2001

Until anyone who has worked in a LTC, couldn't possibly know what goes on. My first experience was in a LTC. The work was hard, grueling and rewarding at times. I came to love my geriatric patients. I have learned so many things especially patience and compassion. Unfortunately the understaff over work CNA's and residents not getting the proper care made me leave that area. I was always down for my staff I stood up for them. I find those with the powers that be were nothing but money hungry ass individuals that didn't care about the residents only what was in their bank account. For what these kind people pay the service was lousy. They need to revamp the whole system. I really think they are the worse place to put anyone. Some nurses like yourself make a difference unfortunately not enough is being done to assure they these residents are getting good care. I have told many administrators where to go to make my point. They could never say I was a bad nurse. I just cared!

Trauma Columnist · Dec 17, 2001

I was an LPN for a couple of years, while in school for my RN. I worked in LTC and loved it.

I also want to thank the nurses that took care of my mother-in-law for six years after a CVA. When she died in Jan 2001, the nurses cried with us. They gave her excellent care!! THANKS

Although I'm an RN now and work in a large ER, I still remember how isolated I sometimes felt in LTC.

WriteStuff · Dec 17, 2001

Hi mtgirl63,

I'm one of the "seasoned" among us.....thirty years in this profession. Three years ago I made a decision to leave the acute care setting after 25 years as a bedside nurse in hospitals hither and yon. (I ended up specializing in Oncology Nursing the last ten years, which was a good foundation for transitioning to the LTC setting, which is where I am now full-time.)

At my age (57) I have my big toe in the front door of possibly becoming a resident myself in a LTC facility. (*grin*)

I live in rural Minnesota, a small community of 750 people and we have a Nursing Home here in town which is where I work.

When I made the decision to switch from the hospital setting I was uncertain, even "skeptical" as to whether or not this area would be a "fit" for me. I've been at it now for three years and have found it to be the most rewarding part of Nursing so far. I've discovered that living in such a small community there are some "built in" benefits that might be lacking in more urban settings. Here, everybody knows everybody and everybody is related to everybody and it really IS like one big huge family. As a result, there is a bond that exists that carries over into the Nursing Home in unique ways. The local Churches, community organizations, and businesses are all very actively involved in volunteering, visiting, being available for special occasions for our residents and it has a very positive affect on Staff morale because we know we are supported community-wide.

And 95% of the Staff who work where I do, live in the community as well. So we all know each other not only on a professional basis, but socially too.

As Staff we are far more ready to give and take, as well as go the extra mile, which happens a lot with scheduling and call-ins, etc.

And you are absolutely correct when it comes to what State Departments of Health REQUIRE in terms of rules, regulations and documentation in LTC facilities these days. If the hospitals we held to the same standards we are in terms of quality of care, they would all be out of business in a nano-second!!

When one of our residents shows up in an ER, or a Doctor's office it's not because we don't know what we're doing, or have nothing better to do........these decisions are not only sound, but supported by our Departments of Health.

And our elderly, very vulnerable senior population is the richest most rewarding source of life's experiences you will find anywhere. I absolutely love serving them in their declining years!!

ComicRN · Dec 18, 2001

I've said it before and I'll say it again.......LTC nursing is still nursing. It's just "high touch" instead of "high tech."

This may come out wrong, but...........thank goodness there are nurses like us who can LOOK at our patients/residents and see that something is not right, instead of depending on machines to tell us (as CANRN mentioned). We are fortunate enough to have the time to get to know our residents well enough to know when they "just don't look right."

Thank goodness there are nurses who like working in ICU's and ER's. I know I never could. I think we should all just appreciate each other for our skills, knowledge and caring that we show people along all paths of the health care "system."