Just curious what's so bad about working LTC?

I think another problem is that LTC nurses get a bad rap from other nurses. For whatever reason, the medical profession seems to think that only ER and ICU nurses really matter. They seem to think that only "poor" nurses (and I mean skill wise) work in LTC. Frankly, I think it takes just as much skill to work LTC as anywhere else.
But until we can change our own attitudes towards LTC and the elderly, we will not get better staffing, supplies, support etc.
Just my opinion of course!

I disagree. You required just as many skills working LTC. Assessing elderly pts with dementia requires more skills because they cannot always articulate where their pain is. Ulcer care, dressings, etc are not different in a LTC facility than an acute. And keeping someone comfortable and properly medicated if they are dieing requires a lot of talent and compassion. Finally, as the nurse/pt ration is often much higher in a LTC area, you really have to learn how to organize your time!

I work at a nursing home (LTC/SNF combo), and I am definitely an LTC nurse with some skills. I work on a short-term rehabilitation unit where the typical patient is discharged home in 2 weeks.

I deal with mostly postsurgical patients who are too deconditioned to go home. These patients are CABGs, knee and hip arthroplasties, thromboembolectomies, hysterectomies, post CVAs, fractures, and so forth. One time I received a gentleman who was badly beaten and robbed, and needed reconditioning. Many of my patients are middle-aged, and wouldn't fit the description of the average nursing home patient.

I regularly give drugs via IVPB and IV push, especially antibiotics. We frequently must start our own IVs to create peripheral access. I remove sutures and staples, dress complicated wounds, apply new ostomy appliances, operate nebulizers, CPM (continuous positive motion) machines, iceman machines, oxygen tanks, concentrators, and PEG tubes. I had been employed on a traditional long term care unit for a year, and I had not been exposed to some of these skills that are necessary in the short term rehab unit.

There's always something to learn at my workplace, which happens to be a nursing home. The opportunities might not be so obvious, so you have to be aggressive and seek them out.

Not all LTC nurses are 'deskilled.'

Just curious, How many IV's do you start? I know there are good nurses that work in LTC but it has been my experience, just taking report from LTC nurses, that there knowledge base is not as high as an acute care nurse. Acute care being any nurse in the hospital setting. You are mainly taking care of patients who when they become ill are transfered to an acute setting. I disagree with the comment about acute care nurses having an attitude about the elderly though. I think a majority of the patients they take care of are elderly.

I have had only positive experiences in LTC. Sure sometimes we are under staffed or out of some kind of supply but what hospital isnt both of those sometimes as well? I think it depends on where you work and management of the place. Where I work its fabulous and I really feel we give A++ care to our residents. I love that you can get to know your residents and really make a difference in their lives because of the amount of time and follow through you are allowed. Getting to know your residents so well allows you to better customize their care and its so rewarding being able to actually see the positive out comes of your interventions. Something that is unique I think in LTC.

I also have to disagree with this comment. I think that is a huge misconception in LTC. I was surprised myself the diverse population we care for and the numerous IV, feeding tubes, vents, incision, pins ,wounds, infections, etc we deal with. Let me tell you we handle our fair share as well!

I am one of those fortunate nurses who has worked in a lot of different areas of nursing and to say one set of nurses is "better" than another is absurd. There are weak and strong nurses everywhere, including ICU. I will never forget some of the awesome LTC nurses who helped me along as a new grad and their assessment skills and knowledge base were as broad and deep as any nurse I know. It is just a different focus of nursing. There is a different "skill set" for each specialty of nursing, along with the basic assessment skills. Then there is that hard to quantify skill, intuition, which I believe all great nurses possess. You know, those nurses who just know when something is not right or know when to check on a patient because something tells them they are in trouble. That kind of deep insight exists everywhere in nursing and is not dependent on the specialty where one choses to be a nurse. If your heart and commitment is with LTC residents go and be happy in your choice. God knows great nurses are needed there too. The so called "skills" some think LTC nurses don't have like starting IV's is one of those skills that even if you do work in a hospital, doesn't mean that you are any good at it... what else...reading heart rhythms, etc are all skills that can be acquired without a lot of difficulty. The basic nursing skills, the ability to spot a patient in trouble, safe medication administration, skillful handling of family situations, compassion, end-of-life care is at least if not more keenly developed in LTC nurses. The LTC nurses I worked around are some of the most efficient anywhere. If you want to learn time-management skills, work LTC! Efficiency is key.

I am sincerely grateful for all of the great nurses I had the pleasure to work with in all different areas of nursing. Follow your heart and never feel inferior or superior to any nurses anywhere.

I never made the claim or assumption that LTC nurses possess knowledge bases that are higher or lower than that of their acute care hospital counterparts.

Rather, it is best for me to state that each nurse has a knowledge base that it uniquely different from the next nurse. For example, I know a whole lot about the aging process, death and dying issues, and other aspects of gerontology that are intertwined into LTC. The next nurse may know a whole lot about oncology, because he or she has spent much of his or her career working on a hospital oncology unit.

It is prudent to refrain from assuming that all LTC nurses possess lower knowledge bases than acute care nurses, because many of my LTC coworkers started at hospitals before they moved on to the nursing home setting. One of my male coworkers was an L&D nurse. Several coworkers were med-surg nurses. Some worked in telemetry, triage, the OR, and other varied areas. When I ask about the reasons for leaving hospitals, they all state that they were looking for something with a slower pace that paid more money.

I never felt that working in LTC was bad. It's just that i did it for so long, that when i went to LPN school, i wanted to try something different from LTC.

When I applied for the telemetry job at the hospital here the NM said her only reservation was that I had spent most of my nursing career in a nursing home and I would basically be a new grad..

I was a little insulted at this. I know that I worked in an intermediate care facility, I've never started an IV, have rarely done blood draws and had never read an ECG monitor. But to say I was basically a new grad was an insult, because I definitely realize that I know and can do A LOT more now than when I just got out of nursing school. The NM was giving me scenarios to see how I would respond and I was thinking she must think I'm some kind of idiot!
I even found myself buying into this mindset of LTC nurse=no skills.
I think LTC nurses are the Rodney Dangerfields of the nursing profession and our roles are devalued among other nursing disciplines.
I'm kind of offended when I look at how underestimated our abilities are.