ALF nursing as as different from traditional nursing-home nursing as night is from day. I'm the RN health services director (DON, in LTC terms) and I do very little resident care, although I have a few 'projects' at any given time (I love wound care!!
) and once in a great while will do a NOC shift as med aide. I'm also on-call 24/7, but my staff is well-trained and rarely needs to call me, and 99% of the times they do, I can handle it from home.
I'm fortunate in that I have the autonomy to shape my job to my own needs and preferences, and I run my department as I see fit. At present I do the scheduling, interviewing, and staff delelgation/supervision pieces, as well as resident assessment and health services coordination, plus even some marketing. I'm also acting administrator whenever my boss is out of the building........that part I'm not too keen on, as I don't understand a lot about the business end of things (nor do I want to).
There is a fair amount of record-keeping involved, but it isn't a fraction of the paperwork you do in LTC---no MDS/RAPs, no Medicare charting, no documenting every little ointment and cream in five places. The pay isn't as good as in LTC, at least not in my neck of the woods, but my stress level is so low that I've been able to go off my 2 most expensive blood-pressure meds, so in my case anyway, I think it all evens out.