Long Term Care Nursing is Lame

  1. Having worked in a long term/short-term rehab facility combination for a year now, I have to say that in comparison to other areas of nursing, it's pretty lame.

    Yes, we work hard. We have 20 or more patients on our own who require medications. Sometimes they'll have tube feedings, ostomies, JP drains, etc. There are many wounds, blood sugars, bladder scans and emergent situations aren't as rare as you would think. No one is denying people at these facilities work hard.

    At the same time, when looking at other areas of nursing, including ICU and ER, it's safe to say we don't really do as much for these patients as these incredible nurses do. For example, I am highly impressed with a cardiovascular surgical ICU in my town, one of the best in the nation. These nurses see and do EVERYTHING. Skills include Skills include TPM, PPM, Chest reopening, chest tubes, trach, PEG, JP, NG/OG, pigtail cat, extubation, sedation, CT/MRI, Bronchoscopy, line placement, cortrac, IR, specimen collection, medications including inotrops, vasoactive, blood administration, insulin, heparin, CPN/lipids, paraltyics, and lines such as arterial lines, Cordis/STCVC, pAC, TDC, TPM wires, PICC, non-VAT blood draws, CRRT, Flexiseal, and pumps including PCA, Medication and Tube Feeding. They have LVADs, ECMO machines and take care of ALL ages from the newborn to the elderly. The MICU is also quite an impressive area, as are all the other ICUS. Plus, you can't beat the top notch nurses in the ER.

    Sorry everyone but it's true...there's a reason why long term care nurses/rehab nurses are paid less than others.
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  2. 119 Comments

  3. by   purplegal
    People I graduated with are working on some of the units I described. Two are in the MICU and one of them is transferring from the OR (another pretty awesome area) to the cardiovascular surgical ICU, which I forgot to mention, also sees lung and heart transplant patients. Talk about top notch nurses! I would much rather have those jobs on my resume than the ones I have!
  4. by   Zyprexa
    If you don't like what you're doing, then why not apply for those "impressive" specialties you obviously envy rather than insulting an entire nursing specialty?
  5. by   purplegal
    The weird thing is, I'm good at the job I have now. I actually enjoy most of my shifts. But I'm not at all impressed by what I do.
  6. by   Here.I.Stand
    Please give yourself and fellow geriatric nurses some more credit.
  7. by   Davey Do
    Quote from purplegal
    I'm not at all impressed by what I do.
    But you've impressed me, purplegal...
  8. by   Zyprexa
    Quote from purplegal
    The weird thing is, I'm good at the job I have now. I actually enjoy most of my shifts. But I'm not at all impressed by what I do.
    What you (and all LTC nurses) do is impressive. And it makes a difference for all the residents you take care of. Even if you move on to critical care or another specialty, you should feel proud of what you did in LTC. I was a CNA in LTC prior to becoming a nurse, and I understand the challenge. You might not feel like you're making a difference or doing anything special, but believe me...you are.
  9. by   Libby1987
    Quote from purplegal
    The weird thing is, I'm good at the job I have now. I actually enjoy most of my shifts. But I'm not at all impressed by what I do.
    I don't think there's a person on this planet that wouldn't find a role model who performs with high standards and commitment to excellence in any field anything but impressive.
  10. by   DontStealMyPenRN
    I'm personally not a fan of when people associate "incredible" nursing with psychomotor skills. Yes, critical care nurses are capable of many great things (I am one), but I will tell you that some of the nurses that I work who are particularly skilled in things such as IV insertion are not necessarily "great" nurses. They are handy to have around if I have a patient who needs IV access, but their soft skills need a lot of work.

    I'm teaching clinical at a nursing home right now, and it's interesting to see the differences between critical care and long-term care nursing. After working with the nurses at my clinical site, I've found that they are particularly skilled at providing wound, orthopedic, and dementia care. As a critical care nurse, I too am competent in these areas but I would definitely not consider them my strengths. Our skillsets are very different. Similarly, I HATE that my hospital floats our critical care nurses to med-surg areas. Their specialized skillset becomes very apparent to me when I'm expected to manage a 6-7 patient assignment (our normal ICU ratio is 2 patients to 1 RN). I've never been one to consider that "a nurse is a nurse is a nurse."

    It's always been my opinion that nursing excellence is achieved when you have a good balance of things like psychomotor skills, critical thinking, and emotional intelligence in your practice.
  11. by   NurseCard
    I'm honestly not "impressed" by my current job either, but I love it.
    I work on a med surge unit of a critical access hospital. That basically
    means that the patients that reach our floor are typically not very sick.

    You know what DOES impress me? The fact that I worked 1.5 years in
    one of the worst nursing homes in Kentucky, and survived. The fact that
    I've survived through some tough, tough jobs, not just that one.

    A good LTC/rehab nurse is to be admired. Don't ever forget it.
  12. by   blackribbon
    Okay...I don't work in one of the highly specialize areas but I do work med/surg with a huge variety of patients. I see the result of good and poor LTC nursing by the condition of the patients when they get admitted into our service. We often spend a long time repairing poor nursing care from outside the hospital (pressure ulcers and other wounds of neglect are high on the list). I also see it in patient's faces when they know they are being sent back to LTC facilities that isn't a quality place. Most people will never need the specialize services of the nurses that you idolize but most people will need the services of a LTC facility, either for themselves or for their loved one.

    To make a comparison, yes, someone repairs some exclusive expensive cars may have special skills that makes him seem special but the reality is that the mechanics that work on the average nothing special car have more value to society as a whole. You are taking care of someone's mother or father when they no longer can do that. How on earth can you minimize your role and value as a nurse? Our value as a nurse isn't determined by the skills we have but the difference we make to the patient in front of us.
  13. by   dirtyhippiegirl
    I sit at a computer all day and talk to patients over the phone doing PAT assessments and teaching. I also don't work weekends or holidays. Lame-o city but it's all relative. I've caught a couple of medication errors and had a couple "you need to see your doctor about that" come back as big deals.
  14. by   calivianya
    I work in one of those super high acuity areas, and let me tell you... I could never do what you do. I would be ready to throw myself off a bridge having to take care of 20 patients. I hit almost basket case level when I have three. Props to you for succeeding where I would fail!

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