Really, how bad can it be to work in LTC?

kbrn2002, ADN, RN · Nov 18, 2015

Don't go into LTC thinking it will be a walk in the park, because it's not. Just the nurse/patient ratio alone makes getting your job done a challenge. Time management skills will be a must.

Then there are the staffing issues that exist in most LTC. Continually understaffed to begin with and if there is a call in it's not like they can float somebody from a different unit so there is also the frustration of rarely working with adequate staff.

Now, enough of the negative. LTC is the only place I want to work. It is a privilege to care for our elders. I can't count how many valuable lessons I've learned from hearing their stories. There are way more pluses than minuses in my opinion. You will really make a positive impact on your residents lives. You will get to know them and most likely their families very well. The staff that is good tends to be very, very good. I have never seen a more dedicated and compassionate group of nurses and CNA's than those that are passionate about elder care. If you are fortunate enough to work with a good management team your input will be valued and acted upon.

You will also have way more autonomy in LTC than acute care allows for. We don't have staff MD's so the rounding and on call doctors are 100% relying on your excellent assessment skills. There is also not nearly as much concern about "losing" your nursing skills as some nurses think. We do some really complicated nursing care.

Then there is the added plus of not having to work rotating shifts and having a set schedule. My schedule does not change, if I want vacation at a specific time next year it is easy to plan for knowing exactly what days off I need to ask for. For example, I took the entire week of Christmas off this year. I put in for that vacation and had it approved in January. Good luck ever doing that in acute care!

Of course there are good facilities and bad facilities. If you are going to be working in a good facility this can be a job that you will grow to love.

BirdieBird, BSN · Nov 18, 2015

kbrn2002, thank you so much for the positives list. I wish more posts on here reflected the rewarding nature of geriatric/LTC nursing.

bathrobemom, LPN · Nov 19, 2015

I start at 6am, pm shift comes in at 2pm. Yesterday I left at 5pm without any kind of break. I'm on my feet at least 7.5 hours whenever I work. I deal with "multiple MDs, family, and other disciplines". There are 26 beds on my wing and naturally they don't all see the same doctor. Families visit most often during the week on day shift. We have a rehab wing. During weekdays all the office personnel are in (administrator, payroll, business, social worker, scheduler) along with all the cleaning crew, maintance, etc. I should count how many people I talk to in one day, I would not be surprised if it's around 75 between all the people at work plus phone calls to and from the pharmacy, and to and from doctors.

I need to figure out how to cut down on interruptions, it's relentless. There's two sets of rooms where if one resident wants something, then the resident nearby thinks they need something as well. One room is like the Bermuda Triangle, I could disappear for hours in there going back and forth between residents.

I'm thinking about quitting, I bust my rear, I've never worked so hard in my life and pm shift ******* that I can't get everything done. They have half the meds I do and they can't get all their stuff done. There's one nurse I absolutely love and she won't let me quit lol.

I love the residents and there's some good nurses and the dietary staff is pretty good...but if you think LTC is a walk in the park - that is just hilarious!!! Good luck working your hinder off and people still think you don't do anything. It drives me nuts.

LPNtoRNin2016OH, LPN · Nov 20, 2015

What is your patient to nurse ratio? That makes ALL the difference in LTC, seriously. I have 25 patients, 10 skilled, and in a 8 hour shift, I don't sit but I usually leave on time. The other day, rehab was in between admissions, and I only had 20 patients. Literally, I took a lunch!!! A real lunch were I ate a meal and went to the bathroom. I was amazed at what have 5 less (granted they were my most needy residents) patients had on my work day.

BirdieBird, BSN · Nov 21, 2015

I have 20 residents, primarily long term and very few are affected by dementia. Overall, the current nurses there seem happy and not too stressed. I start floor orientation on Monday, so we'll see how it compares to what is described above.

quiltynurse56, LPN, LVN · Nov 21, 2015

Day shift is usually the busiest in LTC. I work the evening shift in LTC. There tends to be admin around and much more physician communications going on during the day shift.

Reading the threads pertaining to LTC do seem like it is the worst place to work. I love it. I think one advantage is you don't have the revolving door of patients. You get to know your residents so that many times with one glance or one question you can tell if something is off or not and you can ask further questions and do an assessment. Not that we aren't assessing anyway.

We have 31. The day shift nurses my stay longer by an hour usually, though we have one that seems to find things to do and stays longer. That is a whole other story though.

As was said above, I have a set schedule so it makes it easier to plan appointments and such around my schedule.

kern really summed it up well.

kbrn2002, ADN, RN · Nov 21, 2015

I have 20 residents, primarily long term and very few are affected by dementia. Overall, the current nurses there seem happy and not too stressed. I start floor orientation on Monday, so we'll see how it compares to what is described above.

20 residents in LTC should be a very doable ratio, especially if the CNA's are efficient at their jobs. I have 24 residents on AM shift and actually have plenty of time to get everything done. The only days it is a bit of a challenge are when multiple docs round and they all seem to write orders on every resident they see.

Are they giving you a decent orientation? LTC is notorious for very short orientation times, especially if you are already an experienced nurse. As long as the other nurses you will be working with are understanding when you are not a pro at everything right out of the gate it will still be ok.

Seeing that the other nurses seem relaxed and overall happy means this is probably one of the good facilities. If the staff seems happy and supportive of a new nurse it usually means that management is good, or least not bad. This sounds like you might have landed in a good place.

BirdieBird, BSN · Nov 23, 2015

I would say the orientation schedule is quite nice- 10 shifts over two weeks. I just got home from my first day on the floor, and am happy to report it went well. Working almost alone on my hall, we were done with med passes on time, treatments were early, and all the CNAs were excellent. I can say, in earnest, I will very much like this position.