Role of the RN in LTC

Specialties Geriatric

Published

I know this varies from state to state and facility to facility.. but I have a general question.

I'm probably the only nursing student in the world who had little-no experience in LTC during clinicals.

I'm considering taking a job at a local LTC. The perks are that it is in my hometown (where we live now and are already well established, kids, etc), pays relatively well and has flexible shifts. I don't know about the negatives... I never pictured myself working LTC (I did an externship and will do a preceptorship in ICU, which I would like to do eventually.. but am not sure if it's worth uprooting my family over - we'd have to move to a city with a larger hospital). But then, I never really pictured myself not doing it, either.

I'm not really sure of the role of the RN in LTC facilities. In general, is it usually case manager type role? For example, in facilities I have visited in the past, LPNs did most dressing changes and medication administration. The RNs at that location mostly managed paperwork and staffing. Not sure if that's the way it is in most locations or not, though.

I'm meeting with the DON at this LTC facility tomorrow, so I know I can ask my questions there. However, I don't want to show up looking like a complete idiot! LOL

Oh, by the way - I graduate nursing school in May, so this would be my first nursing job. IS it hard to transition from working LTC to a staff nurse job? I wouldn't want to rule that out in the future....

Specializes in LTC, Hospice, Case Management.

In the LTC facilities I have been in there is little to no difference in what an RN and LPN do. Both work the unit; ie: med pass, dressing changes, IV"s, documentation, following up w/ Dr. talking to families, etc. In my experience, you will die a slow painful death if you go into a LTC with an "I'm the RN" attitude (not saying you planned to... just wanted you to know!)

I'm the night shift supervisor of an LTC facility. I'm a night owl by nature, so the job works out well for me. I love it.

There are a lot of responsibilities. I'm the only RN here at night. I make rounds, do med pass reviews (but I don't have residents or meds of my own to deal with), monitor staff, make schedule adjustments according to callouts, compile a report for day shift, do compliance checks of rooms, handle resident/staff complaints, troubleshoot any problems (and there can be some doozies here), respond to any falls or health crises, evaluate the need for EMS transfer, perform assessments as needed, and basically keep the shift running smoothly. There are 165 residents in my facility, so there is a lot that could go wrong, but there are also 5-6 LPNS and 10-12 CNAs who do a great job. I love what I do. The downside is that the autonomy is tremendous, there is noone for me to go to if I don't know what to do and everyone looks to me when there is a problem, no matter how big. However, in a sense that is an upside because noone is here breathing down my neck. What shift are you considering?

I am also an RN in LTC. Been at the same facility for over 6+ years, both as an LPN and RN. My responsibilities are about the same, except I am held to a higher standard, and I am ultimately "in charge". I have done nearly everything,too. Everything depends on your own "style" of doing things, remember that.

Suebird :p

Well, I met with the DON and she was GREAT! Very nice lady and I spent a little over an hour in her office. She told me to come back anytime. I asked if I could shadow one of her RNs for a day to see their typical responsibilities and she said that would be fine. When I get my preceptorship schedule, that's what I plan to do.

Cons: I am not 100% sure that I would like LTC/geriatric nursing. I'm scared it will be difficult to transition back into a hospital setting if I ever decide that is would I would like to do (other RNs looking down on LTC nurses?). Shorter/less thorough orientation. A little worried about being charge over LPNs/CNAs and taking a high number of patients on my own straight out of nursing school. I also have liked working 12hrs in the past because it gives you more days off per week, even if the hours are longer. Doesn't have as good benefits as larger facilities/hospitals - no student loan repayment (may qualify for HRSA?), not alot of educational/CEU opportunities, no pay for board review, etc.

I always thought I wanted to work critical care (did an externship in MICU/SICU last summer and doing my preceptorship in SICU) - but taking a job in a unit like that would require moving away from my hometown and family and settling for several dollars less per hour.

Pros: Perfect hours (7-3 weekdays-almost the same hours as my kids school! very flexible scheduling, off every other Christmas, etc). Is in my hometown. My husband already has a relatively well paying job here (which is a biggie since he has no transferrable skills/education). Pay is better than any of the local hospitals or facilities. Benefits (health insurance and retirement) are just okay, nothing stellar.

Specializes in Geriatrics/Oncology/Psych/College Health.

Removed posts that sent this thread off-track. Re-opened.

Removed posts that sent this thread off-track. Re-opened.

Thank you! :) :) :)

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

At the LTC facility where I am employed as an LVN, our shift supervisor is an RN. She floats to the different nurses' stations and basically fills a supervisory role over the LVNs.

Specializes in med/surg, hospice.

One of my instructors was talking about this very subject today.

I think that so many positions have to do with where you are in your life. If you have small kids, you need predictability. Single mom, ditto. If you are either an empty-nester or single no kids then you have so much more flexibility in your schedule.

Oh. but I had a point...:idea:

oh, yeah....

My instructor said that she "topped out" working LTC very quickly and became a bit bored with the job after a couple of years. However, her kids were in their early teens and her hubby was going through a rough-spot health wise. She said that professionally, it wasn't her "dream job" but that it was the ideal job for her personal life at that time.

Good luck!

One of my instructors was talking about this very subject today.

I think that so many positions have to do with where you are in your life. If you have small kids, you need predictability. Single mom, ditto. If you are either an empty-nester or single no kids then you have so much more flexibility in your schedule.

Oh. but I had a point...:idea:

oh, yeah....

My instructor said that she "topped out" working LTC very quickly and became a bit bored with the job after a couple of years. However, her kids were in their early teens and her hubby was going through a rough-spot health wise. She said that professionally, it wasn't her "dream job" but that it was the ideal job for her personal life at that time.

Good luck!

I see the point, but the longer I work LTC, I see more possibilities or opportunities. Aside from floor work, there is other areas..MDS, Restorative, Staff development, Wound care...if you are corporate or a chain type of facility....there are traveling positions. Along these lines....I've often thought about working on the "other side"....state surveyor! Just remember that you don't always have to be tied down to the cart in LTC.

As far as getting bored with the same type of pts......of late,that hasn't been a problem in my area. Seems like every week we are getting different, more challanging residents.

Specializes in Home Health, PDN, LTC, subacute.

The RN's in our facility work carts same as LPN's. Our unit managers, MDS coordinator and supervisors are all RN's.

Thanks for all the input.

I shadowed one of the RNs at this facility for about two hours today, and I'm still confused as to what the role of the RN is at that facility! LOL

Not so sure LTC is for me, after all. Thanks again!

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