What do you love/hate about LTC?

It's rough a lot of days. It doesn't seem like it would be as fast as acute care, but it is. You are right, the patient/nurse ratios are much higher; you are much more dependent upon UAP due to the sheer volume of patient care. In my area, one nurse is typically in charge of 20-30 residents as well as the UAPs taking care of them. You need to be on top of your game in a different way than in a hospital - you don't have the resources or personnel available in most hospitals when you work at a nursing home. Sometimes the pace can become incredibly frenetic.

Pros: yes, you do get to know your residents over time compared to the in-and-out care of a hospital. Also, you're much more autonomous. The physician is generally only available by phone and comes in 1x a week for a few hours. And if you're an RN, you probably have a better shot at supervisory/administrative positions at a NH than at a hospital; even ADNs have a fair chance at DON jobs, depending on experience and what the competition has to offer.

I love my residents. They make it all worth it. It is stressful. It is difficult emotionally. You love them, and you have to watch them decline and die. You get really attached to the residents and their families. But, the love is worth the pain. Love always is.

Do not go into LTC until you have at least one to two years experience as an RN! I am speaking from my own experience. LTC will chew you up and spit you out in no time and it is very difficult to get hired back into a hospital without the experience behind you.
What I love about LTC: 1. The hugs that I recieve from my residents. 2. The way that I can tell that something is wrong with my residents just by looking at them. I know their dx, thier plan of care, and many of their allergies and meds by heart. 3. How the residents tell me they are so glad that I am there today because they know that I will take good care of them. 4. The funny things that my residents say and do. They are old and they think they can do and say what they want.
What I hate about LTC: 1. The unreasonable demand that are placed on me daily. I have thrity + residents to pass meds to, do tx on, call the doctor and update if there are any problems, dealing with the unreasonable family members, setting up appointments and transport to said appointments, checking and calling labs to the doctors office, and the list goes on. 2. The lack of support from management. 3. The charting 4. Dealing with CNAs that do not want to do their jobs. The CNAs do not make nearly enough for the job that they do, so you get what you pay for in some cases. 5. Hospital nurses, EMTs, and doctors that thinks because you are working in a nursing home you are not as smart as a hospital nurse. 6. Dealing with the general disrespect that the family members have for you. 7. Dealing with the same residents and family members day after day. They can drive you nuts over time.
Overall, I love my residents and they are what keeps me where I am at now.

Loves:

My residents, of course. They are who keep me coming to work every day.
The autonomy, as someone else mentioned.
The busy pace.

Hate:

The people I work with who feel that you can walk into LTC, be lazy, and then pretend to know everything.
Dealing with difficult families.
Lack of communication between departments.

Overall, I know this is where I belong, as an LVN. When I complete my RN, I'll run screaming! (And probably be back the next day to say hi to everyone! LOL)

I love the residents, also our Medical Director is very good and amenable to nurses questions, not condescending at all.

I hate the reams of documentation, paper work upon paper work and the corporate aspect.

However, I love my coworkers (most of them) and the resident's really make it worthwile.

Roxann