Why do RN's avoid LTC positions?

Specialties Geriatric

Updated:   Published

What are the pros and cons of working as an RN at a LTC facility? It seems as though many RN's avoid LTC positions.

Is it the nature of the job (LTC duties)? Lack of variety? Do hospitals look view LTC experience as unfavorable experience?

I'm pretty new to the nursing world, but am learning that hospital jobs are highly sought after, while LTC facility jobs the ones to avoid. (Not necessarily my opinion, merely an observation.) Just looking for some insight/opinions!

I started working at a LTC facility as an LPN and worked through it during my RN year of school. Understaffed, bed alarms going off 24/7, not enough supplies etc.

After I got my RN license they told me they wanted me to work rehab along side another nurse to ease her patient load, I thought "okay, i'll do that", I was supposed to work Monday-friday, however I was called off each night because "census was too low" the other nurse was able to work her five days (they never called her off), They then decided to make me the night rehab nurse for the weekends but taking care of 30+ people myself, with patient's on other floors to manage as well?! I don't think so.

I found a job ASAP. I love where I work now, and honestly, I don't think I would ever go back to long term care.

Bless the people who love that field of nursing!

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I dont know how old your comment is but I want you to know that you really give me

Hope. I start my 1st job as an RN at a LTC in a week. Thank you

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I was one who said I would never work long term care but where am I. I work in a private pay facility -certified dementia-so that makes a ton of difference I do t think I could do a Medicare/ Medicaid facility. I think it depends on what patient population you want to work with . I started in med- surg and that was getting horrible 8 years ago I can't imagine how it is now.... Just try stuff before you say you won't ever do it you might find you like it after all.

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It is very easy to misinterpret long term care based on negative experiences in your clinical training but you shouldn't condemn the industry entirely based on that experience. ..times have changed, rules change everyday! LTC is one of the most regulated industries, right up there with nuclear energy. We in LTC are asked to do more with less everyday and we do it in spite of overwhelming odds. It is a completely different kind of Nursing compared to hospital nursing...you have to treat each patient holistically, not just the diagnosis...we have to see the whole person...emotionally, psychosocially, spiritually, culturally, clinically, psychologically and then their families too! They don't just discharge and go home in a few days. ..they come to adjust to a different way of life...not necessarily the end of the road as people often believe but to live life to their fullest within their expressed wishes and ability! It is very hard work and emotionally demanding but the rewards are worth every bit of it! The people who need long term care need the clinical expertise of licensed nhrses, especially RNs and allied health personnel as well...they also need that part of Nursing that cares, that wants to help the person, that wants their quality of life to be the best it can be...the LTC nurse has the opportunity to practice every aspect of nursing...technical skills, wound care, psychiatric nursing, social worker, public health, infection control trol, education, assessments of all sorts everyday...communication skills are essential for physician and family and team function. Are some managed not as well as others...of course! We don't live in a perfect world...but that applies to every industry, goverment, society in this world. Truly the adage "don't judge a book by its cover" applies to many areas in nursing as well as life! You are correct though, not everyone can be a LTC nurse...it is a gift and technically oriented nurses generally don't last in the environment but, the nurse who truly wants to make a difference and values the diversity in working with chronologically challenged individuals, or otherwise challenged and requires LTC will thrive in it. For myself, I started as a CNA in LTC and didn't like what I witnessed in some nurses I worked with. I felt there had to be a better way and went on to become a licensed nurse...30 years later I can tell you there is a better way and we can make it happen ! I hope you found your niche in nursing but please don't judge LTC by your experience during clinicals...you might miss some very meaningful and stimulating opportunities.

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Well I have to say I tried LTC 3 times and this time I'm gone for good. Back to the hospital I go. I was in charge of 58 patients and 2 LPNs and like my last 2 times returning to the specialty, it is horrible. (Please don't throw tomatoes). Management is just as bad as ever. Patients are sicker which increases the acuity level. Staffing is a nightmare. Most of the time I'm on the med cart and in charge due to excessive call outs. I'm gonna stop right now because I'm depressing myself just thinking about it. Anyways, I'm out for good this time.

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Hello All, in response to the OP's question, RN's avoid LTC for a variety of reasons, judging by the responses given. Prioritizing and organization are two of the greatest strengths needed in working in long term care today. I have worked in many roles in LTC: CNA, RN floor nurse, and RN evening supervisor. Is it a lot of work? Yes, but knowing what your priorities are, and how to go about accomplishing them will definitely guide you in providing nursing care. Working with elderly, chronically ill patients and their family members requires a certain patience, compassion and commitment in dealing with their issues on a daily basis. As a floor nurse, you can only do the best you can with what you have to work with, in relation to staffing shortages/supplies. LTC is not for everyone, as stated in many of the responses here.

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I couldn't have described my own experience in LTC better if I tried! You nailed every point. While, I also believe the frail & elderly are in desperate need of quality care, the management (corporate AND DOH) will continue to devalue their care in favor of money in their pockets.

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Hi

I think those are some valid points How would your propose fixing some of the issues you talked about?

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This is just my opinion. But I do not think that LTC nurses should be frowned upon. I think that LTC nursing is just as real as being any other type of nurse it has its good and bad points. I am going to nursing school and I am hoping to become a geriatric nurse( having previous experience as a CNA in A LTC facility). I look at it this way. I may some day end up in a facility and I would want to think that I am being cared for by a nurse who wants to work there rather than hating being there wishing she/he where doing a nursing job some where else.

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You are absolutely right .I admire your desire to make a difference. I had been working at a LTC facility for 2

months and I came in to work with the same vision. Be ready to deal with all types

of nurses. The time you have in your hands is not enough for the amount of patients you are required to take care of. It is really challenging. I recently received a job offer at a hospital in a New nurses program with a contract of 2 years. I was told by a fellow nurse "are you ready to be a real nurse" my question to her was "so the elderly are not considered real people" I guess the fact that we dont deal with daily emergencies make us less nurses in the eyes of the hospital nursing staff. Maybe that is the reason why hospitals rarely hire nurses from LTC

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Omg!!! It has NOTHING!!!! to do with the elderly. I have elderly patients everyday in the hospital. In fact, when I last left the nursing home there were lots of patients in their 30s and 40s. It's not just a nursing home for the elderly, it's a skilled nursing facility with rehab/therapy which makes the facility big bucks. The population has is all ages. My point is management in these facilities don't care and the impossible nurse to patient ratios. And everyone, please please understand that just because a nurse does no desire to work in a nursing facility does not mean it has anything to do with caring for the patients. Like I said before, I take care of elderly patients everyday.

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Specializes in Emergency, Trauma, Critical Care.

It has more to do with severe understaffing, increasingly higher acuity and I lasted a whopping 4 months in one before I quit. I had 38 patients by myself. The only RN was our manager who she said we could call her anytime, but not really. On night shift I had two night med passes, 15 sugar checks, and two pegs.

The day nurse never did her wound care treatments, she just signed she did it and left the old dressings on. I had issues getting a hold of a doc on nights regarding an issue with an insulin not arriving for a patient and what other options we had because her sugars were high and I was documenting this issue. I got written up despite the effort I had made while this other nurse who was signing off things she wasn't doing got nothing. After that, I quit.

There are great and terrible nurses in LTC. I recently got a pt in the ER from a SNF whose foley had 25 mLs of saline in a 10 mL balloon and he had purple to drainage all around the catch. Diagnosis was urosepsis. These situations give the LTC a bad name, but I know that there are many truly amazing nurses and CNAs working in them with rockstar attitudes because of the situations they deal with daily.

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