Why I am a LTC nurse

Specialties Geriatric

Published

Specializes in LTC, home health, critical care, pulmonary nursing.

I'm an LPN, finishing my RN. I have had so many nurses/doctors/instructors etc tell me lately that I MUST work a few years in a hospital, that LTC isn't real nursing, I'll lose my skills, "You're too smart to work in a nursing home," you'll never get a job anywhere else, your whole day is figuring out how to make them poop. I can see where they're coming from, really I can.

I love coming to work every day. I know those 32 dementia residents like the back of my hand. I know how to soothe them. I figure out when they're hungry/tired/have to pee/in pain when all they can tell me is "AAAAAHHHHHH!!!!" I have time to sit under the table with a lady and help her clean the floor with her sock. I have time to sit with an anxious resident who is screaming, not from pain, but from fear and confusion, and stroke her hair while she falls asleep. I have time for that macho man to "help" move the furniture around. The man who can't remember he can't walk sits behind the nurses' station with me while I chart and eats bacon and eggs so he won't fall. I have time to give a bath now and then. I have time to have popcorn fights with them. I argue, sweet talk, and get feisty with doctors, pharmacies, case workers, administrators and others to make sure my residents get what they need. Like my med surg instructor said, "A monkey can start an IV. A monkey can do procedures. That's not nursing." And that makes sense.

I may want to move on some day. I'm still very young. But for now, I'm where God wants me. And I'm blissfully happy.

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As if anyone could say you're not a 'real nurse'!! It's great that you've found an area that you enjoy.

I've got to ask, though, where you work in LTC that you actually have time to do more than pass meds & chart. In many facilities, med nurses are responsible for around 30 patients and the unit nurse is responsible for over twice that (renewing prescriptions, calling MDs, doing transfers). Sounds like a wonderful facility that you work at!

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Specializes in LTC, home health, critical care, pulmonary nursing.

The facility I work at has 88 beds, three locked units. The whole place is for dementia patients with behavioral problems. The vast majority of them are DNR, and comfort care only. So, not many transfers, we have an in house pharmacy, and not a whole lot of things to call the doctor for. Most of the residents have the same doctor, and he has protocols for just about everything, so I call him maybe once or twice on the days I work. Plus he and the NP who works with him do rounds twice a week, and the psychiatrist comes every week as well. Because of the population, there's VERY rarely any IVs, tube feeders, trachs or vents, etc. So I literally pass meds, chart, and play. There's much more time to nurse the emotional and spiritual parts of the residents. As well as provide information and support for their families.

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Specializes in LTC, Psych, Hospice.

You sound like a wonderful, caring nurse. I wish I had more time to spend with my pts. In my LTC there are two nurses and six CNA's at night. I'm responsible for 56 pts. When I do get free time, I too, like to sit with my pts. So many of them had wonderful, exciting lives and they love to share these things if someone only takes the time to listen to them.

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Specializes in LTC, home health, critical care, pulmonary nursing.
You sound like a wonderful, caring nurse. I wish I had more time to spend with my pts. In my LTC there are two nurses and six CNA's at night. I'm responsible for 56 pts. When I do get free time, I too, like to sit with my pts. So many of them had wonderful, exciting lives and they love to share these things if someone only takes the time to listen to them.

I have great CNAs and an awesome DON and ADON. Very much a team environment. That makes it much easier to manage time so I can spend it with the residents.

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Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

With the aging of the baby boomers, LTC seems to have become the new Med/surg learning for new nurses. 20 or 30 years ago what you have in LTC is what you had on a med/surg unit. You learn to organize your time, look for acute problems, utilize critical thinking skills, really tune in to slight changes and call docs for orders on patients in acute situations. Learn about dealing with end of life issues, rehabilitation for post ops that will go home, and deal directly with patients and family about care issues. Nope I don't think you are losing any skills working in LTC, you are gaining valuable skills that can be utilized in any nursing environment. If you need to learn how to level an art line or do a cardiac output in the future you will get that orientation. Some faclities are so poorly staffed I wouldnt let my dog work there but other than that, it is a good learning envioronment just as any nursing job is.

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Specializes in Vascular Access Nurse.
the facility i work at has 88 beds, three locked units. the whole place is for dementia patients with behavioral problems. the vast majority of them are dnr, and comfort care only. so, not many transfers, we have an in house pharmacy, and not a whole lot of things to call the doctor for. most of the residents have the same doctor, and he has protocols for just about everything, so i call him maybe once or twice on the days i work. plus he and the np who works with him do rounds twice a week, and the psychiatrist comes every week as well. because of the population, there's very rarely any ivs, tube feeders, trachs or vents, etc. so i literally pass meds, chart, and play. there's much more time to nurse the emotional and spiritual parts of the residents. as well as provide information and support for their families.

sounds nice.....it's good that we have nurses who love that sort of thing! where i work in ltc, i don't enjoy the dementia unit, but do like skilled care. we have our pts longer than a hospital setting, but do a lot of skills, such as iv's, trachs, gtubes, med monitoring, frequent labs and calls to the doc. the hospitals send pts to us sicker and sicker, so it's like acute care of 10 years ago. i love it....more autonomy, and more critical thinking since the docs aren't in-house most of the time...and we make a difference. we do our share of rehab and it's great to watch someone recover and go home...without umr breathing down our neck to discharge them too early.

anyway, my point is that we all like different things...and thank goodness!! i love my skilled old folks, you love dementia, some nurses love er, med/surg, ob, peds, etc. don't let anyone put you down....you sound like someone i'd want taking care of my mom! :nurse:

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Specializes in Geriatrics/Family Practice.

It's sounds like you're right where you a supposed to be. Hollistic nursing is taking care of the whole person, which is what you are doing. As far as skills go, yes a monkey can learn to start an IV, do trach care, insert a foley, etc., but real nurturing and tuning into the patients needs is real nursing to me. I don't know how many nurses that I have talked to that haven't done any of the things listed above in school and don't do it until they get their first job. Every area of nursing needs special training. A NICU will have a hard time on med/surg and visa versa. There are so many areas of nursing and so many ways to nurse that if you can find what makes you happy and makes you feel like you went into nursing for the right reasons, than you have the perfect job. Your residents are very lucky to have you. And as far as some of the comments that were made to you, "Shame on them" and they can only be so lucky to have such an unskilled (kidding) nurse as you taking care of them if they ever need your type of facility. I'm a LPN and I've heard so many times especially on this website that we are not really needed, not really nurses and so on. At first I was devastated and hurt but then I thought "Do I actually really care what other people think?" NO!!!!! I'm a good nurse whether my nametag says LPN or RN, MSN, OCHN, jjjeeejjjje (you get the idea). Like I've always said if all of us had our masters in nursing, who would be left to take care of the patients? There are different levels of nursing and different skills we contribute. If anyone of the levels were to be removed, healthcare would definitely suffer, but if all of us were at the highest level healthcare would also suffer. If hospital nursing was the only true way to be a nurse than God help the geriatric patients of America. Ultimately, do what your heart tells you to do and what makes you happy.

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Specializes in Wound Care, LTC, Sub-Acute, Vents.
i'm an lpn, finishing my rn. i have had so many nurses/doctors/instructors etc tell me lately that i must work a few years in a hospital, that ltc isn't real nursing, i'll lose my skills, "you're too smart to work in a nursing home," you'll never get a job anywhere else, your whole day is figuring out how to make them poop. i can see where they're coming from, really i can.

i love coming to work every day. i know those 32 dementia residents like the back of my hand. i know how to soothe them. i figure out when they're hungry/tired/have to pee/in pain when all they can tell me is "aaaaahhhhhh!!!!" i have time to sit under the table with a lady and help her clean the floor with her sock. i have time to sit with an anxious resident who is screaming, not from pain, but from fear and confusion, and stroke her hair while she falls asleep. i have time for that macho man to "help" move the furniture around. the man who can't remember he can't walk sits behind the nurses' station with me while i chart and eats bacon and eggs so he won't fall. i have time to give a bath now and then. i have time to have popcorn fights with them. i argue, sweet talk, and get feisty with doctors, pharmacies, case workers, administrators and others to make sure my residents get what they need. like my med surg instructor said, "a monkey can start an iv. a monkey can do procedures. that's not nursing." and that makes sense.

i may want to move on some day. i'm still very young. but for now, i'm where god wants me. and i'm blissfully happy.

your post is very inspiring! i should be taking my board's next month and i hope i find the same facility you have. you're an excellent nurse!! :bowingpur

angel :yeah:

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Specializes in Hospice.

Thank for such a positive post.

I work prn as a CNA, and it's such a different place when I work with nurses who have attitutes such as yours.

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Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.

You have found the right niche for you. I think this is wonderful. I have had the experience of having a job I dreaded every day and one I loved as you do, and believe me , there is no contest. Ignore the nay-sayers!

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Specializes in Director of Nursing Long Term/Subacute.

Long Term Care Nurses are the best of the best. The stigma of old has changed.

Long Term Care nursing is nursing at it's best and most basic. Care and compassion are a must. I never thought I would want to work in LTC but I took a job as an ADON---quickly I was DON and I loved every minute. Even the bad parts.

I was DON for 7 years. It was the best job I ever had. I would still be there if I had not have had a wreck that disabled me. I am now a Nurse Author sharing my experiences and this huge heart I have for LTC nurses.

Yall are the best of the best and don't let anyone tell you any different!!!!

I have recently been in the hospital as a patient--I would have rather been in a LTC facility anyday!!!

Keep on doing what you do. Love those patients and each other.

Angela RN BSN former DON

:nurse:

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