Why is LTC so hated

[MadameFreckles]

I hope I am not offending anyone with this question. I have been on allnurses for a while now, trying to find out as much as I can about the nursing career before getting started. One thing I have noticed is that LTC seems to be thought of as the last resort for nurses who can't get jobs elsewhere. I've seen many posts with people saying, "getting a hospital job seems hopeless, I guess I'll go to LTC." I don't get it, why is LTC worse than working at a hospital? I was thinking of volunteering at an LTC or hospice and getting a CNA position there later so I can hopefully be hired as an RN upon graduation. I am also interested in Hospice but that seems to be hard to get into for new grads. From some of the posts I've read though, it sounds like working LTC is the tenth circle of hell . Can someone enlighten me? Can LTC nursing be enjoyable?

[JosephLove, CNA]

People think that LTC is hard work sure I can agree but it's just depending on the facilities that you work at like mine I work nightshift the first few hours are usually rough but it slows down yes there might be for example a fall or couple there might be a couple call lights here and there but it's all about the facility that you feel most comfortable working at and what shift and if management is trash or not

[Red Shirt 6, CNA]

To me it seems that LTC is less desirable because

That the Patient ratios are higher supplies are fewer and working conditions are more demeaning that at hospitals.

Having acute experience is more desirable to chronic experience especially with gaining employment.

Getting away from the bedside; People do not associate leaving the bedside with Long Term Care. 

That the owners and administrators of LTC Facilities are worse than those at hospitals.  

[CalicoKitty, BSN, MSN, RN]

I'm pretty sure it is the patient ratios the most. Med-surg nurses can get overwhelmed with 6+ nurses, and there's talk of many LTC nurses having 50+ patients. There's often a different "hierarchy" such as "med-techs" to pass some medications.

I feel when working when the nurse to patient ratio is too high, I can't give my patients the care they need/deserve. And that makes for a frustrated nurse. Even if I "love" my job/patients, etc, when I feel unable to do my best because there's just not enough time.... it leads to burnout. 

Plus, the annoying nursing home patients that come into hospitals, well, we get to send them "back home" once they are well enough, but for those nurses, the annoying patients have nowhere else to go..

[kbrn2002, ADN, RN]

On 7/16/2021 at 7:06 PM, CalicoKitty said:

I'm pretty sure it is the patient ratios the most. Med-surg nurses can get overwhelmed with 6+ nurses, and there's talk of many LTC nurses having 50+ patients. There's often a different "hierarchy" such as "med-techs" to pass some medications.

I feel when working when the nurse to patient ratio is too high, I can't give my patients the care they need/deserve. And that makes for a frustrated nurse. Even if I "love" my job/patients, etc, when I feel unable to do my best because there's just not enough time.... it leads to burnout. 

Plus, the annoying nursing home patients that come into hospitals, well, we get to send them "back home" once they are well enough, but for those nurses, the annoying patients have nowhere else to go..

All of this, especially the part I bolded is so true!  Too many, just way too many residents to feel like there's time in the day to get everything done much less done well.  Even in facilities that use med techs for the med passes the nurse is still glued to the computer charting when not doing everything else but meds. 

Those annoying patients you mention? Yep, the LTC is expected to deal with them without using any kind of physical or chemical restraint which can be a challenge with extreme behavior issues. All the behavior contracts in the world do zero good when  the resident's poor behaviors is secondary to advanced dementia. 

In extreme cases the LTC I worked in would get an order to send a truly unmanageable resident to the ER for hospital admission until a bed in a geri-psych unit could be arranged.  So sometimes the hospital nurses would inherit our problem residents for awhile as geri-psych units are few and far between in our area and often full. At least in acute care that resident can be managed with meds and even physical restraints if it is deemed necessary for pt and staff safety.  The LTC nurse isn't able to use these sometimes needed resources  due to regulations.  

[maddy]

LTC are frowned upon mostly due to short staffing of CNA/nurses which gives a high patient load to the staff from what I know. Also good management is key to a LTC facility. I believe those who otherwise frown upon LTC nurses don't really know what we do and how SNF works. They see short staff and soaked residents but don't know all the other responsibilities and charting we have to do. 

[Tired nurse]

Long term care nurses love the residents but hate their jobs the disrespect they get and often open hostility you get esp. if your an LPN. Not to mention the fact you get thrown the keys and told here is your list of residents which may be as many as 60. And Don't  listen to the low acuity crap most are people pushed out of hospitals but still need hospital care, an impossible day every damn day. Why do you think nurses run screaming out every day! I know I have been punched hit grabbed threatened and given so much love by the residents! But so much hate from other nurses because of were I work (mostly sadly from RNs) instead of getting useful tips we get turned up noses and insults.

[FiremedicMike, RN, EMT-P]

To each their own.  My wife became an LPN during the dark days when LPNs could only work LTC.  She bounced around over 15 years to countless facilities, from facilities primarily staffed with medicaid to facilities that were absurdly expensive private pay only rooms.  They were all the same.  Terrible management, inappropriate patient ratios, completely unreliable staff, and abusive family members.  She actually made it to management and was the DON at 2 different facilities but that only lasted for a year.  Not only was she responsible for all the admin stuff, but she was also working the floor 2-3 shifts per week because she couldn’t get staff. 

In this area, the hospitals have started using LPNs again and she now works ER.  While she loves the environment and her coworkers, there are still many times when she misses her “peeps” (LTC residents).  She’s just one of those who’s passionate about geriatric care..  That said, she’ll never go back to LTC

[Tired nurse]

The number 1 problem in nursing homes is understaffing and it has gone on for years! And the reason is because almost all the floor nurse are LPNs who have no representation like RNs and have always worked under staffed and been completely ignored and mistreated because management is usually RNs. You think those high paid RNs want to take care these people that they deem beneath them. Nothing on TV about sexy LPNs in tight uniforms working bedside at LTC! Go figure! Anyway now that hospitals need more nurses even the LPNs took off from LTC. Most figured like me never going back to staff at LTC because you make much more as agency or travel.

 

 

[Tired nurse]

It seems to me you just hate LTC nurses because they are almost always  LPNs not RNs! That's OK we are used to the RN attitude! We can take it! But I have never understood it! Love to all my LPN brothers and sisters!