Attitudes of nurses who don't work in ltc

TheCommuter, BSN, RN · Nov 27, 2013

I worked in LTC on and off for six years, so I know all about the attitude, rudeness and eye rolls that others in the medical community bestow upon LTC nurses.

The prestige of our nursing position is closely connected to the patient populations with whom we interact. Our society devalues the elderly, poor people, alcoholics, drug addicts, the mentally ill, the disabled, convicts, criminals, and the chronically ill. Our society places a very high value on infants, children and healthy younger adults.

Therefore, if you are a nurse who works in LTC, psych, addictions, jails, prisons, group homes, or free clinics, many will look down upon you. On the other hand, a nurse who works in specialties where younger patients are seen (L&D, pediatrics, ER, reproductive medicine, NICU, trauma, etc.) is admired by the healthcare community.

It might be unfair, but that's the way it is.

amoLucia · Nov 28, 2013

The prestige of our nursing position is closely connected to the patient populations with whom we interact. Our society devalues the elderly, poor people, alcoholics, drug addicts, the mentally ill, the disabled, convicts, criminals, and the chronically ill. Our society places a very high value on infants, children and healthy younger adults.

Powerful synopsis of LTC in a nutshell.

I would add that high-valued pts also include the beautiful, the athletic and the famous.

CrossCountryRN2008 · Nov 29, 2013

I got stuck in SNF and prison nursing as a new grad. It took me 5 years to get an acute care job because yes there is s stigma on ltc

BrandonLPN, LPN · Nov 29, 2013

I worked in LTC on and off for six years, so I know all about the attitude, rudeness and eye rolls that others in the medical community bestow upon LTC nurses.
The prestige of our nursing position is closely connected to the patient populations with whom we interact. Our society devalues the elderly, poor people, alcoholics, drug addicts, the mentally ill, the disabled, convicts, criminals, and the chronically ill. Our society places a very high value on infants, children and healthy younger adults.
Therefore, if you are a nurse who works in LTC, psych, addictions, jails, prisons, group homes, or free clinics, many will look down upon you. On the other hand, a nurse who works in specialties where younger patients are seen (L&D, pediatrics, ER, reproductive medicine, NICU, trauma, etc.) is admired by the healthcare community.
It might be unfair, but that's the way it is.

Very apt.

One of the first things I noticed as a new nurse was that most of the places I was "permitted" to work at as a lowly LPN were.... prisons, nursing homes, methadone clinics, dialysis centers, etc.

This might sound harsh, but as long as there are patient populations the about which the general public doesn't give a flying fig (the elderly, the incarcerated, addicts, chronic dialysis), there will always be a place for LPNs.

As for the attitude from nurses in the hospital.... Yeah, I've experienced that, too. EMTs and paramedics are the worst in this regard, though. I've been Johnny-on-Spot with all the paperwork and a full report every time I sent a resident out, but most times they still act like it's an unbelievable indignity to have to converse with a LTC nurse.....

WAheartnurse · Nov 29, 2013

I have never worked in LTC or a SNF but I have friends that have. From what they tell me it is a very task oriented job- you have so many residents that you are often just focused on passing meds because you have so many people to pass meds to that by the time you are done it is time for the next round or for charting or wound care. Most of the residents are there for a long time, they are like family and are somewhat stable. Changes or declines are often subtle and it takes a keen eye to spot them.

Nurses who work in a SNF as opposed to assisted living or LTC are looked on as "more skilled" as they do just about everything a hospital nurse does (IV antibiotics, start IVs, wound care, etc).

In the hospital, the changes are often more acute, the response of the nurse is expected to be over minutes to hours (instead of days to spot subtle changes). We have access to more exams and labs and interaction with doctors and generally the expectation is that we FIX these folks- not just take great care of them. Many elderly will not get better and go home- they are going have hills and valleys but generally slowly decline.

As an ED nurse, I see that LTC/SNF nurses care for patients like family. When they decline, they either go to comfort care or you send them to us to fix. Well, that requires a higher level of knowledge (urosepsis protocols, MI care, etc.) and access to more technology (CT scans/STAT labs, etc).

I found moving from floor nursing to ED nursing was completely different- the skills/needs were different. Same thing with different types of facilities.

Yes, I have found people who work in LTC who seemed a little "not up to par" but have found floor nurses that way too. I have also found mostly excellent LTC nurses who called to check on their beloved patients and gave me a report that was detailed and also very different from the story the medics told (the medics had messed up the report). I think we all need to give each other respect and the benefit of the doubt that are jobs are very hard and very different.

I think you are also running into a bias against LPNs. I think LPNs are amazing and wish that hospitals would use them more often as adjunct personnel to raise up the standard of care overall.

Hats off to you that dedicate your careers to the elderly. It is an underpaid and underappreciated job.

Ruby Vee, BSN · Nov 30, 2013

I've never worked in LTC, and I'm not an ER nurse. I've worked in critical care since the Reagon administration. Let me just say, however, that I have the utmost respect for LTC nurses and the work they do. My mother and my mother-in-law are both in LTC, and I've seen first hand what a great job their nurses do, and what a heavy workload they have. Kudos to LTC staff everywhere -- from DONs to nursing staff to CNAs to janitorial staff. I don't know what I'd do without you!

Here.I.Stand, BSN, RN · Dec 1, 2013

Thank God for people like you...from a critical care trauma nurse. My grandpa became a resident in LTC after some falls at home, sustaining compression fx's in his spine. Those LTC nurses and CNAs knew him so well, and they saved his life several times by knowing him and recognizing immediately when things started to head south. They were instrumental in getting him transferred to a hsopital when he needed one, while my mom is the type to explain away ev.er.ry thing. I sometimes wonder if she were to have pain with an elephant on her chest, she'd say she was fine and just pulled a muscle. So anyway, SHE wouldn't have gotten Grandpa to hospital as quickly as he needed.

ProudLPN10 · Jan 13, 2014

Thank you, as an LPN in LTC, you make me feel good about my choices. At this time, with a 1 year old, I am not planning in the near future to continue on to be an RN, so I'm "stuck as just an LPN," as some people like to think. I, however, love being an LPN in LTC!

WorseNurse · Jan 14, 2014

When I worked as an aide in the ED the nurses were very judge mental of LTC nurses. I'd often remind them that these nurses don't have multiple doctors sitting right next to them to lean on. Just remember and ED nurse usually has many other nurses, attendings, residents, PAs, and RTs readily available to bounce ideas off of.

SleeepyRN · Jan 15, 2014

I'm getting to a point in my life where I don't care what others think of me. (I'm 32.) I've recently, for a few months now, have decided to enjoy my job, enjoy my husband, enjoy my life. After many many years of allowing others to make me feel inferior, I've finally realized I DO have the ability to not let my emotions bring me down. When someone doesn't like me for example, or if a doctor is grumpy and annoyed when I page him/her, I tell myself, "I'm doing my best, I'm kind, I'm continuously, eagerly learning, and I'm very dependable." The rest is on THEM, and I now refuse to take it personally. It's a decision I make multiple times a day. When I page a doctor for example, and I anticipate that he/she will be annoyed, I briefly prepare myself by making the decision that I will NOT let a doctor intimidate me. I personally believe in God and feel that He is helping me in this area. But whether you believe in God or not, you have the ability to DECIDE "I WILL NOT let other's opinions on my career, on my personality, on my goals bring me down. I enjoy my residents (frustrations with work and all), and then I get to go home and enjoy my time with my husband, friends, or simply have me time.

Muttlover2 · Jan 15, 2014

Thanks for all of the great posts above on this topic. I am an RN (Associates degree) and have an interview today in a LTC facility. I have gotten the same attitude from other nurses I work with. I, too, have gotten to that fabulous, freeing point in your life where you don't care what others think! I do what is best for me, with what I've got presented to me at the time. I would love to care for the elderly.....we have a lot to learn from each other:) Thanks for all of the great comments.....very inspiring way to start my day!