Considering position in LTC

phoebebrat, ASN · Apr 16, 2008

Thank you NewEngland RN for your question about working in LTC. I also have about 2 yrs. exp. in med/surg, am currently not working and I'm considering LTC. I can't answer your question but I am curious to see your responses. It's like you read my mind! :wink2: Good luck with your decision.

jjjoy, LPN · Apr 16, 2008

It sounds like you haven't worked LTC before. It's quite different than hospital nursing. Would you be able to spend some time observing at the LTC before making a decision?

NewEnglandRN, RN · Apr 16, 2008

I was there for about four hours during my interview and got to observe. I also did a student internship at an LTC facility for 12-weeks. But, that was days.

I worry about the nights and being supervisor. I have a second interview on Friday and will compile a list of questions to ask.

SitcomNurse, BSN, MSN, EdD, RN · Apr 16, 2008

I was there for about four hours during my interview and got to observe. I also did a student internship at an LTC facility for 12-weeks. But, that was days.
I worry about the nights and being supervisor. I have a second interview on Friday and will compile a list of questions to ask.

Be sure to ask questions like:

Security? What is your command therein? Do they have a guard? Are you in charge of him/her?

Staffing? What are the minimums, when are you allowed to use overtime? How is the system for mandation, if indeed they have one? How much of the daily verses monthly staffing are you responsible for? Covering vacations for staffers?

Monthly reports you may be required to hand in? Quality controls?

Emergency contacts for night shift like: Administrator/DON? incase of fire or other natural emergencies(watermain breaks etc.)

I worked many years in LTC as a supervisor. I loved it, the staff is good, the ladies work hard.. I had a great system of backup, and day staff always willing to help in a tight situation. There are these systems in place for emergencies, just know who your resources are!! and good luck! It can be rewarding!!

Sometimes God puts on the SitcomNurse channel.. its like Comedy Central for him. :lol2:

2006RNCS · Apr 16, 2008

Hello!!!

I am an RN who graduated two years ago, too. I have experience in Cardiology and ICU. I decided in January of this year that I wanted to get out of the hospital setting, so I interviewed at a LTC facility. I am RN supervisor on night shift now I LOVE it. Sure, when I first started, I was amazed at the differences in LTC and the hospital. But now, I feel really comfortable doing my job. There are difficult people to deal with, but that is the case anywhere you work. For the most part, I am much happier in LTC.

I believe you need lots of patience, a caring attitude towards others, and the ability to confront others in a restrained, respectful way. I have learned valuable time management skills. The main problem that I have in LTC is the disorganization of it. Maybe all facilities aren't like the facility in which I work. At my facility, I find myself scrounging for supplies. It is frustrating to no end to start an IV with 16 or 18 gauge catheter. But, if that is all you have, well, that's what you do. That kills me.

LTC is completely opposite working in a hospital setting, but if you are burnt out, or just need a change, please really, really consider it as an option. I am so glad that I had the courage to accept the position. I was scared to no end, but now I feel so good about the job that I am doing, and I feel valued and respected. I did not have that in the hospital setting. I dreaded going into work at my last hospital job. I loved the patients, but hated the being short staffed, working extra hours, and the bad attitudes of coworkers. LTC pt to nurse ratio will blow your mind at first, but you quickly learn how to manage your time and pace yourself.

Good Luck at whatever you decide to do!! :mad:

LVN76 · Apr 17, 2008

new to snf atmosphere. Should I take a 7-3 shift

bluegeegoo2, LPN · Apr 17, 2008

Hi there,
I am an RN with just under two years Med-Surg experience. I am presently not working, but considering two positions right now 1.) Med/Surg/Tele 2.) Supervisor at LTC. Both are night positions, which is fine with me. I am leaning toward the LTC position, but after reading this forum, I am having concerns about staffing ratios and keeping my license!
Any word of wisdom?

Hello! I am a LPN in a LTC facility working nights, and the biggest issue my supervisor has is she has NO autonomy whatsoever. Regardless of what she sees or hears, her hands are tied to do anything about it. In fact, during one conversation she told me "I'm nothing but a glorified babysitter". I would DEFINATELY look into whether or not you would be allowed to make decisions and impliment ideas on your own, or if you'd have to "run it by" upper management first. She isn't even allowed to fire anyone. She has to make a case to the uppers, who obviously don't see the staff behaviors, and is rarely "backed" by them. The only reason I am mentioning this to you is it seems to bother her more and more the longer she is there. On the upside, it is usually relatively quiet at night save for the occasional fall or death. The staffing ratios are...well...interesting to say the least. I have been a nurse for only 5 MONTHS, and have 60 pts and 3 (4 if I'm lucky) aides on an Alzheimer's unit. Scary, I know. If you take the LTC, just make sure your nurses know you will be available to answer ANY questions, no matter how seemingly silly. It will help you be more at ease with your license, and help me be a better nurse!

deleern · Apr 17, 2008

“hello! i am a lpn in a ltc facility working nights, and the biggest issue my supervisor has is she has no autonomy whatsoever. regardless of what she sees or hears, her hands are tied to do anything about it. in fact, during one conversation she told me "i'm nothing but a glorified babysitter". i would definately look into whether or not you would be allowed to make decisions and implement ideas on your own, or if you'd have to "run it by" upper management first. she isn't even allowed to fire anyone. she has to make a case to the uppers, who obviously don't see the staff behaviors, and is rarely "backed" by them. the only reason i am mentioning

i have been a nurse for only 5 months, and have 60 pts and 3 (4 if i'm lucky) aides on an alzheimer's unit. scary, i know. if you take the ltc, just make sure your nurses know you will be available to answer any questions, no matter how seemingly silly. it will help you be more at ease with your license, and help me be a better nurse!”

i am an rn in ltc i am charge and assistant care manager. i work most days as the care manager, as i cover for the care manager on her days off. we have good staffing ratios... (for now. with the cost of doing biz going up so fast it will be interesting to see how that shakes out.) we have 52 residents. during the day we have 2-3 rn’s 2 lpn’s and 5 - 6 na-r’s (pm’s doesn’t have full rn coverage) one of the rn” just does mds, one is the care manager, i do charge and cover for the care manager on her days off… if i am charge i work until 6pm, we take turns doing call. as part of the budget cuts we do not have rn on the pms or the night shift.

rn's are considered management so we are supervisors, but thankfully i don't have to fire any one... don't even want to go there. i can certainly report, and write them up. all firing goes thru the don and the administrator, with all the labor laws i would not even consider it. i can tell some one to go home and come back and talk to the don.

i was the charge nurse at night when i was an lpn i loved it. its busy, with lots of things to do but not as physically demanding as med surg. night charge has 52 residents and 2 aids. when you say 60 res. and 3 aids that has to be at night. i would not work under those conditions if it were days.

good luck, go in with a good attitude and ask lots of questions

bluegeegoo2, LPN · Apr 17, 2008

Yes, it's nights. I forgot to put that in my previous post!

jj1986 · Apr 18, 2008

LTC staffing is a constant up and down DCS to patient ratio. The employee turn-over is high in almost every facility but it doesn't take long to develope a routine and adjust to the extra work load.I love my LTC nursing position and feel as though the implementations I initiate to a care plan are part of an important goal to improve the quality of life in someone's mother, father etc. But PLEASE! DO NOT:nono:be one of these nurses that avoid simple patient care just cause "it's not you job". Since the staffing in LTC is often inadequate please realize that it's not just meds and tx! It's toileting, showering,ambulating,feeding, and loving. Alot of times we become all these people have and they rely on us to protect their dignity and over-all well-being.