Do acute care nurses look down on LTC nurses

BluegrassRN · Mar 28, 2011

I think more than anything, most acute care nurses pity LTC nurses, and have a total lack of respect for most of the *facilities*. A lot of times, I call to get info, and there's an agency nurse who doesn't know where the chart is, has no idea about the patient, and can't tell me anything. That's not her fault...it's that the facilities can't seem to retain staff, which in this economy, in my mind, means that they must be truly, truly awful.

I did some agency work on the side and worked a few nursing homes...I was shocked at how terrible the working conditions for the nurses were. CAs, too. There were several times that not a single staff member was a regular employee; we were all agency! Confused pts, don't wear bracelets, can't tell me their name, date of birth, no one has any idea of their baseline. How the heck are any of us supposed to know who is who? It was terrifying. After a few shifts I decided that the money wasn't worth it.

There are a few exceptions to these terrible facilities. There are a couple of NH in the area that really seem to take good care of their patients. One of our nurses left for one of these; we thought she was crazy. She says she loves it and will never return to the hospital setting. So I know there are good ones out there, but man, when they're bad they're really really bad.

MouseMichelle · Mar 28, 2011

Thankyou for your replies and I'm reading them avidly. Also now LTC is not just for "old people" we get quite a lot of younger patients for rehad and piccs and ivs and trachs etc. I love my work in LTC, and I love dealing with the patients, and I love the adrenaline rush I get working with 52 under my belt. It's hard hard work and very very stressful, I am the only nurse on my shift and it's all up to me. I trust my CNA's as I have great CNA's on my shift, they are my eyes and ears. Thankyou again for your replies.

SummitRN, BSN, RN · Mar 28, 2011

It is often human nature for an individual to look down on those who do tasks undesirable to that individual, or who have jobs that requires different skills and motivations than the individual has.

I find that the type of people who would, as an acute care RN, look down on an LTC RN, are the same people who would look down on an RT, or CNA, or MD, or janitor, etc.

My outlook is that I think people who do what I don't want to are AWESOME! As I am a student, I only get to look up to people... and I will keep doing that when I'm an RN too.

Auburnaire · Mar 29, 2011

Please don't forget about the MDS nurses who work in LTC I have worked for over 30 years as a floor nurse, treatment nurse and Charge nurse. Now I'm an MDS Coordinator. Assessing 15 to 20 pts a week, making sure all other departments sections are completed and input into the computer and accurate, and writing CAA's and care plans. Add to all of that making sure it is transmited to CMS within the timeframe allowed. Keeping on top of the rehab dept. so they have enough days to keep the patient on Med A, and communicating all the correct sequence ICD-9 codes to the billing department. I thought this would be a lot easier as I got older than running a floor with 40-50 residents, but though I'm not racing to complete a med pass, what I do now is much more stressful mentally. I challenge any acute care nurse with 6-7 pt.'s to ponder the scope of what I just described and thank an LTC nurse for doing what she does so well every day. :nurse:

SaraO'Hara · Mar 29, 2011

We send packet of recent chart copies and perform a skin check (if pt condition allows) before transfer to ED.

Acute sends us patients before any report (even pts on oxygen! no warning!) with undisclosed skin integrity issues. ED returns patients with no report, no labs, new orders...

It took me three phone calls and case management intervention to get my new admit's orders faxed from acute care.

Not every day is like this, but when acute care dumps on us, it's ridiculous. Busy is one thing; a lack of basic civility is quite another.

Deb, RN · Mar 29, 2011

No matter what our specialties, I think we can all agree that we are very busy, to say the least! There is no one area more formidable than another. We are all unique.

It is obviously very sad when there is dissention among nurses, keeping us from being able to work as a more effective team for the patients in the continuum of healthcare. These patients are going to need every single one of us at some point in their journey.

Even if we cannot walk in each other's shoes, so to speak, in order to have more respect for each other, we absolutely must find ways to be able to continue to pull together as a team. Disrespecting each other will only ruin it for everyone, especially our patients/residents.

R*Star*RN, BSN, RN · Mar 29, 2011

I worked in LTC for about a decade first as a CNA and then as an LPN. I was offered a job in LTC as an RN, but felt that it was time for a change of scenery.

Looking back on it, my time in LTC as an LPN was actually one of my favourite nursing jobs. I worked at a small facility with an assisted living attached, we had about 60 patients total divided up into 3 wings. Each wing had 1 LPN or TMA assigned for med pass, and the LPNs did all the dressing changes and whatnot. So I had 20-25 patients depending on my wing. I really enjoyed talking with my patients during the med pass or treatments, and was able to time things so that I could usually help out with "activities" after dinner. We did things like movie night, WII bowling or golf, card games, etc. Also I absolutely loved working with the "memory loss" patients. I know that this facility was a little more laid-back (ie better staffing) than other LTC facilities I've worked in though.

I do think there is a stigma that is given to nurses who aren't working in acute care. That applies to LTC, HH, Hospice, Private Duty nursing, etc. I think this stigma is carried over from long, long ago when the job was "easy". Nothing in the nursing profession is "easy" these days, and each specialty comes with its stressors.

Natkat, BSN, MSN, RN · Mar 29, 2011

A nurse who looks down on another nurse for her choice of career or speciality is a bad nurse.

maire, ASN, RN · Mar 29, 2011

A nurse who looks down on another nurse for her choice of career or speciality is a bad nurse.

Amen.

misstoast · Mar 30, 2011

We're getting ready to graduate in May. I think, out of a class of eighty in our ADN program, I am the only one who is willing to work in LTC. I work as a CNA, so I suppose I am aware of what I'm getting myself into. As far as the hospital and LTC rivalry goes, I pretty much agree with the points previously posted.

angelkerri · Mar 30, 2011

I am a new nurse as well as an LTC/SNF nurse. I have a had a few patients come to me for short-term rehab that were in such a state that I was flabbergasted. To me they belonged in a step down unit--not in a facility with 20 year old equipment. I find it frustrating, though, because, while I am comfortable in my LTC job, I am looking to explore different career options just so I can get a wide array of nursing experiences and find my niche, but being a newer nurse with "only LTC experience" it seems I am not marketable at all. Very frustrating.

Black Jade, BSN, RN · Mar 30, 2011

I am a new nurse as well as an LTC/SNF nurse. I have a had a few patients come to me for short-term rehab that were in such a state that I was flabbergasted. To me they belonged in a step down unit--not in a facility with 20 year old equipment. I find it frustrating, though, because, while I am comfortable in my LTC job, I am looking to explore different career options just so I can get a wide array of nursing experiences and find my niche, but being a newer nurse with "only LTC experience" it seems I am not marketable at all. Very frustrating.

I agree that it is frustrating. Even with my background as an ambulatory care nurse, I sometimes have a hard time getting hired at other places. Like you, I would like to explore different specialties but they always say that you have at least one year of experience. How are you supposed to get that experience if they don't give you the opportunity? Better to have some type of nursing experience, than none at all.