Do acute care nurses look down on LTC nurses

highlandlass1592, BSN, RN · Mar 31, 2011

Actually, that statement is showing a bit of bias on your part. We ALL should be paid a decent wage to deal with very unique patient populations.

You made a comment about patients coming back from acute care having skin issues. That is not an uncommon problem, as in many cases in the ICU, some patients become so critically ill that turning them is impossible if you don't want them to code. Add to that malperfusion and skin issues can become a special problem. As nurses, skin management is an issue we own...the problem becomes when we decide between turning a patient or allowing them to turn and "go to the light". It's a difficult situation all around.

Caffeine_IV · Mar 31, 2011

I don't but I used to work in LTC as an LPN and I learned many skills that have helped me in my hospital job.

A lot of people have misconceptions about specialities that they haven't worked in.

Over-the-hill-Nurse · Mar 31, 2011

I personally applaude each and every one of you who work LTC. I spent most of my years in a hospital sitting and throughly enjoyed it but because of some long term health issues, I was let go after serving 20 years at that one facility. At first they were welling to work with me and I can't condemn them for not trying, what I can do is to let them know that no matter what, I was still going to be a nurse somewhere and things were very easy going until I got hired into a long term care facility.

Let me say that my thought processess were miles away from theirs. For the most part I took care of the residents who were still classificted as "acute care" which I didnt mind a bit. These nurses who do LTC do it very will. Taking care of the patients wasn't the issue for me. It was the mounds of paper that had to be taken care of, the repeating orders that needed to be written 10 times on another form, and another, etc... And believe me when I say I was totally out of my element when it came to asessing the MDS forms, the PT forms and yes even the RT forms. And I think I never managed to get it right the first time but no one showed my "how" to do them form the get go.. but I do get written up for it every time. I only managed to work there 6 months before getting out of there. The day that I left, I had had enough of the back-stabbing, and the tattle telling. But I can honestly say that I think LTC nurses, LPN's and RN's, do a hell-of-a job! LTC is for some people and not for others. Me, I prefer the Acute Care. I have to give you guys KUDO'S for what you do, and yes you do it well. I certainly learned that I was not cut out for it.

Now if I only knew where to go from here. sigh....Unless something comes along I could sink my teeth in and be happy, my cap is going to stay right where it is-hung up. :heartbeat

rnccf2007, BSN, RN · Apr 1, 2011

I worked in LTC as an STNA for eight years (some while attending nursing school). I was offered tuition reimbursement if I worked for 2 years after I received my degree. I refused, because my passion was to work in critical care. However, that was my personal choice. I do not look down on other nurses who chose a different career path than me. That is the beauty of nursing, so many choices. As nurses, we are all united in providing quality patient care as well as compassion and empathy for our patients, no matter what area of nursing we pursue.

**NickiLaughs, ADN, BSN, RN** · Apr 1, 2011

I feel very sorry for LTC nurses, that's all. I think the ratios are so completely unfair and unrealistic to provide the sort of quality any nurse would want to provide. I worked LTC for 4 months as an LVN, that is all I could last. I usually could finish my shift on time, but that required no breaks on my part. Staff was always quitting. I remember at one point there was only 4 nurses, to cover all the shifts in the entire week, and we were working doubles, and just tons of overtime.

I work in a hospital now, it's a different sort of challenge, but I can usually leave feeling like I did a good job with my patients, in the nursing home, my goal was to get all the pills done and paperwork done. The residents complained about how lonely they were, and I felt so bad, but I really didn't have time to stop and have a conversation.

I have worked with a few nurses in the hospital, who I think, simply lacked the knowledge of the situations in nursing homes. They stated "oh yeah the nursing home patients come in with decubitus ulcers frequently." When I said "yeah cuz they have 50 patients and two techs on a shift." They couldn't believe that I wasn't exaggerating. Until they met several other nurses who said the same thing.

I really wish there was a more reasonable ratio law, because I loved taking care of the elderly and I wouldn't mind going back to it someday, if it wasn't a constant run without the chance to even catch lunch.

Multicollinearity, BSN, RN · Apr 1, 2011

Let's just be straight up, honest. Yes, I have seen quite a few acute care nurses who look down on LTC nurses.

The sub-specialty I am in (not LTC) is also looked down upon by many acute care nurses. I can only grin about this because when they come to my place of employment as travelers, the acute care nurses are lost and don't know how to make autonomous decisions and operate independently in emergencies without other nurses or MDs present.

All you can do is be secure in what you do, and try to be open and without bias about others' specialty fields.

Chixie · Apr 1, 2011

I spent the day with a critical care\ITU nurse whilst i was a student on a care of the elderly ward and at the end of the day i said that i didnt think that i could do her job as it is so complex with all the machines and different things going on with the patient. This nurse turned round to me and said ' i dont know how the care of the elderly nurses do their job dealing with combative/aggressive dementia patients and doctors rounds, meal times and balancing the 101 other jobs that they do. if i was left with the drug trolley i would be passing a brick'

Personally i dont care where you work, LTC, surgical,theater or medical. Each jobs as hard as the other.

86toronado, BSN, RN · Apr 4, 2011

Why do acute care nurses look down on LTC nurses? Here is a sampling of patients from LTC facilities who have been to my ER in the past week, and the treatments received.

-On "Clogged G-tube" we changed out the clogged stopcock on the end of the tube and it worked fine.

-On "Decreased LOC" in an 89 year old, we held her Q4H Lortab for a few hours and then sent her back with instructions to change it to a PRN.

-On "Urinary Retention" we irrigated his foley catheter.

I realize that LTC nurses can have 30+ patients apiece, but a little trouble-shooting before calling the ambulance could probably save millions in healthcare dollars, not to mention the stress and worry that these patient's family members go through each time they hear that their loved one has been sent to the ER for an "emergency"

JSlovex2 · Apr 4, 2011

i'm a nurse intern at a hospital and since i've never worked in a LTC facility, i've been considering getting a job in one just for the experience (not the money). there's one less than 1 minute down the street from where i live that's always hiring (not a good sign in itself) but i always give the benefit of the doubt. after i got off work yesterday (night shift) i stopped by the LTC facility to pick up an application and there was a sign on the door that said, "please see a staff member for the code to exit the facility." this was in an effort to keep the residents safe.

so, i picked up an application from a table that had a sign above it which said "applications" and then walked over to the nurse's station and waited patiently about 1 foot away from a nurse who was doing something on a computer so i could ask the code to exit the facility. i counted 4 minutes i stood ONE foot away from this lady and she never looked up at me. she never said, "hang on" or "i'll be with you in a moment" - NOTHING. for all she knew i could've been an inspector.

after five minutes of standing right in front of her i walked away and said, "no wonder you can't get anyone to work here."

i went to the door and held down the handle (which sounds an alarm incase residents are trying to leave) and a CNA said, "you have to type in the code" at which time i told her, "i know, and i tried to get it, but the lady at the desk just sat there."

needless to say - as a person who was considering LTC just for the experience of it - my first impression (along with what i've heard) was a very, very bad one. i'd be fired if someone walked up to where i was working and i never made eye contact or even bothered to say "hang on" for a complete 5 minutes - i don't care if it was a patient, family member, inspector, or a drunk guy off the street.

gentlegiver, ASN, LPN, RN · Apr 4, 2011

Why do acute care nurses look down on LTC nurses? Here is a sampling of patients from LTC facilities who have been to my ER in the past week, and the treatments received.
-On "Clogged G-tube" we changed out the clogged stopcock on the end of the tube and it worked fine.
-On "Decreased LOC" in an 89 year old, we held her Q4H Lortab for a few hours and then sent her back with instructions to change it to a PRN.
-On "Urinary Retention" we irrigated his foley catheter.
I realize that LTC nurses can have 30+ patients apiece, but a little trouble-shooting before calling the ambulance could probably save millions in healthcare dollars, not to mention the stress and worry that these patient's family members go through each time they hear that their loved one has been sent to the ER for an "emergency"

While I have to agree those are not good reasons to send a pt to the ER, please remember, LTC facilities have protocals that sometimes require a pt shipped out for the smallest of reasons. I worked one place that wanted pt's sent to the ER to have foley caths replaced! (I mean, seriously, just replace the darn thing, it's faster than completeing the paperwork to send them!) I have also found that some (not all) LTC are hiring new grads, giving them 2 weeks orientation and sending them out on thier own. These poor new Nurses have very little idea how to handle, correct, or repair many things and are scared to ask for additional help for fear they would be considered unable to do thier job. And then, as in all branches of Nursing, you sometimes just get bad/lazy Nurses who are clueless. There are many "tricks to the trade" that we all learn from more experienced Nurses, but, with the facilities cutting down on staffing, you often don't have an experienced Nurse working with new ones.

Scary situation: 2 New Grad Nurses work a LTC/Rehab unit, neither has more than 6 months experience and no one to turn to for help. I've seen it, felt bad for the Nurses and the Patients!