Don't feel sorry for me because I work in long term care...

Mandychelle79, ASN, RN · Jan 13, 2014

My mom has worked Ltc her entire nursing career, 34 yrs, progressing from cna, to lpn, to rn, to daylight charge, then adon/don roles that she has switched between numerous times. I could never work Ltc, did so for 6 yrs in activities and I know it's not for me. However I work psych which usually gets a similar response.

BSNbeauty, BSN, RN · Jan 13, 2014

Some of my greatest nursing moments was as a long term care nurse. Thank you for what you do and the way you do it!

sugar rush · Jan 13, 2014

Hello Rose,

Congrats on your humble career path. BTW, why does LTC cause RNs to lose their assessment skills would be lost and future employment opportunities outside of LTC would be nil ?

I'm a newbie, so I still cant comprehend your quote.

BuckyBadgerRN, ASN, RN · Jan 13, 2014

Yep, anyone who tells you that you'll lose your skills doesn't know what they're talking about! I'm on the rehab side of a SNF and not a day goes by that I'm not using assessment/critical thinking skills. I get to start lines, draw labs, do trach cares, wound vacs, some really interesting dressing changes and so much more. I talk with RN friends who have "dream jobs" in hospitals. Where there is an IV team, so they don't start lines. There are "wound care nurses" who get to deal with the dressing changes. RT does all of the breathing assessments/treatments. Turns out that the bulk of their day is passing pills sometimes--the very epitome of what so many think SNF nurses do!

SleeepyRN · Jan 13, 2014

I love working in long term care. In nursing school, LTC was touted as being the least desirable job in nursing. Instructors warned students that assessment skills would be lost and future employment opportunities outside of LTC would be nil.
When I proudly attained my first job as an RN, I was surprised at how many people, (lay persons as well as healthcare workers) responded apologetically when I told them my job was at a LTC/SNF. "Everybody has to start somewhere", and "You'll find something better, don't worry" were the typical comments, instead of "Congratulations!".
After two-plus years in LTC, I still love it. While each day presents challenges, each day also brings joyous rewards. I am surrounded by people who have made amazing contributions to society throughout a lifetime. Their generation worked hard to help build our country into a land of promise. There are so many who sacrificed. Brilliant men and women from every walk of life. Women who stepped way outside of societal norms of the day to pursue master's and doctorate degrees. Men with full-ride scholarships who gave up that opportunity to serve in the armed forces. Talented authors, actors, musicians, engineers. The list is endless.
So here they are. These amazing people who have given so much and lived so much and their greatest joy is that I greet them with a smile and a gentle touch on the shoulder and give them a few minutes out of my day. I am humbled to be among such greatness.
I am a registered nurse. I choose to work in this specialty. I applaud all nurses in their chosen specialties. Be proud!
By the way~my assessment skills are just fine!

Working LTC/SN is the most challenging thing I have ever done. It is also the most rewarding. I love my residents. I enjoy them. When I'm having a particularly challenging shift, I make sure I take those moments to enjoy these people we care for. Whenever I care for a resident, I always leave them saying "thank you." Sometimes they say "why are you thanking me? You are the one that helped me." I thank them because they give meaning to my life. I thank them for allowing me to be a part of their life. My mom is a nurse who works for very little pay as the RN and office manager in a doctor's office. When she first graduated, she spent a short amount of time making good money in a hospital. Since I graduated, my mom has been all over me about applying to hospitals. I finally said to her, "Mom, I don't think I WANT to work in a hospital" She's placing her regrets in life on me. I get the chance to get to know my residents and their families (yes, even the ones that drive me nuts sometimes :-) I wouldn't get that in a hospital. I can see myself working in an office as well. I did for a year and a half. I'd go back to it. I currently ENJOY where I'm at. Oh, and I make $3 more an hour than a couple fellow grads of mine that work in the ER of a hospital where I used to work as a PCT.

SleeepyRN · Jan 13, 2014

Yep anyone who tells you that you'll lose your skills doesn't know what they're talking about! I'm on the rehab side of a SNF and not a day goes by that I'm not using assessment/critical thinking skills. I get to start lines, draw labs, do trach cares, wound vacs, some really interesting dressing changes and so much more. I talk with RN friends who have "dream jobs" in hospitals. Where there is an IV team, so they don't start lines. There are "wound care nurses" who get to deal with the dressing changes. RT does all of the breathing assessments/treatments. Turns out that the bulk of their day is passing pills sometimes--the very epitome of what so many think SNF nurses do![/quote']
Ditto that. It's my assessment skills that saves lives. First day off orientation I sent my resident (who was in for rehab) to the ER and it turned out he had a PE. With my assessment skills, I notify the MD and report my findings. For example, the x-ray order that we nurses obtain from the MD because we suspect pneumonia and the following antibiotic therapy that gets started. Losing assessment skills....pffft.

SleeepyRN · Jan 13, 2014

LTC is not what it was even 10 years ago. We are doing things that would never have been entertained in a LTC not so long ago or at the start of my working days as a new nurse.

Exactly. We have higher acuity residents nowadays. And with our assessments, we either send a resident to the ER possibly saving a life, or decide that they can be treated in house because we do higher acuity care than days long ago.

AngelicDarkness · Jan 13, 2014

Congrats OP! I found my assessment skills became stronger in ltc.

Meriwhen, ASN, BSN, MSN, RN · Jan 13, 2014

I love working in long term care. In nursing school, LTC was touted as being the least desirable job in nursing. Instructors warned students that assessment skills would be lost and future employment opportunities outside of LTC would be nil.
When I proudly attained my first job as an RN, I was surprised at how many people, (lay persons as well as healthcare workers) responded apologetically when I told them my job was at a LTC/SNF. "Everybody has to start somewhere", and "You'll find something better, don't worry" were the typical comments, instead of "Congratulations!".
After two-plus years in LTC, I still love it. While each day presents challenges, each day also brings joyous rewards. I am surrounded by people who have made amazing contributions to society throughout a lifetime. Their generation worked hard to help build our country into a land of promise. There are so many who sacrificed. Brilliant men and women from every walk of life. Women who stepped way outside of societal norms of the day to pursue master's and doctorate degrees. Men with full-ride scholarships who gave up that opportunity to serve in the armed forces. Talented authors, actors, musicians, engineers. The list is endless.
So here they are. These amazing people who have given so much and lived so much and their greatest joy is that I greet them with a smile and a gentle touch on the shoulder and give them a few minutes out of my day. I am humbled to be among such greatness.
I am a registered nurse. I choose to work in this specialty. I applaud all nurses in their chosen specialties. Be proud!
By the way~my assessment skills are just fine!

I don't feel sorry for you in the least. If anything, I feel a sense of admiration for you and anyone that works LTC. It's a very tough job in a very tough environment, and it takes a special kind of nurse to hack it there.

motherof3sons · Jan 13, 2014

LTC nurse here and I don't regret one moment since I walked away from acute care. I have 20+ years experience and I have better skills now then when in acute care. When all the administration staff leaves at 4pm and you are the one in charge of 50+ residents, 8 or so CNA's, and dietary....you sharpen your skills to meet the challenge! I love LTC and don't see myself going back to acute care.

It does take someone special to work LTC and I am proud to do it!

ana0715 · Jan 13, 2014

I Agree with you, I have worked in LTC for 6 years now, and yes, there can be stressful moments but there are many good ones also. I have a lot of connections with my residents and they look forward to seeing me to the point where they get upset when I am off or go on vacation. This makes me feel good, cause at least I know I am making them happy or feel good. Enjoy what you do, it doesn't matter where you work or what people say, as long as you feel good about what you are doing. Nothing else matters.

Concerto_in_C, BSN, RN · Jan 13, 2014

I was dismayed by my experience in LTC but it taught me many useful time management habits. After LTC, when I moved to a med-surg unit I was running in circles around seasoned med-surg RNs because I was used to working efficiently and quickly with minimal resources.

A lot depends on your area of interest. Some nurses function best working with chronic cases like chronic wounds-because they enjoy the pace. If that's what they like, they will have a better outcome than sitting in a telemetry unit in a hospital and getting frustrated because telemetry alarms are going off and they don't know what to do.

Good luck.