Losing your skills in LTC

Specialties Geriatric

Published

I hear frequently on this BB, other BBs, Nursing magazines and other Nurse friends that "If you go into LTC you loose all of your skills" This is so untrue, it makes my blood boil.

I know that we do not HAVE to do alot of the procedures that Nurses in Acute care settings are asked to do, but there are alot of human skills that we have to have in abundance to succeed in LTC.

I did not go into Nursing to become a LTC Nurse. I did go into Nursing to help anyone and at every chance I could. Geriatrics gives me that opportunity. We don't just treat the ill, the infirmed. We have to see the big picture. My residents are not just sick and in the hospital. They are dying. And I take a great honor in being able to help them and their families prepare for this finality. I get to know these people as human, I know their children, their grandchildren, even their dogs/fish. The staff of a LTC facility are often the only family these forgotten souls have. I take great pride in being a LONG TERM CARE NURSE. And there is nothing lacking about my skills, there are different thats all.

Very well put Jennifer :)

i have to agree with frazzledrn.....very well put. i've worked icu, med surg, oncology, hospice and now ltc, with the focus/subspecialty on hospice. we're a small facility, 80 beds. my particular floor sometimes feels like an er since half of my pts. are dnh's and are treated at the facility. we treat cancer patients, trach and frail 90 y.o.'s with central lines because their children cannot let go. and it's so true that we exemplify the nursing process at its' finest, especially our assessment skills. more times than not, these pts. do not present with your typical s/s, and will usually start manifesting s/s when a process is in its' advanced stages. treating the geriatric population presents itself with its' own unique set of challenges and i for one, honor every one of these people and want to ensure that when they are sick or at the end of their life, there will be a very skilled nurse who will understand their very unique physiological and psychosocial requirements.

It is not just you LTC nurses who hear "You're gonna lose all your skills" , I have been in OB for 3 years now and worked LTC for 2 years before that. I hear all the time that I should float to the other units in my hosp. (med/surg and ICU) or I am gonna lose all my skills, this is usually form one particular RN on the ms floor, and it drives me nuts, no I shouldn't float over there, for one thing I HATE it and that is not good for anyone the pts, my coworkers or me, and another thing is like some one else pointed out it is a whole different set of skills used to work Ob, Not worse or lacking but different, just like nurses who work in ER, ICU, Ortho, LTC ect each specialty area has different skills. That is WHY there are specialty areas.

I use my skills in LTC, I also work on a skilled unit but I still use all of the skills that I learned in school. Suctioning, catheters, trachs, etc. But I have learned one new skill since graduating and that is the skill of time management. I am the only nurse on the floor for 22 residents, I am responsible for 2 CNAs and a float CNA and a non-certified and I usually have to be in three different places all at the same time. It can get very stressful in LTC but I'd rather do that anyday than work in acute care/hospital setting.

Anyone who feels that nurses in LTC are in danger of 'losing their nursing skills' has not worked in LTC. If anything, the LTC nurses have a more well-rounded practice than nurses working in other sub-specialties. Think about it...we have cardiac, pulmonary, renal, GI, oncology, psych, etc., etc, all under one roof. We have to multi-task like no other 'specialty' does. We have to have an all-around knowledge base to deal with any potential problem that these residents could possibly present. LTC IS 'acute' care nursing if it is anything else. As for the comment someone made in one of the earlier replies that 'these folks are dying,' I have to disagree. Some LTC residents may live 10-15 years in a nursing facility and this is their HOME. As a DON, I encourage my charge nurses to feel empowered to not only make suggestions, but to present me with solutions for how to implement any improvements they think will improve work performance or patient care. It is vitally important that the charge nurses feel that they are exactly that....in charge. LPN's have much more freedom to act autonomously in the LTC setting as well. They shouldn't have to feel that every decision to be made has to be run through the nursing administration. Suggest that your facility have standing orders if it doesn't have them already. Request a meeting or inservice with your DON and Medical Director, if possible, to open a discussion about how the LPN's can be given more decision making abilities. The physicians are funny about some things. Some get perturbed with every phone call you make to them, no matter how serious the situation. Others want to be called for the slightest thing. Determine what your MD's want and set into motion a program for what your docs want. They would love for you to make their life a little easier too.

Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.

I'm in charge of 70 residents who are only seen by a doctor every sixty days. He's not there to recognize problems when they are just beginning. It's all left up to me. Lose my skills? I'd better not!

Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.

I'm in charge of 70 residents who are only seen by a doctor every sixty days. He's not there to recognize problems when they are just beginning. It's all left up to me. Lose my skills? I'd better not!

I'm in charge of 70 residents who are only seen by a doctor every sixty days. He's not there to recognize problems when they are just beginning. It's all left up to me. Lose my skills? I'd better not!

GREEEEAAAAAATTT point sharylynn, absolutely great. as one md told me, we are their eyes and ears. you go girl.

I'm in charge of 70 residents who are only seen by a doctor every sixty days. He's not there to recognize problems when they are just beginning. It's all left up to me. Lose my skills? I'd better not!

GREEEEAAAAAATTT point sharylynn, absolutely great. as one md told me, we are their eyes and ears. you go girl.

Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

I am so happy to hear of so many nurses who, like me, love geriatrics and LTC. I have worked everywhere...ER, ICU, House Supervisor in Acute Care, Med/Surg, Pediatrics...and more, but I always come back to LTC. I appreciate so much hearing nurses say that they get to know their patients as HUMANS and that they become "family". It really does my heart good! I am considering a position as Director of Nursing in LTC...I hope I can instill in my staff (if I decide to take the job)..to not be afraid of getting close to their patients, to treat them like they would want to be treated, or have a member of their family treated. Long term care can be viewed as the same thing "over and over"...but the poeple are not the same everyday. There are days when I too want to be the "Wal-mart greeter"...but then one of my patients takes my hand and thanks me for just being there...that's what it's all about.

Specializes in Registered Nurse.

i think it depends on what skills you want to be proficient at. some kind of jobs are better (but not exclusive) for some kinds of skills. i worked hospital the most number of years. the skills i use there are not always the same as the skills i use in ltc. but the skills i use in ltc are not nothing either. as a new unit manager, i am learning more about managing and supervising, which is new to me. i didn't do that in the hospital. i was not responsibile for so many people there....patient/residents and staff included.

undefined :) :)

i think it depends on what skills you want to be proficient at. some kind of jobs are better (but not exclusive) for some kinds of skills. i worked hospital the most number of years. the skills i use there are not always the same as the skills i use in ltc. but the skills i use in ltc are not nothing either. as a new unit manager, i learning more about managing and supervising, which is new to me. i didn't do that in the hospital. i was not responsibile for so many people there....patient/residents and staff included.

:) very true and well put!

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