Losing your skills in LTC

[Cubby]

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.

[jkaee]

:angryfire :angryfire :angryfire

I got so angry tonight!! It has to do with this topic, so here it goes.

My mom works in a neurosurgeons office with a nurse that I went to high school with. This nurse is all up in arms because the drs hired some PA's and she found out how much they are making and feels she should be making more, too. So, to force their hand, she put in her notice. She was talking to my mom about it and told her "I'll just get a job in some nursing home and be bored to death, they don't do anything anyway." My mom was like, "Well, I don't know that you'd be bored, but you'd sure make a lot more money." (good for you mom!) I can't believe that some nurses STILL have this view of LTC and their nurses. It is SO frustrating, and if there's one thing that gets me going its that attitude. ARRGGGGRRRHHH!

Okay, just needed to vent to my fellow LTC nurses. Feel better now.

And, Bre, if I could move I'd go down to where you are in a second! I love the south!

Take care everyone!

Jennifer

[CoffeeRTC, BSN, RN]

:) thank jennifer. i like to think that most dons do as i do. at least the ones in my professional organization that i communicate with say they do. and c'mon down to south carolina, got a job for ya. :chuckle as for appreciating me.. some do, some don't.. the grass is always greener, etc etc.. but all in all i have a very caring, responsive group of nurses working with me who have the same goals as i do.. that being to provide the best care for our residents that we can and it takes every one of us to do it.

god bless, bre

i would love to work for a don like you!!

[irishnurse67]

I

[CoffeeRTC, BSN, RN]

This is a old post, but I'd like to respond anyway.

I agree, there are quite a few nurses like that in LTC. IV skills is just one of many. I'll be the first to admit,that I won't try to start a peripheral on most of my pts. First of all, since I'm prn, I don't have the opportunity to keep up my practice on IVs and draws...you don't use it you do kinda loose it. Then its rare that we actually have the supplies needed to start the IVs. Finnally, most of my pts have poor viens or need longer term IVs (more than 3 days). Most of our pts will get midlines...saves money, time and is more comfy in the long run.

Sometimes I will ask the nurse if they can put a line in before they leave or how old the one in is so I can plan for a restart if needed.

Saying we don't know how to do a nursing procedure or just won't is awefull.

Remember too, that not all of those services can be done in the PMs or on weekends...Xray, Lab services and pharmacy.

[johnson0424]

i am so glad u brought this post back up michelle, thanks!!! I love LTC too but it is getting tiring for me. I have been a manger in LTC since 2002 and was at a m/s unit prior to that. I love LTC but the regs are getting so out of hand-at least in maryland...no elderly person(who is on plavix/asa) can have a bruise b/c if they do a whole investigation is under way for it. Now this may be just my facility or my state I dont know. I used to have such great passsion for LTC but do ya'll think an administration can turn you away from your passion? that is what is happening to me. I definately think that you acquire a different skill set in LTC , my assessment skills are keen but i am not so good at IV's anymore like I was when i was in the hospital..i dont know many of the drugs except for the ones we use alot in geriatrics but i think that we are to be the eyes and ears for the md's.

[sharlynn]

Suctioning is another story - yuck - we don't have trachs because our building is older - no wall suction. Oh well, we can't have everything.

We don't have wall suction either, just portable, and we DO have trachs. Our facility is not old. It just looks more like a home than a hospital or LTC!

Sharlynn

[jennyga]

i cant believe i found people who agree with me!!!!

i am in nursing school and all i hear is go to an acute care setting and get all your skills, well, well, well, i worked in a ltc facility since i was 15 and working there is what inspired me to become a nurse, so why the heck would i want to go to an acute care setting when ltc is what i love?? just today at lunch some other students were talking about where they were going to work and they say " i hate ltc, you loose all your skills, you will never see me there, blah blah blah", so i was sitting there thinking well good we dont want you in ltc if you feel that way, please dont come, go to the hospital i know you will do great there, but dont put down something when first of all you dont even have experience enough yet to judge any type of care and still should'nt even if you are an experienced nurse! okay now now i feel much better.

thank you all you skilled wonderful, ltc nurses, you each make a difference in someones life everyday and deserve respect and know that we can all stick together!!!!

[chadash]

Cubby--

I know exactly what you are talking about. I have been in LTC for 9 years now, and ever since I graduated my dad keeps telling me that I need to "get in a hospital" (note, I am married with 3 kids, but he still gives me career advice!) I have always felt (because of other nurses and docs views on LTC nurses) that I needed to get more skills and be a "real nurse". I was offered many acute care jobs, even one in maternity, and worked on a med surg floor for about 8 months once. And guess what....I hated it! Every time I was offered a acute care job, I thought "Now I can get good experience" as if working LTC isn't experience enough. We are all in the fields we chose for a reason, because we all have special skills and qualities that make us good nurses for the critically ill, the laboring mother, the preemie baby, the rehab ortho patient. I, personally, am sick and tired of feeling like I have to apologize for being a LTC nurse, as if I wasn't good enough or motivated enough to get in a hospital. I am sick of hospital nurses (although by no means all nurses that work in acute care) think that I lack assessment skills. I know plenty of hosp nurses that tell me they couldn't do what I do...and it's a whole different set of "skills" that a LTC nurses uses that acute care nurses don't have to possess. We don't rely on machines to tell us when something is wrong, we don't have doctors in house 24/7, we don't have a lab, or a pharmacy on site. We need to be innovative, creative and compassionate with our approaches to resident care. We know our patients better than we know our own families. And our time management skills are to die for, otherwise we'd never get done a med pass for 30-40 patients.

We all have invaluable and exceptional skills, no matter what field we choose to work in. A successful IV stick does not a skilled nurse make.

Jennifer

Geriatric RN extrordinaire :rotfl:

Wow! I think it is just fantastic that you are in LTC because you have the drive to excell in that environment.....

LTC can become what it should be with people like you.

[dawnb70]

I haven't been a nurse for that long (going on 4 yrs.), but I feel that I am using so much of what I learned in school. I change catheters, insert IVs, do blood draws, do trach. care, deal with G or NG tubes/feedings, do wound care for various stages or types of wounds, have residents with central lines or shunts for dialysis, do pacemaker checks, participate in codes, and the list goes on and on. I know there are a lot things that I haven't been exposed to, but I feel that I'm still learning to be a well-rounded nurse. I also feel that working in a LTC has helped me to do a quick and accurate body assessment. Plus, I have really learned a lot about medications. I feel completely safe when doing my med. pass. I have every one of my residents meds. memorized. That's the benefit of having basically the same routine day in and day out. If a family member asks what meds. a resident is on I can recite them off to them, plus give them a list of the side effects. Not to mention that we know our residents diagnoses by heart, and can remember when certain labs or tests were done. I don't think that LTC nurses get enough credit for what we do, and are capable of doing. I even had a nursing instructor tell our nursing class (when I was still in school) that we should never go into LTC because we would lose our nursing skills, and that most hospitals won't hire a nurse that has worked in LTC for too long. It's just unreal the perception that others have of us. I think we all deserve a pat on the back!

[suebird3]

Lose our skills? I thinks we re-invent them at times, or as a previous poster said, put a new twist on them. I have been in LTC for many years, the past 6+ at the same facility. Yeah, my folks tell me to apply at the hospitals now I have my RN. Know what? I don't wanna!

Suebird

[cuetorn]

Hi Rusty,

Where Do You Work In Nm? I Have Lived Here For 1 Year And I Am Already Frustrated With My Ltc Positon, Secondary To The Lack Of Direction And Assistance By Nsg Adm; Not To Mention The Extreme Lack Of Staff.

[AlmostBeth]

Military girl, it is not possible to not get a long term care job. I have always been hired in my interview. They are really desperate. I have worked long term care for 15 years and am an LPN. I agree that getting acute care experience is a good idea. I didn't. I used to think that hospital nurses were better until I had to stay in the hospital. I received poor to negligent care from my nurses and Thank God there were no complications because I would not be here today. Being a good nurse is about knowing your specialty and doing it with integrity.