LTC nurses: Can I hear from you, please?

  1. Hello all ~ I am looking to hear from nurses who are currently working or have a lot of experience in LTC or AL.

    I'd like to use this thread as a place to get to know you a little better & ask questions as I think of them. And maybe get your opinions on jobs down the road, etc... should I choose to head down this path.

    I am beginning the last semester of my ADN program. People have been asking me what I'm going to do ~ and while telling them I'm still not sure, I'm also telling them I think my heart is in LTC.

    I have felt this way since before I started school.

    I had a great experience in clinicals at the nursing home. I know not all facilities are like this one -- I know that, for sure. But it was good. It was smaller. Homey. If my grandmother needed to go somewhere, I would have no qualms about this one.

    I've been in touch with the ADON there, and she's offered to meet with me to discuss LTC vs hospital, as she has had experience in both.

    I have an aunt who has worked her way up in LTC management over the years and is pretty high up, over many facilities. She is encouraging me to head this direction, as well, as I already have an associates in Business Administration. She says LTC needs people and I could move up quickly if I can do a good job and manage a team well.

    I don't have a strong desire to work in a hospital. My local hospital does hire ADN nurses regularly, so it's not that I can't -- it's that I don't necessarily want to. I think I just prefer a different environment.

    I will be almost 40 when I graduate, and I am not dead-set on pursuing my BSN. That would be required to be completed within 5 years at my local hospital. I'm not sure about others. But my kids will be starting college soon, and I'm just not sure if that is the direction I want to head.

    I'm also looking for days. And I know, as a new grad, that is limiting. But I also don't need the benefits, I don't have to be full-time, and I'm cool with PRN days, if that is all I can find.

    One thing I noticed while looking through the threads in this section is that people were saying LTC pays less than hospitals. I have heard the opposite here, from my aunt, as well as from one of my instructors who worked in LTC. My aunt said her company also pays $2/hr more for PRN employees. I'd love to hear thoughts on this. I wonder if it is area-specific.

    Thanks to anyone who responds! I value your experience, for sure. As I currently have none.
  2. Visit 37changes profile page

    About 37changes

    Joined: Nov '16; Posts: 321; Likes: 359

    34 Comments

  3. by   CapeCodMermaid
    My facility....we have close to 200 beds. We do all sorts of IVs, TPN, large bore chest tubes, trachs, IV push meds....you name it, we do it. Not much different than a med surg floor except you have more patients. I started years ago in the business. I went to a hospital based nursing school (I already had a bachelor's in something non nursing). I worked my way up to be the Director of Nursing. I'm now trying to back off because I was on call 24/7 for 13 years. There is always a need for smart nurses in LTC. Even the people on the so called long term floors need nurses with excellent assessment skills since the big focus is on keeping our residents in the facility and not sending them out. IM me if you have specific questions. I've been in the business for years and years and have done it all.
  4. by   Tenebrae
    I've been working in LTC for the last four years.

    Sort of fell into it but have ended up staying because I loved it so much. I have recently made the switch from hospital level to rest home level of care and am really enjoying it.

    So hit me up with any questions, bear in mind though I live and work in New Zealand so my experience may be different from yours
  5. by   CapeCodMermaid
    Tenebrae- I'm happy that you like your job but a rest home is a far cry from a skilled facility.
  6. by   37changes
    I appreciate the conversation! Reading these posts, I'm thinking the nursing home where we did clinicals may be more like rest home instead of skilled facility... there were no IVs... in our time there, there was one poor guy who needed a straight cath, and they had all 10 of us cram in the room so we could "see the experience"... everybody was *for the most part* pretty happy & healthy, from what I could see. And there was an Alzheimer's wing where we visited one day.
  7. by   Tenebrae
    Quote from CapeCodMermaid
    Tenebrae- I'm happy that you like your job but a rest home is a far cry from a skilled facility.
    excuse me!

    How about you take the time to find out about what a rest home nurse involves before jumping to the conclusion I'm a glorifed unskilled paper pusher
  8. by   37changes
    A huge part of why I chose this path is because there are SO many different places you can work, so many directions you can go. I appreciate hearing what it's like in different environments, because I'm certainly not exposed to even half of those options in clinicals.

    I've been focused on getting through school and doing the best I can with that + my family. But the time is coming to pass the exam and move on to the next big chapter. I know myself pretty well, and I'm trying to get a realistic feel for what that might look like. It's one thing to have a picture in your mind, and sometimes quite another to hear the details from those who are living it. I've learned a ton on this site already, and I appreciate those who are here and take the time to respond. You've given me a lot to think about already.
  9. by   CapeCodMermaid
    WOW...I did not say or imply that you are a glorified unskilled paper pusher. I said a rest home is a far cry from a skilled unit. I've been in the business for more than 30 years and I have worked every kind of unit including a rest home, long term unit, and a skilled rehab unit. Each unit is different...the residents are different and their care needs are different.
  10. by   Tenebrae
    Quote from CapeCodMermaid
    WOW...I did not say or imply that you are a glorified unskilled paper pusher. I said a rest home is a far cry from a skilled unit. I've been in the business for more than 30 years and I have worked every kind of unit including a rest home, long term unit, and a skilled rehab unit. Each unit is different...the residents are different and their care needs are different.
    Quote from CapeCodMermaid
    WOW...I did not say or imply that you are a glorified unskilled paper pusher. I said a rest home is a far cry from a skilled unit. I've been in the business for more than 30 years and I have worked every kind of unit including a rest home, long term unit, and a skilled rehab unit. Each unit is different...the residents are different and their care needs are different.
    Good for you.

    Your experience comes from the US no?

    Mine doesnt

    We have an issue here that its very difficult to get people reassessed for the appropriate level of care and as such we end up having to do alot of the same cares I did in hospital units.

    So please, dont assume your rest home experience is the same as rest home experience in the rest of the world
  11. by   greeneyz99
    I am a LPN with 20 plus years experience most all of which has been working LTC /SNF.
    I have learned a lot in this type of Nursing. I enjoy the Residents everywhere I have worked. Nursing has changed so much through the years. A lot of corporations own facilities . I have always been paid well in this field and for a LTC nurse. Presently I am working in Assisted living slightly different then LTC. I feel it's a great way for a Nurse to get a little experience under her belt . I would always recommend working in a hospital . See and do much more. Can always try LTC later on.
    This is not easy work by any means . God bless the nursing assistants. Always treat them respectfully and help when ever you can . Mostly ,as LPN your a medication treatment nurse. RN the same or nurse manager on floor or staff . Can wear many hats. I love working LTC. Go for it.
  12. by   caliotter3
    All of my experience working in LTC facilities convinced me that I could not go back to that environment. One works to support oneself and one's family. Becoming a sacrificial lamb or martyr to the culture that LTC corporate entities insist upon for their bottom line does not predict a long or healthy career in healthcare.
  13. by   kbrn2002
    I've been in LTC my entire career, by choice. For me the benefits far outweighed the negatives. In my region LTC does pay a little less then acute care, however there are many parts of the country where the opposite is true. Most LTC in my area do not offer charge pay or shift differentials, the few that do it's a pretty small amount. It's rare for LTC nurses to be unionized, so don't count on union support to secure raises. Benefits as far as insurance, 401k match, PTO or vacation/sick time are pretty comparable.

    Opportunities for OT are readily available in both settings. Difference there is if you work for a LTC that utilizes mandating OT to fill a hole in the schedule you may end up with more OT than you want. Unlike a hospital you can't pull a nurse from another floor to fill a need. LTC staffing is a challenge almost everywhere. All the LTC facilities in my area do block scheduling. That's a major benefit for me, I really like that I don't ever need to rotate shifts and my schedule never changes.

    The average nurse to pt ratio in LTC is astoundingly high, but it's usually doable with decent time management, a good support staff and management that doesn't micromanage. You will learn excellent time management skills in LTC. You will also gain amazing assessment skills. There is no full time MD in the building so outside of rounds the providers are writing orders strictly based on your assessment.

    Many nurses that enter LTC do so reluctantly and leave as soon as they can land an acute care position. That's unfortunate as far as I'm concerned. The primarily geriatric population we care for is an amazing group of people. Even on the short term rehab end residents are typically there for weeks or months instead of the continual patient turnover you'd get in a hospital so the opportunity to really get to know your people and their families is a very rewarding part of the job. Of course the occasional downside of this is at least in a hospital you know you won't be dealing with the PITA patient or family too long, in LTC there is a real potential of months to years of dealing with a difficult personality.
  14. by   37changes
    Thanks so much for all of the feedback so far. Of course I know there are those who are not cut out for it -- it's just not their thing at all -- but I also know that those people are out there who love it and CHOOSE it.

    Interestingly, my oldest son has a new girlfriend & her mom called to introduce herself the other night. She told me she'd worked in LTC for many years as a healthcare facility administrator ... and we had such a great conversation. She knows a lot about the local facilities, who to talk to, etc.

    It was pretty cool, since this is someone I did not know before and did not seek out in any way. She came to me.

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