No Respect for LTC nurses?

Specialties Geriatric

Published

I've been in LTC for 14 years. Does anyone else experience the total lack of respect for LTC nurses? Anytime someone finds out I'm an RN, the first question is always "Where do you work?" I always answer with in LTC and almost every time get the same answer.... "Oh". It's like you're not a "real" nurse if you're not working trauma or something. I routinely care for 30 + patients, meds, treatments, documentation, ADL care when short staffed, counselor, social worker, tx nurse, admissions, dietitian, emergency care, etc, etc, etc. Yet what I get is "oh, don't you want to work in the hospital?" It frustrates me to no end. Do people go to the ER and ask them why they don't work in LTC? If my parents were in a nursing home, or myself even, I'd hate to know the nurses taking care of us was doing it "just b/c she couldn't hang with a med surg floor". I get so sick of explaining why I like LTC. I've been a CNA, LPN, RN, and hope to one day be a geriatric NP. But my love will always be LTC. I know people have had bad experiences, and sometimes group all facilities and nurses into a big category, but I'm truly an AWESOME LTC nurse! I even had an instructor in school say LTC was for nurses who couldn't "cut it in the hospital". I briefly went to med surg, and I tell you, other than the fact the computerizd documentation was giving me a fit (used to writing a novel by hand every day), I found it to be a lot less work. (not knocking MS nurses, that would just be doing back what people do to me). I know it's a unique monster all its own. But I've noticed you can say you work in MS, public health, home health, a doctors office, psych, etc, and that's OK. But say you work in "a nursing home" and people look at you like they feel sorry for you??????????

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Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

The general public does not have a clue as to the work a nurse does. Each nursing specialty has a dim idea of what the other specialties do and each is sure their specialty does the most work and is the best.

I have worked in geriatrics, those patients in a sub-acute unit would have been in ICU 20 years ago. LTC includes long term vent patients now, how is that less work? Healing the wounds of a trauma patient so they can go to an acute rehab facility, try that assignment with 8 or 16 other patients in a hospital and the staff will walk out.

Be excited about what you do and educate those that don't understand.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

There's a pecking order in nursing, and LTC tends to be toward the bottom.

Much of this is the result of societal attitudes regarding the elderly. The elderly are not really treasured or glamorized in society, so most people don't become particularly excited when they discover that a nurse works in LTC. In addition, certain aspects of growing old are stigmatized in society. Incontinence, poopy diapers, missing teeth, and 'old lady' body odor are just a few of the unpleasant things that come to mind about LTC.

I work at a nursing home, and the first question people ask is, "Do you have to clean poop and pee?" Very few folks have a clue.

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Specializes in Staff nurse.

Your work is important to the residents, their families, society,their physicians and mostly to God. I worked 8 months in LTC and learned a lot. Don't let anyone make you feel less than what you are, a valued health professional.

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Specializes in Emergency Dept.

There may be some stigma too about nursing homes and the poor care the elderly receive. This has nothing to do with the staff, etc, but the lack of money in the field - being able to properly staff, having the appropriate equipment, etc. That and the fact that nursing homes do tend to hire cheaper (SOME CASES - NOT ALL), so some of the individuals aren't the most qualified.

I know the one poor experience I have had with a nursing home - the woman repeatedly identified herself as my grandmother's nurse. I was so mad about the poor care (waited 4 hours to call an ambulance for her after a fall, of which they said she was completely out of it) By the time the ambulance got there and loaded her up, they thought it was prudent (good ambulance care might I add) to check her blood sugar since she is diabetic. So 4 hours after the first fall and being completley sluggish the entire time - her blood sugar was 32. The 'nurse' hadn't called the ambulance, hadn't checked her blood sugar, hadn't done anything but attempted to make her get up and walk again - where she fell for the second time. In addition to the low blood sugar, she broke her leg - I don't know if it was from the first fall or second. So - I was upset enough to notify the BON - she is not an LPN or RN as she had stated. She was a CNA.

Anyway - the point is, there tend to be a number (as with any field) of poor care givers in long term care. But I have the utmost respect for anyone - CNA, LPN or RN who works long term care and does well at their job. It is not a job I would have the patience or ability to do well. We will always need people with your special skills, talent and ability to take care of this patient population.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I was upset enough to notify the BON - she is not an LPN or RN as she had stated. She was a CNA.
I apologize for digressing, but I merely wanted to point something out. It was illegal for this CNA to represent herself as a 'nurse' without a nursing license of any type.
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STUPID PEOPLE SAY STUPID THINGS

don't take it personally

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Your work is important to the residents, their families, society,their physicians and mostly to God. I worked 8 months in LTC and learned a lot. Don't let anyone make you feel less than what you are, a valued health professional.

Believe me, this is what gets me thru. I've learned when I go to work, I carry myself as if I'm doing work for God. Not just doing "God's work", but like he's my direct supervisor. :lol2: I'm a Christian, and have always felt this is where God wants me. But it is still very frustrating to have to keep "defending" myself. When I'm doing a shift, I am pretty much talking to God all day long. I complain when I'm tired, pray to keep my mouth shut when I'm angry, pray for insight and wisdom with a difficult family member or patient situation, and have MANY times had God ask me to pray for a particular patient (just a short, simple, silent prayer, they usually don't even know I do it) But for whatever reason, He puts them on my heart. It truly is what gets me thru most days. Thanks for reminding me. ;)

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Specializes in Emergency & Trauma/Adult ICU.

If it makes you feel any better, I work in the ER at a Level I trauma center and I sometimes get a similar reaction from people, including some other nurses. "Oh, the things you must see ..." "Don't you ever want to get away from all that?"

My mother told me the other day that she's proud of me & what I'm doing, but she's "curious to see how your career progresses" i.e., she's told me about 50 times about the "pleasant" nurse in her "nice" dermatologist's office. Picking out the praise buried in my mother's criticism's has been a life-long learning process ... but I digress. ;)

I wonder if some part of the reaction you're perceiving is a more general discomfort that many people have with the idea of aging in general -- your specialty is a reminder that each of us will become elderly sooner or later. Most people find it difficult to accept that.

For what it's worth ... have a great day, from an ER nurse. :flowersfo

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Great thread!

I have worked LTC for 15 years. It's amazing how rude people can be when they make statements to you about working in a "nursing home". Just last night I was at dinner at a Japanese restaurant. There were some people at my table that were actually from my home town. One of the women asked me what I did now and when I told her RN she was like "oh?? where do you work" and when I told her LTC her face just dropped like she felt sorry for me. She even asked me if I had ever worked in a real hospital. a real hospital? like my job is fake? geez lol

The truth is I HAVE worked in a real hospital lol. after 6 months I went back to my sad nursing home job lol

I think just like some people are destined to work in trauma or with children...some of us are destined to do LTC. I know I am! and I am darned proud of it too!

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Specializes in ER, ICU, Infusion, peds, informatics.

i encounter this attitude quite a bit, and i'm not a ltc nurse.

i work prn in a sm/md er. there are two not-so-good near-by ltc faciliites that tend to send their patients to our facility when needed.

one of the paramedics that worked for the ambulance company that we use to transport patients back to ltc always said just horrible things about ltc nurses. i used to try to defend those nurses, because i'm sure that he has no idea what you guys do, but he would always cut me off. he had some saying, somewhere along the "those who can, do; those who can't, teach" line of crap (modified for nursing) that he would say when he'd cut me off. thankfully, he moved to a different city so i no longer have to deal with him.

i know that i could never do what you all do. i could never pass meds to so many paitents, or do any of the stuff you have to do with so little resources.

the thing is, there are a lot of bad ltc nurses out there -- like the one another ltc nurse talked about in an earlier thread. unfortunatly, those are the nurses everyone remembers. and though i heartily disagree with the statement that "ltc [is] for nurses who [can't] cut it in the hospital," i think it is easier for not-so-good nurses to work in ltc, just because ltc faciliites tend to be so underfuned and hurting for nurses all the time. they have a harder time getting rid of bad employees.

like another poster said, it is a very sad reflection of how our society treats the elderly.

as far as the facilities near my er, when i take a phone report from some of these nurses that are sending one of their residents to our er, it just amazes me the stuff they don't know about the patient. something as simple as "when was he last dialyzed?" can't be answered (along with "who is his nephrologist?"). i realize that ltc nurses have many patients, but we don't ask these questions because we want to chat -- it is important information.

i don't generalize these experiences to all ltc nurses, becaue i know there are many, many wonderful ltc nurses. i've worked with a few (i worked as a cna when i was in nursing school), and i read stuff that you guys post here. but the nurses that don't care, don't care enough to post stuff here. to them, it is just a job. some just don't seem to "get" that they are dealing with humans.

of course, there are "bad" nurses in every nursing field. ltc isn't alone in that respect. but like another poster said, the public doesn't have any idea what a nurse does, let alone a nurse in a ltc facility.

the job that you guys do isn't easy. in many cases, you are dealing with chronically ill patients, with many comorbidities, with very little funding and resources, and many, many, many rules and regulations (some of which make practically no sense). to those of you who do it well -- you are amazing.

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Thank you for your reply CritterLover. You're right, there are some "bad" LTC nurses. I work with them all the time. Some you wonder how they got thru school. But thanks for realizing we're not all clueless idiots. It never fails that if I have to call EMS for a patient, they look shocked as all get out that I've actually bothered to get VS, O2 sats, blood sugars, whatever. And that I actually can hook up 02 and IV's before they get there. And I can actually tell you what they're diagosises are. I'm sure they've seen it all.

But now there have been times when I've gotten a new patient that goes bad within a few hours of getting there that I probably couldn't tell you when they were last dialyzed or who their nephrologist is without looking it up.

I'll say the worst thing that ever happened to me was I had a patient come in, ambulance dropped him off, 30 minutes later he coded. I haven't even gotten his discharge paperwork yet from the hospital. All the family could tell me was "He got off the ventilator yesterday". Geez.

No, take that back. Had one worse. Ambulance transport (not EMS) brings my new admission in the back door, in full arrest. They were doing CPR and everything, and had every intention of dropping him off in his bed:idea: Because they were transport and not EMS, they couldn't do anything. Even though they were licensed paramedics on their other jobs. I don't know all the liability issues, but the ER was just across the street. Seemed like a better stop in my opinion ;)

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