Why do RN's avoid LTC positions?

[amyca]

What are the pros and cons of working as an RN at a LTC facility? It seems as though many RN's avoid LTC positions.

Is it the nature of the job (LTC duties)? Lack of variety? Do hospitals look view LTC experience as unfavorable experience?

I'm pretty new to the nursing world, but am learning that hospital jobs are highly sought after, while LTC facility jobs the ones to avoid. (Not necessarily my opinion, merely an observation.) Just looking for some insight/opinions!

[heartnursing]

I think it all boils down to what your looking for in the nursing profession.

Personally coming into nursing school I always said "I would never work with the elderly"

Little did I know that whether you work in the hospital or LTC a vast majority of the population is with older people as they seek out a lot of health services. Unless you work with kids or NICU or LD

I no longer have that opinion as this program has shown me the reality of health care. I have also learned that elderly dont get as much respect as they deserve in our society.

[PeepnBiscuitsRN]

I am another person who would have to be dragged kicking and screaming into LTC. I would rather chat it up with an elderly person than watch them die, put away in some little room, or left in the hallway slumped in a wheel chair wearing a bib, drooling. Or hear them hollering out, over and over and over and over, while the aide screams at them to shut up. The nursing homes I had to be at for my LPN clinicals were horrible. They were dark, poorly kept, the staff were jerks (both to students and the residents and to each other). And it was depressing to see these poor elderly folks who were once vibrant people who had a life, and raised children and kept a home or job now reduced to drooling, shells. I'm not saying that to be mean, I'm summing up all of my experience in a nursing home from clinicals, and from taking care of the patients that the nursing home dumps off on us- "hey, this little old lady has become more confused from baseline, lets pop her on an ambulance to the ER with no representative and let the ER figure it out." Then they get admitted to our floor with a UTI...and lots of bruises. We treat them, we call their facility to tell them they're ready for discharge- oh really? You don't have a bed for them now? They were gone 2 days? What did you do with their belongings? Throw them out on the lawn?

I realize this doesn't speak to everyone who works in a nursing home. I mean no disrespect to nurses who truly love working in that population and actually treat them like humans and try to keep them interactive instead of putting them in a wheelchair and leaving them in a corner. I guess what really got me was the attitude of the staff at a couple of the places we were at- this was some time ago before I was an RN, so maybe they all did themselves a favor and quit. I was just really put off by the aids who would scream at the residents, and then just sneer. Nobody seemed real happy to be there. I had a co-worker who was an aid at a nursing home who said she witnessed an aid slap a resident, she witnessed another nurse "feeding" a resident by basically jamming the spoon in the person's mouth, while shoving their forehead back. Seriously. I believe it. I hope that the places where you all who work LTC aren't as atrocious as these places were.

[heartnursing]

PeepnBiscuitsRN said:

I am another person who would have to be dragged kicking and screaming into LTC. I would rather chat it up with an elderly person than watch them die, put away in some little room, or left in the hallway slumped in a wheel chair wearing a bib, drooling. Or hear them hollering out, over and over and over and over, while the aide screams at them to shut up. The nursing homes I had to be at for my LPN clinicals were horrible. They were dark, poorly kept, the staff were jerks (both to students and the residents and to each other). And it was depressing to see these poor elderly folks who were once vibrant people who had a life, and raised children and kept a home or job now reduced to drooling, shells. I.

So sad that it has come to this. I worked in a LTC home over the Summer few years back and this was my exact experience..

I remember talking to this one resident who was an avid cook/chef.. now they are forced to eat LTC home food... I could not imagine that

[leslie :-D]

peepnbiscuitsrn said:

I hope that the places where you all who work ltc aren't as atrocious as these places were.

Tragically, I too, hear of many horror stories re ltc facilities.

I remain dumbfounded, that aides or anyone, can get away with telling a pt to "Shut up"...

And slapping them????

That thought makes me regress to being 15yo, and wanting to knock the living **** out of them.

Why this crap is allowed, escapes me but do know there are facilities that still exist, and treat staff/residents like total dirt.

Kind of ironic, considering how ltc is so tightly regulated, isn't it?

heartnursing said:

I remember talking to this one resident who was an avid cook/chef.. now they are forced to eat ltc home food... I could not imagine that

When I worked 3-11, I used to order out a lot.

If I got it delivered, I'd always make sure I got lots of fries, to distribute to those residents who lounged around the nurse's station...

And would give them fries with ketchup on the side.

You would think they had died and gone to heaven.

Other times, I'd pick my food up from the sub shop (right down the street), bundling up one of my residents, and wheeling him/her in their wc.

Dang, these have to be some of my warmest memories...

And it takes so little to make them happy.

Seriously.

At one time, I considered applying as a don in a schleppy facility (to try and evoke positive change)...

But decided I remain too emotional, where I don't think I could handle reports of any type of abuse/neglect, w/o ripping the perp a new one.

That said, I very much appreciate those who believe in treating our elderly with the reverence they so deserve.

They are out there....Just not near enough.

[Cls62011]

I was told by other nurses that once you go into LTC, it's hard to get back out as far as other places hiring you even if you've had previous experience. Don't quote me on this though.

[johnnyarei]

I think that a lot of RNs aspire to work in a hospital setting. As a result, they don't want to work in a LTC setting. Sometimes it can hurt a person more than it helps. Many hospitals do not consider LTC experience as acute experience. When applying for a hospital job, they may not receive experience credit for LTC experience and/or may not even be considered.

[PMFB-RN, RN]

I hardly know anything about LTC nursing. However I do have regular contact with a large number of nursing students and new grad nurses. It cracks me up when I read articals about how supposedly the baby boomers are going to need so many nurses to care for them. One thing I have learned in dealing with many nursing students and new grads is that almost none of them want to take care of old people. When I ask what area of nursing they want to go into I hear L&D, peds, PICU, NICU, ICU, ER. I can't remember ever once having a student or new grad tell me they want to work LTC. This is particularly true for BSN students / grads.

I assume that many of the new nurses will be forced to work LTC in order to find a job and some of those will discover they really like it and stick with it. Others will bide their time in LTC until they can get an acute care job and I bet that lots of those will leave nursing altogether if that acute care job doesn't come along rather than take care of the elderly.

I forget the title but recently here on AN there was an article about the coming need for nurses to care for an aging population and how since nurses tend to work within a few miles of where they went to high school there is a need for more nursing programs in some areas. I laughted to myself thinking "ya but those nurses don't WANT to take care of those old people".

[PMFB-RN, RN]

I can say this. At my hospital LTC experience is considered valid RN experience and an LTC RN with good references is far more likely to get hired than a new grad. Unless of course the new grad has an "in".

[PMFB-RN, RN]

I started right on med/surg/tele after nursing school because that's what everyone in school advised me to do. "Go to med/surg, get good experience, learn all you can there.." Blah blah blah.

*** WOW! what bad advice. Was that a really long time ago or did those advising you really have no clue?

well, I tell ya what I got from med/surg.. Alot of chaos, running around, feeling like I was not providing safe care, not having a second to learn about a medication or procedure, etc.. backstabbing which sucked out most of my energy and spirit, just plain overwhelmed.

*** Yes of course it is. I never advise students to work med-surg unless med-surg is what they want (or know they will have) to do.

[TheCommuter, BSN, RN]

Cls62011 said:

I was told by other nurses that once you go into LTC, it's hard to get back out as far as other places hiring you even if you've had previous experience. Don't quote me on this though.

johnnyarei said:

I think that a lot of RNs aspire to work in a hospital setting. As a result, they don't want to work in a LTC setting. Sometimes it can hurt a person more than it helps. Many hospitals do not consider LTC experience as acute experience. When applying for a hospital job, they may not receive experience credit for LTC experience and/or may not even be considered.

I worked in LTC as an LPN/LVN from 2006 to 2010. I earned my RN license in May 2010 and had gotten hired at two different acute care hospitals (both were med/surg oncology units), but rejected the job offers due to the low pay rate and the foreseeable working conditions.

I have been working at a freestanding rehabilitation hospital for the past year and a half, and I have always maintained a second job in LTC. For some reason, a piece of my heart remains in LTC.

[Music in My Heart]

Reading through most of the posts, I think I can sum it up with the following:

There is no generic "LTC experience." Working at an LTC can be very good or very bad, depending on the organization and its management and ownership. The same can be said for any given acute-care hospital and any floor or unit.

Don't stereotype.

[Cls62011]

PMFB-RN said:

I hardly know anything about LTC nursing. However I do have regular contact with a large number of nursing students and new grad nurses. It cracks me up when I read articals about how supposedly the baby boomers are going to need so many nurses to care for them. One thing I have learned in dealing with many nursing students and new grads is that almost none of them want to take care of old people. When I ask what area of nursing they want to go into I hear L&D, peds, PICU, NICU, ICU, ER. I can't remember ever once having a student or new grad tell me they want to work LTC. This is particularly true for BSN students / grads.

I assume that many of the new nurses will be forced to work LTC in order to find a job and some of those will discover they really like it and stick with it. Others will bide their time in LTC until they can get an acute care job and I bet that lots of those will leave nursing altogether if that acute care job doesn't come along rather than take care of the elderly.

I forget the title but recently here on AN there was an article about the coming need for nurses to care for an aging population and how since nurses tend to work within a few miles of where they went to high school there is a need for more nursing programs in some areas. I laughted to myself thinking "ya but those nurses don't WANT to take care of those old people".

A lot of patients in the hospital though are older patients so I don't think it has to do with taking care of "old people". I think it might have to do with the LTC facilities themselves and lack of funding, etc.