Help me understand the stigma Acute Care Vs. "The Rest of Them"

jadelpn, LPN, EMT-B · Feb 12, 2015

There are many, many different areas of nursing. Some enjoy one thing over something else. There are nurses who can't imagine doing anything but long term care, and love it.

I think that your bragging classmates may find that in acute care, a BSN may be required....

SNBTaylor · Feb 12, 2015

Trust me! They're already signed up for their online RN-BSN completion programs.

What do you think drives people into the longterm care field?

TheCommuter, BSN, RN · Feb 12, 2015

LTC/nursing home settings are stigmatized in the healthcare community because of the patient populations they serve. Bluntly put, the frail elderly are very devalued by US society, which results in LTC's dubious status as a 'low value' workplace setting.

Meanwhile, infants, children and younger adults are highly vauled. Hence, specialties such as pediatrics, L&D, antepartum, emergency nursing, NICU, PICU, postpartum, sports rehabilitation, reproductive medicine, aesthetic plastic surgery, and trauma ICU are assigned a high value in the healthcare community.

AJJKRN · Feb 12, 2015

I honestly don't think I could handle LTC as a nurse because I worked it as a CNA. While acute care is also really busy with high acuities, even if the patient to nurse ratios are overwhelming it just doesn't seem to compare to LTC ratios. I don't know how the nurses in LTC pull it off every shift honestly, kudos to you all!

CT Pixie, BSN, RN · Feb 12, 2015

I've worked with the geriatric population in one form or another since I was 16 years old. I absolutely love working with this age group. Some people just don't like working with this population. What's funny is, the majority of hospital patients ARE in the age group, so they end up working with them anyway.

I've done work as a medical receptionist, CNA and LPN and RN in LTC/SNF. Most days I loved my job. The nursing home of 1985 (when I started) vs the nursing home of present day is very different. In my earlier years, the LTC/SNF had patients that were chronic but stable. Now, the patients are a higher acuity. Not 'sick' enough to remain in the hospital but way too sick to be home. My unit was much like a med/surg unit with the types of patients I had. Many people think you would waste your assessment skills etc working at LTC but I'm here to tell you...no way. I can do a great head to toe assessment in very little time on anyone now.

Many are worried they will lose their skills in LTC/ SNF. But in all honesty, I have used more of my skills in that setting than I do in my current acute care postion in the hospital. I've had to show my preceptor how to do things that were routine in my position in LTC. These are things that she learned about but had never experienced as a student during clinicals or working RN on our floor.

I had 32 patients every shift in LTC. I learned time management really quickly. Huge med passes along with tons of treatments...I can do without batting an eye. Charting on 1/2 those patients..no problem. I liked having the same patients every time I worked. It was easier to build a relationship with them, they tended to trust you b/c you were that familiar face. In acute care, you have that patient maybe for 1 or 2 shifts, leaves little time to really get to know the person, their baseline etc.

LTC isn't everyones cup of tea, but that does not mean that LTC is 'below' acute care.

DUDERNGUY, BSN, MSN · Feb 12, 2015

No matter where you work the job is going to be pretty ****. thank the over supply of nurses. It is no longer the great profession it once was and now tries to be.

SNBTaylor · Feb 12, 2015

Wow... I never really though about it that way! I've always though our society were pretty good to our elderly! In some other cultures once grandma is yelling and screaming and fully demented they just let her out to pasture to pass on... But here in America at 93 years of age you get a free knee replacement and all the Percocet you can swallow! (I'm completely kidding).

But now that you put it that way I guess it does make sense... we put the value of the nurse on the value of the patient that they serve...

Thank you SO much! that really opened up my mind about some things.

SNBTaylor · Feb 12, 2015

Thank you for opening my eyes to that... The SNF's really do have it rough! 32 patients to be responsible for compared to 5? THAT'S INSANITY! But I fear at most LTC's and SNF's some nurses just become content with being "pill passers" and in a way give up on wanting to maintain their skills as now they are just there for the paycheck. Do you notice this as well?

SNBTaylor · Feb 12, 2015

Why do you say over supply of nurses? I thought there was supposed to be a shortage? and it always seems like some SNF or hospital is hiring?!

I'm kind of confused by your statement?

happyinmyheart · Feb 12, 2015

Why do you say over supply of nurses? I thought there was supposed to be a shortage? and it always seems like some SNF or hospital is hiring?!
I'm kind of confused by your statement?

There is an over supply of nurses in many areas of the United States. It really depends on where you live- so it's possible you live in the "in demand area". However, many places (Ex. California) have a severe over supply of nurses. Where I live, it is near impossible for a new graduate nurse to find a job (especially if you do not have your BSN). I suggest using the search bar on AllNurses and typing in "nursing shortage". After you read some of the threads you will definitely understand how there are way too many new grads and not enough jobs. There is no "nursing shortage"

mmc51264, BSN, MSN, RN · Feb 12, 2015

My first job was in a LTC rehab unit. I loved the population on my side and the LTC side. The problem with LTC is staffing. I had 20 beds on my unit and if I was lucky, I would get one aide, sometimes 2. These were post-op joint replacements or hip repairs. Almost all were +1 assist. being the on;y nurse, it is very overwhelming. In an 8 hour shift, there is just enough time to pass meds, assist w/toileting, chart a little, 2nd med pass w/toileting and then final charting. heaven forbid something goes sideways. I the whole facility, there might be 3 LPN, 2 RN and 4 aides. Not much help in a crisis. You learn time management REALLY quickly. I had to drive a long distance and I had an opportunity for my dream job. I did not leave because I didn't like it, I left for a once in a lifetime opportunity.