Hello! I'm an ADN student about to graduate in May and I'm currently looking at job opportunities. I've heard my classmates brag and state that they can't wait to graduate as RN's so they can work in acute care and be able to stay out of SNF's and LTC's. I was wondering if someone could explain the stigma about working in Longterm care or Skilled nursing? I know some people must like it! It feels more and more like Acute care nurses thing they're better than the rest when they seem to be the first ones to burn out.
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?
No, I have NOT noticed this at all in the facility I worked for. Most of the nurses wanted to maintain their skills and did things to be sure they didn't lose them. Being a 'pill passer' (this is actually a little offensive) isn't all we do. Until you are working in a SNF/LTC facility you can't really grasp all we do, it is much more than passing pills. (BTW, passing all those pills really ramps up your pharmacology knowledge :)
And in CT there is no shortage of nurses...hasn't been in close to a decade. We are oversaturated with new nurses. It's not uncommon to hear someone has been looking for a job for 6-12 months.
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"
To add: there are not enough specialty nurses to fill needs and hit the ground running.
In short: there is a experienced nurse "shortage".
I worked in LTC as an assistant supervisor back in 1988. Newish grad and I only lasted 3 mos because it was nothing but burned out nurses and unmotivated CNA's that didn't want to be there. I had enthusiasm but not enough of it nor the experience to turn that train around. I'm glad to hear that it's a different environment now, I love the older folks in home care, and the families working hard to care for them.
Hard to comprehend for some, but there are folks that appreciate and enjoy working with the elderly. They are our mothers & fathers, grandparents, aunts & uncles, neighbors and friends. They deserve the same level of care and compassion (if not more) than any other patient.
And you can read the "Pain Seekers" thread to hear how the acute units are full of drug seekers, and others that desribe the entitled patient trend..I thought those were sure exaggerations as I don't see either in any sort of significant numbers in home care and I doubt in LTC either.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
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...
It's not just LTC/SNF/nursing homes that are stigmatized. Basically, almost any type of nursing specialty that deals with a high proportion of elderly people is viewed as less desirable.
This includes areas such as chronic dialysis, geri-psych, stroke rehabilitation, oncology, ortho, hospice, home health, and so forth. I expanded upon this phenomenon a while back. Click on the link below if you are interested in reading more.
The acute care nurses are better mind-frame is quite insulting to us LTC nurses. Though to be fair, I have nothing to compare it to as I've worked LTC my entire 20 year career. By choice, not for lack of ability to get an acute care position. Just a few reasons why I like LTC:
I really get to know my residents and their families. In some cases where family is nonexistent or lives far away we are their family.
I do use my assessment skills, frequently and well. Think about this, LTC facilities don't have MD's in the building. I can't just page somebody if my resident goes south. I am calling a doctor and that doctor is trusting my assessment skills to give him/her the information needed to write appropriate orders without seeing the patient, a patient they may not have ever seen before.
We also have no allied health team present, we do everything. There is no RT, no IV team, lab techs come in only once a week, so the rest of the time those blood draws are performed by us. Those super complicated wound treatments? Yep, we do those too.
We do however have a great social services department, a registered dietitian, PT/OT/ST and restorative aids for functional maintenance. We also utilize portable x-ray so no need to send somebody out for these procedures, they come to us.
So in short, you bet your booty LTC nurses utilize our nursing skills every day.
There is also the very nice plus of my schedule. It doesn't change. No rotating shifts, I know what days I will have off as far into the future as I need to know. I already have vacation time approved for Christmas this year, easy for me to know what days to ask for and easy for our scheduler to know which shifts need to be covered.
The staff is excellent. Sure there will always be some lousy nurses and CNA's, that's true no matter where you work but they are rare. Not a single nurse I work with is just pushing pills until something better comes along. Management on the other hand...but that's probably also true no matter what setting you work in.
The only real negative to LTC is the pay. I understand in some parts of the country LTC pay is actually better than the hospitals. Well, not around here. I could make considerably more money by going to work at one of the hospitals, so far the added income hasn't lured me away from what I enjoy.
I think this "we vs. them" mentality in nursing originates from a pool of uniformed, small-minded folks.
It's a fact that the fields of medicine/nursing cover an enormously broad scope. No one person, physician or nurse, is capable of "knowing it all" or possessing every imaginable skill needed to treat any and all conditions.
The sad thing is, physicians are taught this and that's why they must specialize in area of medicine. That's why when a physician realizes that a patient's problem is out of his or her scope, they respect the fact that they do not possess the knowledge needed and therefore consult other physicians to join in on the care team of the patient. They actually RESPECT the opinions and input of their colleagues...crazy, isn't it?!? Imagine how ludicrous it would be for a physician to claim to be an expert in primary care, neurology, cardiology, pediatrics, obstetrics and sports medicine, etc.......you get the point.
Yet nurses don't seem to appreciate that we all have different talents, skills, abilites and interests and are all needed in the grand scheme of things. Nurses continue to tear each other down and assume a holier than thou attitude towards nurses they consider to do less meaningful or important work. And then we wonder why we aren't taken more seriously or worthy as professionals.
Maybe one day they'll invent a "head-shrinking" pill.....
The ironic thing is that there are a TON of nurses who have started out in LTC and ogre out if the hospital setting that have experience in having a sense of critical thinking, autonomy, patient education and "desirable acute skills" while not being in an acute care setting; it is such a myth that the acute care setting is the be all end all; I have been in situations where my "out of the box" interventions were appreciated in the acute care setting because the acute care nurse had "no idea" or "never seen" certain aspect of care to the patient.
I do work in acute care now, and O have always been a candidate due to the aspects of my choice outside hospital settings have made me a desirable candidate.
To add: there are not enough specialty nurses to fill needs and hit the ground running.
In short: there is a experienced nurse "shortage".
Completely agree with this sentiment. Nursing school teaches the fundamentals, but it takes most of us a good year or two to even begin to feel confident and capable in our roles.
I have been in situations where my "out of the box" interventions were appreciated in the acute care setting because the acute care nurse had "no idea" or "never seen" certain aspect of care to the patient.
Yes!!!!
I have learned tips for turning patients easier from experienced nursing aides. I have learned tips for safer patient transport from flight teams picking up my patient. I've learned balance tips from physical therapists. I've learned about the behind the scenes process from knowledgeable case workers. I've even learned a handy trick for securing the trash can liners better so they don't fall in when something's thrown away by housekeeping staff.
The key is to have an open mind and realize the benefit that all members of the healthcare team bring to the picture.
And, of course, climb down off that high horse. You don't learn anything new way up there :)
CT Pixie, BSN, RN
3,723 Posts
No, I have NOT noticed this at all in the facility I worked for. Most of the nurses wanted to maintain their skills and did things to be sure they didn't lose them. Being a 'pill passer' (this is actually a little offensive) isn't all we do. Until you are working in a SNF/LTC facility you can't really grasp all we do, it is much more than passing pills. (BTW, passing all those pills really ramps up your pharmacology knowledge :)