I don't want to work in a nursing home...

Nursing Students General Students

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As a student, I have been asked by many people "what field are you interested in working?". My answer is always something along the lines of being very open minded, except I have figured out that I never want to work in a nursing home. People look at me as if I've said something offensive.

Okay, so maybe you're asking why? I find it depressing, monotonous and I cannot see myself spending my career doing ADLs and nothing really "clinical". I really have an urge to be inside the hospitals, performing skills to help those needing acute care. In order to stay open minded, I'm curious to find out why others may desire to work in LTC environments. So, what's the deal?

I kind of have the same feeling you do, but I think my dislike for it comes from a job I tried out when I was a younger.

I was offered an overnight shift working in a home for dementia patients and this was the FIRST job I have ever had that was not retail, so you understand what a new experience it was. When I met with the owner of the home and the day staff everyone was so nice and loving. They spoke to the residents with such respect it was amazing.

I was so excited to start... but when I came in for my overnight shift it was a totally different story. I met some mean and nasty women who wanted to gossip and take their time doing everything. The were SO MEAN to the residents, just the way they spoke to them, yelling at them for messing themselves. They were rough picking them up and rough putting them into a tub. They made shortcuts cleaning dishes, clothes, and rooms.

I was utterly disgusted. I was so afraid of the staff and I was so young that I didn't want to speak up. So after my shift- I never showed up again. I didn't even go back to pick up my check for the 12 hours I did work.

There were times that I have told my experience and have heard some nurses, and others say, "Oh that is the way it is everywhere. People with dementia are like little babies and you have to treat them like babies. They are difficult..." I'm sorry- but I would NEVER speak to any baby the way these women did.

I also found it very depressing that the residents were so lonely. The nurses that night told me about each and every patient we assisted and most of them were just "dumped" there and forgotten. I could not imagine doing that to my grandparents or parents. So I can see how it is depressing...

Because of this experience, I would like to work with in geriatrics. I have realized many older people are lonely and love having company! I would like to provide them with a friendship while helping them, even if they don't understand because of dementia or something similar.

I am a newly licensed LPN in a LTC unit, not the acute side and I need my RN for everything I am not allowed to do. RNs are treasured in my LTC unit :)

I'm with ya, OP.

If given my pick of jobs, I wouldn't choose a nursing home. Frankly, I just don't relate well to elderly people.

That being said, I wouldn't turn down an opportunity for experience. I'm open enough to understand that my views and opinions may change. I mean, just because I have my eyes set on being a CRNA doesn't mean that I won't get in there and change my mind. I'm open to new experiences and settings. I may consider doing a short rotation in LTC just to see what it's like. But I'm not chomping at the bit.

Don't let people feel bad for knowing what you want. For example, I don't particularly like kids. I don't want to have kids, and I would hate L&D/NICU! [When people ask me "When are you and your husband gonna start having kids?" and I reply with "Oh good lord, never!" ... well, that tends to get me some pretty weird looks lol]

Know yourself. Know your strengths and weaknesses. But still be open to the opportunity to change your mind.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Woah!!! Ok, I appreciate the responses from everyone but need to make myself VERY clear. I did say "In order to stay open minded, I'm curious to find out why others may desire to work in LTC environments." I never meant to discredit anyone who works in the field, nor did I have intentions of having judged harshly and prematurely and I don't see how what I said was any different than someone saying "I don't want to work in Oncology" or "I don't see myself working in Pediatrics"; etc.

My message was, not to be harsh, but to take a moment and listen to what you are saying. I think you judged LTC to harshly. I hope that you are aware that more and more grads, even with a BSN, are not finding work in the acute care arena. Your choices in the current job market are limited.

I think you would get the same response if you said oncology nursing was

I find it depressing, monotonous and I cannot see myself spending my career doing ADLs and nothing really "clinical".

Patients in acute care are not the only patients that require acute care. More and more patients are being discharged early and cannot go home. The acuity in LTC/LTAC is more than residential these days. Many facilities are accepting vents, meds, IV's and long term antibiotics...so the face of "nursing homes" is changing.....and so must their staff.

You need to keep your mind and options open. I wish you the best.:loveya:

I have to say that at the beginning of nursing school I felt the same way. I would see my older patients in the hospital and mentally withdraw from them...until that ONE elderly patient. He was a DOLL! Now, I know they aren't all that way, but this one patient was rather old and close to death and that's when I realized, I didn't have a problem with the elderly because it was "boring" and lacked skills to use...far from it! I didn't want to work with them because they forced my own mortality in my face. They forced me to see that I was going to be old one day too, I too was going to die, and all I could do was hope that I had a nurse that was compassionate and would LEARN from me! From that point on I made it a point to talk to my elderly patients, hear what they had to say, listen to their stories...they are an AMAZING group of human beings who more often than not are way better than the 40 somethings that had over stressed over worked lives chasing the almighty dollar. These patients had INSIGHT and man, they wanted SOMEONE to listen to them! I love my older patients now! They remember life when it was a slower pace, when you cared about your neighbor and really, everyone pitched in and worked together, whether it was at work or at home in the neighborhood. I am SEARCHING for an LTAC facility to hire me once I graduate (and yes, there are several other floors that I also consider "dream" jobs)...but I know that I DO want to work with the elderly. Whether I get that elusive full time job there or am lucky enough to grab a per diem spot, that generation is a wealth of wisdom, and they just want someone to listen and care about them. I hope that, if you never want to work with them, at least you learn what JEWELS of human beings they are and what your care can really mean to them.

I did TONS of ADLs as an RN in acute care. It's simpiy not reasonable to expect the CNAs to do every ADL for every patient. It's a team effort, and the RNs, in my experience, tend to not only do assessments, treatments, medications, and interdisciplinary coordination of care, but lots of ADLs as well. Even in the ED, you can't just have a tech go change a patient's bedding or assist someone to the bathroom. The tech will most likely be busy taking a possible TIA to CT, transporting an admit to the floor, starting a line and drawing labs on a person with chest pain, and have a long list of things to do when they're done with that. In many ICUs, they don't even have CNAs. The RNs do total care on their own patients.

So, if it's ADLs you don't like, acute care will most definitely not absolve you of them. In fact, I think that in LTC, there is a more distinct division of labor, where you might need to jump in and help the CNAs at times, and of course they will *love* a nurse who will do that (I did when I was a CNA in LTC) but for the most part, ADLs are assigned to CNAs. As an RN, you will be too busy passing meds, doing treatments, making phone calls, charting, etc.

I get where you are coming from about ADLs. I don't particularly like them, and nursing that is heavy on the ADLs is not the kind of nursing that I want to do. However, I started out doing ADLs as a CNA and learned so much about how to talk to people, how to connect with people, what is most important to people. Helping people with ADLs gave me the foundation to be able to do what I do now, which is heavy on patient teaching. You can't teach a patient a thing until you know how to connect with them, and that is a skill I learned through ADLs.

Edited to add: ANY job will be monotonous at times. It's unavoidable.

Specializes in Forensic Psych.

I'm with ya, OP. While I can't speak to the specifics of what RNs do in every LTC setting (my experience is as a CNA in a nursing home, so it really was all ADLs lol), the environment and population were not my cup of tea. I left completely depressed. I appreciate people who could walk into an atmosphere they find sad and decide, hey, I'm going to commit to making things BETTER with a positive attitude, but I didn't walk away with that passion. Odds are I'll probably end up in some sort of LTC setting, and that's fine, but I'm not going to feel guilty for not being into geriatrics. And maybe I'll change my mind along the way!

I'm with ya, OP.

If given my pick of jobs, I wouldn't choose a nursing home. Frankly, I just don't relate well to elderly people.

That being said, I wouldn't turn down an opportunity for experience. I'm open enough to understand that my views and opinions may change. I mean, just because I have my eyes set on being a CRNA doesn't mean that I won't get in there and change my mind. I'm open to new experiences and settings. I may consider doing a short rotation in LTC just to see what it's like. But I'm not chomping at the bit.

Don't let people feel bad for knowing what you want. For example, I don't particularly like kids. I don't want to have kids, and I would hate L&D/NICU! [When people ask me "When are you and your husband gonna start having kids?" and I reply with "Oh good lord, never!" ... well, that tends to get me some pretty weird looks lol]

Know yourself. Know your strengths and weaknesses. But still be open to the opportunity to change your mind.

I am with you on this. I am not a L&D, OB, peds etc type of gal either. I don't have kids and don't want kids either. Not my cup of tea. I am not interested in LTC either but I certainly love elderly people and caring for them. If a person knows what they want or what they do not want, why is that a bad thing? I don't see that as a bad thing.

Specializes in ICU.

IMO, it takes all sorts. It doesn't bother me when someone knows what they want (or don't want, in this case).

Specializes in Oncology/hematology.
IMO, it takes all sorts. It doesn't bother me when someone knows what they want (or don't want, in this case).

Exactly how I feel. I would never want L&D or peds either, but would be willing to work LTC. To each their own. It takes us all to make it work.

After years as a critical care nurse I took a job at a nursing home. But it advertised itself as "more" than a nursing home to the outside world. Unfortunately, it had no infrastructure in place to fulfill the promises made. No built-in oxygen next to the bed. No built-in suction apparatus next to the bed. We had to scramble to find the portable O2 machines and the (one or two) portable suction machines when, for example, the NP ordered q2h and prn suction.

There were few working defibrillators and no crash cart of course. The place was spread out over a large area so we were running all the time. (How to lose ten pounds in three months without even trying.)

The place insisted upon written charting plus computer charting for the same things. Why?

We were giving patients many, many pills. If one doctor sat down, face-to-face, with each patient and his/her family, at least half of the pills would not be prescribed.

Working in a nursing home is not for everyone. You seem really uncomfortable with the fact you don't want to work in a nursing home environment. Some people look at me like I am heartless when I say I don't like working with children. I'm okay with that although I am not a heartless person. It's okay to want to be in an environment where there is more action and an opportunity to use the most of your skills. You are motivated and have a lot of possibilities that are ahead of you. Personally I like older adults population-wise however I don't want a job with too much routine. We are all okay.

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