Is LTC a good route for getting into Public Health? What other experience would help me?

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Hi there,

I am currently a new RN working on an acute hospital unit. I have been unhappy here since I started, not sure if it is because of my particular unit environment or that I am overwhelmed by acute care. I have been given an opportunity to work LTC, and it has become increasingly appealing to me. One thing I enjoy about LTC is really getting to know your clients and build relationships with them that are a lot different than hospital patients who have a lot of acute needs and are admitted for shorter times. I should stress that I am considering LTC because I genuinely like the idea, and also because I think it would be a less stressful alternative to where I am currently working and unhappy (it's not because I have no other options and am just trying to get hours in before something else comes along).

However, I have a couple reservations. I am worried that I will lose a lot of my acute care skills should I ever decide to go back that way. Also, public or community health is where I would ultimately like to end up, in a few years. Is LTC a good route for getting into public health, or would I be better off sticking in acute care for now (even in a different unit).

As an aside, what is your advice for how to get into public health? Are there certain courses/experience I should try to get in the next couple years that would make me a more appealing candidate?

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No, LTC is not the path to public health, suggest you read the job descriptions for public health nurses to get an idea of the education and experiences that are required or preferred. Stay with acute care and look for volunteer opportunities with a non-profit organization that relates to public health or the community such as; homeless shelters, naloxone, vulnerable adults and seniors, youth and mental health etc. Volunteering and taking public health courses will show your interest and suitability to public health more than working in LTC will.

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Thanks for the feedback. Any public health job descriptions I have seen have been somewhat vague which is why I've been unsure of what kind of experience is best to start out as a new nurse. I thought that LTC might be good because as a nurse in this setting, you develop relationships with clients and are more involved in multi-dimensional aspects of health, such as their social, spiritual and mental health and tying it all together with appropriate resources and consults. While I know that is supposed to happen in acute settings as well, the reality is that you are prioritizing their most acute physical health needs and don't necessarily have time to get into their deeper background. When I think of public health, I think of "looking at the big picture", and I think LTC does that as well.

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Working in LTC is very different from being on a student placement. The RNs I worked with had very little patient contact. Their role was mainly administrative. The aides and LPNs knew the patients far better than the RNs. The RNs had lots of contact with relatives and pharmacy.

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Thanks Fiona. I actually already work casual at the facility I'm interested in taking a position in, and RNs here do provide direct patient care, alongside LPNs. But it's good to know that those types of RN opportunities exist, maybe I would like to pursue this in a few years as well.

I guess to sum up my post, my dream job is in public health. But in the meantime, I'm left unsure what I should do, as I am not enjoying my current acute care job, and I've been given an opportunity for LTC that I'm considering. I'm trying to keep an open mind and be open to different experiences, but at the same time I want to set myself up for a track towards my long term goals.

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What province are you in? What is the role of public health nurses in your province?

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I would rather not specify my province, but I know there are many different roles of public health nurses. I am particularly interested in well-baby clinics and perinatal issues, as well as routine immunization for general population. What are the best ways to prepare for that? I am interested in taking a Masters in Public Health later in life, but don't know that that would really be a route to a public health nurse job.

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If your goal is well baby and perinatal clinics, a resume with postpartum experience would be a better fit than a resume with LTC experience. The postpartum patient population is the same for well baby clinics and postpartum, whereas the LTC population have nothing to do with the well baby clinics. Have you checked with your local public health to find out if there are any volunteer opportunities?

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... I am interested in taking a Masters in Public Health later in life, but don't know that that would really be a route to a public health nurse job.

MPH in Ontario anyway, is something held by administrative roles in public health, or nurses in non-union positions. Not sure if you'd want to go the non-union route. The new Public Health Standards show that public health is moving away from direct patient contact. For example, school nurses will be content experts and resources for teachers, but won't be directly teaching material in the classroom very much.

If I had the same goals, I would go get certified in reprocessing (autoclave etc) as well as IPAC (Infection Prevention and Control). Public Health is now mandated to go into clinical settings operated by licensed professionals when a complaint is made by the public. Usually those that go in are a team of two: one public health inspector and one RN. To be quite honest, the inspectors have no clue what they are doing in a clinical setting as they have never worked in one a day in their life. They have no idea how to use an autoclave in the real world. No idea that some meds come in multi dose vials only, etc. They need nurses who have had experience working in a clinical setting and working/dealing/talking with physicians to help them in this new part of their mandate.

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I started in LTC and am now a generalist PHN Nurse but I don't know that the LTC experience especially helped. I'd say what helped more was that I had my perinatal specialty theory courses, neonatal resuscitation, fetal heart monitoring, breastfeeding course, a little experience doing flu clinics, and a willingness to go rural. LDR, Mom&Babe, & flu clinic experience is preferential if you can get. I'd suggest staying in acute for now and start taking courses towards the above rather than leaving for LTC - which can be hard to transition out of.

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Also, if you're willing to go rural to be a generalist PHN, any experience &/or courses in communcable disease control, opioid addiction/ naloxone administration, travel health & vaccinations, sexual health/ birth control, & routine childhood & adult vaccinations would be helpful. Coursera offers free courses online that could help your resume & show your desire to be in PH if you're on a budget.

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Thank you Frances81! Your input is helpful. I do have a bit of experience in perinatal nursing, as I did a one term specialization in perinatal health and my final practicum in LDRP. It's something I have a bit of experience in, but no jobs available when I graduated. I did some time in general surgery, and have accepted a position in LTC for the time being as it just worked better with my current personal situation. Although I have some perinatal knowledge and experience as a student, I don't know how relevant it would be for PHN jobs down the road, so I will definitely look into coursera options that can help build my credibility and show my commitment and interest to this field.

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