leaving office for ltc


Hello all! this is my first post, so hi and thanks for reading!

I haved worked in a pulmonology doctor's office for about 7 months since I graduated lpn school. It's a great place, everyone is nice and it's super-cushy! I thought it would be a great job for a new nurse, but now I am so bored! I don't feel like a nurse, I don't do any skills, just answer the phone and chart all day. I take care of a physician not patients!

So I applied for a position at a local LTC, it's a night position (10p-6a) (I used to work nights as an aid at the hospital and loved it), they have med techs come in a 6a so I don't even have to do a med pass (just prns throughout the night), they pay alot more, which I need, and they offer good benefits and will help pay for RN school if I go. It sounds great to me, but I'm still worried, I will be responsible for 50-55 pts with 3 aides. I think I can do it, but after reading/hearing how hard lpns have it in LTC, I am worried that I am leaving a stable job for something I might reget.

Any comments/advice???

CT Pixie, BSN, RN

3,723 Posts

Has 10 years experience.

I've worked in LTC since the day I found out I passed my NCLEX (2 yrs ago). Let me just say..it takes a special kind of crazy to work LTC :)

50-55 patients with or without a med tech (and ONLY 3 CNA's??), even on the 10p-6a shift..sounds a bit too much to me. I work 3-11p,no med tech, have 3 CNA's and 32 pts. Our night shift, same amount of pts, 1 LPN, no med tech, and 2 CNA's.

As a new LPN, I don't think I could have done 50-55..even with the med tech (our 11p-7a shift doesn't have many meds to pass anyway). I'd think long and hard about going from the office to LTC with that many residents, that few CNA's. Just my two cents.

Even with them helping pay for your RN schooling, you will probably be locked into that company for X amount of time, in order to "pay" them back for funding your education. I, personally, will not get stuck in one place like that.


183 Posts

I agree with CT.... about thinking long and hard before you leave a job that you describe as "cushy" and that you so obviously like for LTC!

While I have seen several folks on this board post about loving LTC and the places they are employed, that was certainly not my experience. I have tried two LTC facilities and quit both of them. Now I sit here unemployed because that seems to be the only thing in my area that is hiring unfortunately. I personally have no intention of ever working in LTC again. If that is all I can do as an LPN... count me out lol!

I have begun pre-req classes to eventually finish my RN. I hope that something will eventually come along so that I can work part-time and also go to school. I am waiting now to hear about a part-time state position in Adult Mental Health that I applied for. I interviewed a few days ago for it. Until then guess I will continue working in my yard... one thing is for sure... it is looking great if nothing else lol.

Good luck to you in whatever you decide to do and have a great evening!

pagandeva2000, LPN

7,984 Posts

Specializes in Community Health, Med-Surg, Home Health.

I am also a clinic nurse. I work in a hospital OB/GYN clinic. Previously, I worked at the same facility as a Patient Care Associate (also working in the clinics), and my job sponsored my education to become an LPN by providing a leave of absence with full salary and tuition paid. I was under the impression that after paying all of that money towards my education and leave of absence, that upon graduation, they would make me pay my nursing dues by placing me in inpatient, however, my supervisor wanted me to remain in the clinic because they really liked me. It was a requirement for new grads to work 2 months in med-surg no matter what the actual assignment was to be.

I can honestly say that the first week in med-surg showed me that this is where I did not wish to be. It was extremely chaotic, disorganized and we had no real support. I did my 'bid' and ran on the first thing smoking back to the clinics. I did, however, know that having inpatient experience was important, so, what I did after a year or so, is signed up for one of the agencies my hospital uses to work med-surg per diem on alternate weekends. I had a two day orientation, and off to the races I went. I did it for close to a year, and added it to my resume. No one had to know that I only did it on a bi-weekly basis. I have been on interviews since (didn't accept the positions, though), was that because I knew that med-surg experience was important, I worked every weekend in-patient to gain experience, and it was looked upon with favor. I had that chance to do suctioning, tube feedings, a few dressings, hang IV bags, mix meds, etc...and got that out of my system. This is not to say that there is no pride in bedside nursing at all. I wish that circumstances were better for it, but it's not. It is not humane to the nurse or the patients to have 50 patients assigned to one LPN and hold them to the same standards as if you were taking care of two. I fail to see how any administration can believe this is humanly possible to render excellent care and attention under such circumstances.

I suggest that you do a similar thing...if you can obtain a per diem or part time position in LTC, even if it is just to get a chance to see what you are 'missing', fine. If you wind up falling in love with it, great. I do agree with the previous posters, though, that you may not be that impressed with it because of all of that pressure. If you get to a good nursing home where there is a supportive administration and the workload or even the teamwork is exceptional, then, I would be very happy for that lucky nurse. But, don't leave the cushion for the thorn of nails unless you have no choices.


343 Posts

Specializes in Geriatrics.

I think you should try working in the LTC prn just so you'll get a feel of how it is before you fully comment yourself

Specializes in Pulmonology Clinic. Has 2 years experience.

Thank you all for your replies!

pagandeva2000, LPN

7,984 Posts

Specializes in Community Health, Med-Surg, Home Health.
I think you should try working in the LTC prn just so you'll get a feel of how it is before you fully comment yourself

YES...try it per diem to see if you can handle it first before you leap into the unknown.


295 Posts

Specializes in LTC, office. Has 19 years experience.

I worked nights in LTC for seven years before leaving to work in a clinic; ten years later and I have never looked back. The small cut in pay was minor compared to the nice working conditions and hours of an office.

I work for a surgeon and we do procedures in the office, so it's a bit more nursing and patient care than some office nurse positions. I hear you; the paperwork is intense!

I agree to try the LTC prn before you make a decision if at all possible.

Specializes in Pulmonology Clinic. Has 2 years experience.

Well---just an update---I made a rash decision and just had the worst morning of my nursing career. I went ahead and took the LTC job because of the $ and everything...after 2 nights of orientation I came home with my stomache in knots. All the things I read about on here 50:1 ration and just the vastly different atmosphere is horrible. I cried all morning, and went to my former supervisor and asked if there was anyway I could get my job back...the amazing thing is she said with a smile that "for me there's a word in front of yes!" the physician I worked for told me he wanted me back and all my friends in the office said it was a blessing and that they didn't blame me for being curious about other avenues. I can't believe how great a place it is.

The issue now is that I have to go through the whole new hire process so it will be a couple of weeks before I can actually start back. My husband is frustrated with me because I took this big leap and then did a 180 and if I don't go back to the nursing home it will take a hit on our bank account. Also, even though I never want to leave the clinic again, I am worried about how just quitting will affect me, I read about nurses doing it all the time on here, but still.

Thanks for listening! I've learned my lesson---work atmosphere and good patient care is more important than money!


183 Posts

Tell your husband to try working a couple of days in the LTC and then see what he thinks about it. Yes it IS more money and there is certainly a REASON why that is the case. You are VERY lucky to get your old job back. Just look at the "hit" on the bank account as a lesson well learned. I am sorry it turned out badly for you, but I am not surprised in the least. It is the reason why after trying two LTC facilities I will NOT work in another one. I have talked to enough folks and read enough on here to pretty much surmise they are for the most part all the same.

I start a new job in a methadone clinic Monday. I hope this is somewhere I will be able to hang my hat for a while. I have been unemployed since I left that last LTC at the end of April. But like I said in previous posts.. if ALL I can do as a LPN is LTC.. you can count me out!

Have a great evening and good luck to you!

Nurse Fee Fee

39 Posts

Specializes in all but OB and Peds.

I wish i would have posted before I took an LTC Rehab position......I took because of the 3 day a week hours and the pay but lawd lawd lawd....I am willing to take a decrease, I don't think it's gonna work out for me there...Truly not happy


38,333 Posts

Yes, you are leaving a stable job for something you might regret. You should try this job out part time for a good look-see before you commit yourself.