Long term care advice/salary

[MeganStar]

Hi all,

I will be pinned as an RN this May, and am thinking about what my future holds. Since day one, I've always wanted to work in an unpopular area of nursing- Long Term Care. My mom worked in long term care for 20 years, and enjoyed it. I have always loved working with the elderly and can't imagine doing anything else.

Now here's the thing: I've heard horror stories about many LTC facilities. I've heard that the nurse to patient ratio can be as high as 40:1. I hear that many LTC facilities treat their nurses...not so well. For those who have worked in LTC, what is your advice?

I know that I will "scope out" any facilities that I would want to work in... to monitor working conditions, nurse to patient ratio, and overall well being of the residents.

Also, one more question... Salary. Is there a certain reason why LTC nurses typically don't get paid as well as other nurses? Are LTC nurses not as highly respected?

Thanks in advance

[vintagemother, BSN, CNA, LVN, RN]

What state are you in? In my area, SNFs pay less because (I think) the pay is tied to Medicare rates and those aren't the same as acute hospital rates. Many SNFs may also be run by a for profit corporation, as well. If you're talking about ALFs, the pay in those is low because the only pay is private from the Pts themselves.

LTC used to be for the not so ill people, which may also be why the pay is lower than hospital. But over time, the acuity in SNFs and ALFs has increased because people live longer with many comorbidities. Pay has not increased at the same time that acuity has gone up.

[MeganStar]

What state are you in? In my area, SNFs pay less because (I think) the pay is tied to Medicare rates and those aren't the same as acute hospital rates. Many SNFs may also be run by a for profit corporation, as well. If you're talking about ALFs, the pay in those is low because the only pay is private from the Pts themselves.

LTC used to be for the not so ill people, which may also be why the pay is lower than hospital. But over time, the acuity in SNFs and ALFs has increased because people live longer with many comorbidities. Pay has not increased at the same time that acuity has gone up.

That does make a lot of sense. I hadn't thought about Medicare playing a part in nurses salaries. It's scary to think about the level of acuity going up in SNF's. One would believe that if the level of acuity increases, the nurse to pt ratio would decrease, or the salary would increase. But it doesn't sound like either of those is the case. I hope I am fortunate finding a job at a SNF that isn't filled with these problems, but those are apparently few and far between.

I live in Colorado, and will probably be moving to the Denver area after I finish school. I've scoped out the job market and it seems decent, however as a new grad, it could take me quite some time to land my first job.