Long-Term Care Nursing: A Specialty In Its Own Right


Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

Barbara, a nurse at a long-term care facility, says, "I've been working in this industry for 30 years." She adds, "I enjoy having the same residents day after day." The purpose of this article is to discuss long-term care nursing, which is a specialty in its own right. You are reading page 2 of Long-Term Care Nursing: A Specialty In Its Own Right. If you want to start from the beginning Go to First Page.


I just graduated from a (LVN) program and I'm really intrested in working in LTC. I really enjoyed my clinicals when I was there.. I take my nclex july 5th. What I want to know is do you have any LTC suggestions? Do know of anyone that will hire a GVN or a new graduate? I would greatly appreicate any advice you could give me. I live in Garland texas area..Thanks! :o

Edited by nursetoi
forgot to add some info

Long-term care facilities are indeed unique. While I understand that many nurses may justify their attitudes of discrimination by categorizing long-term care nurses as something less desirable, I beg to differ. My grandmother spent the last 6 months of her life in an LTCF, and trust me, it wouldn't have been her cognizant choice. Caring for these people in my opinion is an honor and a privilege. They have lived full, meaningful lives and have earned the right to be treated with respect and dignity. Coordinating the care of these folks has to be challenging, because it requires a nurse's time and attention to know what the norm is for these folk and then to identify when they are in an "off" state to seek the appropriate services to get them back on par. And that does not include the communication with family members. I am sure there are hundreds of aspects to the job that I am not aware. But as an ordinary citizen having seen the stresses and workload that these people handle on a day-to-day basis, I have nothing but the utmost respect for the LTC nurses. My mom is getting up there in age, and luckily is still able to handle her affairs. When it gets to the point that our family can no longer care for her, my wish is that she will be taken care of by a person who not only values themselves and what they do, but also values my mom for the independent strong person she is. I don't believe it is healthy for the RN or the patients if the RN is there because it may be the only job in town at the moment in time. LTC nursing is a calling and is not for everyone, but it does not make it any less important than a job in an ICU or other acute care setting. And for those of you who are LTC nurses and reading this, know that there are us out here who are very thankful for the part you play in this circle of life.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

And for those of you who are LTC nurses and reading this, know that there are us out here who are very thankful for the part you play in this circle of life.
Thank you for your wonderful, appreciative post! I've worked in LTC since graduating from school more than six years ago and I feel that it is one of the most underrated areas of nursing practice in existence.

It should be an honor and a privilege to positively touch the lives of our residents during their final years on this earth.

adventure780, BSN, MSN, RN, APN

Specializes in Geriatrics/family medicine. Has 5 years experience.

Thanks for this article! My first few months of nursing were in acute care. The job didn't work out since I was a new nurse floating around aimlessly in a pool of sharks. They advised me to try long term care. I got a job at a nursing a few weeks later. Last October, my Mom had surgery. I was visiting her in the hospital and my sister told them I was a nurse. They asked me where I worked and I said a nursing home. They gave me that look. I felt hurt but I couldn't change the fact that I worked in long term care and not acute care like those nurses. She said you guys probably don't have phones where the doctors can call you on them at the nursing home. I was like no we don't have them.

In fact we take turns racing to the desk to grab the phones. Hey at least I get my exercise in! This article boosted my spirits. A nurse is a nurse no matter where they work!:bowingpur

adventure780, BSN, MSN, RN, APN

Specializes in Geriatrics/family medicine. Has 5 years experience.

I may be in the minority, but I WANT to work in LTC. I was a physical therapist tech at a nursing home and there is nothing better than seeing a CVA come in who can hardly move and watch him literally walk out the door and shake your hand. He was SO PROUD of himself too! It's just INCREDIBLE!!!

I'm still taking pre-reqs right now, but my plan is to work in LTC.

good for you!

artsmom, BSN, LPN

Has 16 years experience.

I worked in LTC for 6 years as an LPN. Then I became an RN and wanted to immediately leave for the more glorious hospital job. Ha! I was an idiot. Yes, I have to do more critical thinking to take care of my hospital patients, but damn if you don't work 10x harder as an LTC nurse. In LTC you have to think about everything, not just current medically critical information. When I hear the hospital RN's talk about leaving to work in the easier LTC, I just think to myself- let them go, they have no clue, and I know half of them wouldn't make it. I still work per diem there and often think about going back full time. I like the continuity of patients, and collaborating mainly with one doctor that is fairly liberal with you once trust is established.

It is a special place to work that requires very hard working, dedicated nurses to make it all flow.

We must all appreciate the LTC nurses ....

An assisted living community is a good choice, but it's not for everyone. I think it's perfect for seniors who are looking to enjoy an independent lifestyle, while also having access to more living support.

Before choosing any facility, I think it's important to consider the needs and preference of the seniors..

And no doubt that the nurses are providing their services very passionately..... But i must say that the nurses that are offering their services in the LTC centers are much more appreciated...

adventure780, BSN, MSN, RN, APN

Specializes in Geriatrics/family medicine. Has 5 years experience.

Every time a patient or family member smiles or says a kind word to me I feel like i did something good that day. For all my moody residents who are upset about their current situations, I take it as a challenge to help them adjust to the setting for as long as they will have to be there whether it's long term or short term. My one resident gets upset easily with staff members i try to be patient with her and even when I am behind try to say a few encouraging words before moving on with my med pass.


Has 15 years experience.

I just want to add my 2 cents. I've been a nurse for 17 yrs, 5 as Lpn and the remainder, RN. I have worked virtually everywhere. I finally decided to return to LTC for numerous reasons, not the least of which is the unprofessional way acute care nurses care for their patients and each other when under stress. Unreal people. The ED was the worst. I quit after a year when I saw what a meat market it was. Also did ICU, med-surg. I believe I made a real difference everywhere I worked. Very passionate about giving evidenced based care, listening, and if necessary, hectoring MD's to get results. I am confident, not pushy, and decided LTC would be nice. So, I support all the LTC nurses I ran away from so quickly 12 years ago.

Now, I am hoping to get some certification so I can move up the chain in my facility as we are woefully outdated in our policies and procedures. But, we give awesome care. I love the interactions with most of my patients. They can be so sweet, even when they are trying to be nasty, its kind of fun, but mostly they want some control. Many have lived long productive lives and find their situations difficult to transition to. I totally get that and am very supportive. I know I sound like Florence Nightingale or something, but I'm not and I know it. I have my faults too. I don't like to make people accountable, it makes me uncomfortable. I recently stepped down from an Acting management position because of long-timers still practicing 1970's era medicine. So, really, I am looking for advice on advanced creditation. I avoided these programs for Med-surg, I.V. therapy, and others for reasons too numerous to mention here.

Does anyone have any suggestions on really good programs for certification. I want to learn what IS correct, what IS necessary as far as compliance is concerned because I can't trust the info the old-timers are giving me. They have their own strengths, but in my facility, they consider me a thorn because I don't believe certain practices are nursing judgements, I don't believe the redundant paperwork is necessary. I want us to move into this century and don't have a mentor. Any advice on certification programs would be greatly appreciated. I esp. need to know about state regs, compliance issues, F-tags. etc. Just cause it seemed to work for 30 years doesn't mean its correct for this day and age. Any input would be appreciated. I don't want to change jobs again because of conflicts with more senior colleagues who refuse to retire. I would rather work with, than against them.


Thanks for your time in reading this.

adventure780, BSN, MSN, RN, APN

Specializes in Geriatrics/family medicine. Has 5 years experience.

I agree with you! In fact in our facility those of us who work on the floor and have nothing to do with management wonder what is outdated and what is current. I think we should check ANA's site if not available there ( the information you are seeking), then try contacting ANA and maybe they can direct you to find the current policies.

Wow, and I thought I was alone, well I was one of those nurses in the nursing program who did not want to work in LTC at first because I was working as CNA in one already and it was wearing me out, and it was very disorganized, but not all LTC are like that, the one I am at now is a lot better and probably one the best you will ever see, and even has electronic charting. It was until i starting working here i realized that i love LTC, i like getting to know my patients, seeing them recover from chronic illness. One thing that does bother me, is that my mother doesnt see a future for me working in one, reading this article give me hope in a bright future in LTC. Also i am a big fan of 8 hour shifts, i like having some hours out the day to myself, seeing my patient more often. Especially love them elders! I hope this field grows.

I also like to add it may not have the best pay, like in a hospital, so i feel that nurses who work here do it for a passion.