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. Specialties Geriatric Article
Long-term care nursing is a specialty that involves helping patients who need extended care as they deal with chronic illnesses and disabilities. Long-term care nurses coordinate the care of patients, perform nursing skills, respond to changes in condition, and provide physical and psychosocial support to patients and their families. In most long-term care settings, patients are referred to as residents because the healthcare facility is also the place where they live.
In most long-term care facilities, the nurse collaborates with physicians, social workers, dieticians, speech language pathologists, physical therapists, occupational therapists, case managers, pharmacists, respiratory therapists, and other members of the interdisciplinary team. The interdisciplinary team is necessary in long-term care due to the elaborate complexity and extent of patient issues that now manifest in this setting.
Long-term care nurses care for patients across the life span with numerous afflictions and diagnoses, although the majority of the patients are elderly. Patients with chronic disease processes such as hypertension, coronary artery disease, hypothyroidism, diabetes mellitus, chronic kidney disease, osteoarthritis, and chronic obstructive pulmonary disease receive care from long-term care nurses. Patients who have been afflicted with progressive illnesses such as Alzheimer's disease, multiple sclerosis, Parkinson's disease, and AIDS wasting complex are also cared for by long-term care nursing staff.
Depending on the type of facility, long-term care nurses may perform skills such as vital sign checks, intravenous therapy, enteral tube feedings, wound care, range-of-motion exercises, indwelling urinary catheter care, respiratory therapy, cardiopulmonary rescuscitation (CPR), ostomy care, tracheostomy care, management of stable ventilators, and medication administration. Long-term care nursing staff members also assist patients with activities of daily living such as feeding, dressing, toileting and bathing. Moreover, long-term care nurses provide education, help apply adaptive equipment, and document all care that has been provided.
A person who wishes to become a long-term care nurse must have completed a nursing program and have attained licensure. Licensed practical nurses (LPN) and registered nurses (RN) may obtain employment as long-term care nurses. Long-term care nurses are employed at nursing homes, assisted living facilities, long term acute care (LTAC) hospitals, adult day care centers, skilled nursing facilities, and retirement communities. They function as bedside nurses, unit managers, staffing coordinators, case managers, directors of nursing services, house supervisors, wellness directors, infection control nurses, wound care nurses, minimum data set (MDS) coordinators, and nurse educators.
Certification in long-term care nursing is optional, but highly desired. Both registered nurses (RNs) and licensed practical nurses are eligible to attain professional certification. The National Association for Practical Nursing and Education Service (NAPNES) offers certifications for LPNs, while the American Association for Long Term Care Nursing (AALTCN) offers opportunities for RNs to become certified.
Long-term care nursing is a rewarding specialty that requires an extraordinary level of patience, knowledge of nursing interventions, analytical thinking, and compassion for helping people deal with chronic issues. The the long-term care nurse is a professional who experiences multiple joys and challenges during the course of a routine shift. Therefore, long-term care nursing is a specialty in its own right.