Having worked in a long term/short-term rehab facility combination for a year now, I have to say that in comparison to other areas of nursing, it's pretty lame.
Yes, we work hard. We have 20 or more patients on our own who require medications. Sometimes they'll have tube feedings, ostomies, JP drains, etc. There are many wounds, blood sugars, bladder scans and emergent situations aren't as rare as you would think. No one is denying people at these facilities work hard.
At the same time, when looking at other areas of nursing, including ICU and ER, it's safe to say we don't really do as much for these patients as these incredible nurses do. For example, I am highly impressed with a cardiovascular surgical ICU in my town, one of the best in the nation. These nurses see and do EVERYTHING. Skills include Skills include TPM, PPM, Chest reopening, chest tubes, trach, PEG, JP, NG/OG, pigtail cat, extubation, sedation, CT/MRI, Bronchoscopy, line placement, cortrac, IR, specimen collection, medications including inotrops, vasoactive, blood administration, insulin, heparin, CPN/lipids, paraltyics, and lines such as arterial lines, Cordis/STCVC, pAC, TDC, TPM wires, PICC, non-VAT blood draws, CRRT, Flexiseal, and pumps including PCA, Medication and Tube Feeding. They have LVADs, ECMO machines and take care of ALL ages from the newborn to the elderly. The MICU is also quite an impressive area, as are all the other ICUS. Plus, you can't beat the top notch nurses in the ER.
Sorry everyone but it's true...there's a reason why long term care nurses/rehab nurses are paid less than others.
I really hate to point out all these "skills" you mentioned with reverence are actually attached to REAL PEOPLE experiencing them. I find it somewhat morbid and gauche that you idolize doing these things, as well as place those that do actually do them in the course of their job on a pedestal. Back when I worked ICU that would have certainly creeped me out a bit to hear.
I really hate to point out all these "skills" you mentioned with reverence are actually attached to REAL PEOPLE experiencing them. I find it somewhat morbid and gauche that you idolize doing these things, as well as place those that do actually do them in the course of their job on a pedestal. Back when I worked ICU that would have certainly creeped me out a bit to hear.
Ah, no offense.
Of course I know that they're real people. I just find it fascinating what can be done to save people's lives.
My starting pay in LTC was way higher than starting pay for any of my nursing friends that took positions at the hospitals and with my annual raises, my pay is still higher. I think there are some "nursing homes" that give this field a bad name, but there are some good ones out there just have to do your research
We work in an environment that is long term and difficult. You make actual bonds with you patients and this can be one of the most brutal situations when the end comes.
Also, we have to be able to notice and intervene when things are going wrong for a patient without the incredible amount of resources of a hospital.
We also handle a huge amount of responsibility at work, I've had 50 patients I was responsible for during a shift. QMAs are amazing but not nurses.
I've learned more about wound vacs, peritoneal dialysis, and wound care than a number of my hospital nurse friends. They're often impressed with my abilities in areas they would call in a team to handle.
I currently work in geri-psych and I always tell my coworkers who have second jobs in LTC that I have so much respect for anyone who works in LTC. Since I work in an acute setting, my patient ratio is 6 to 1. And some days I feel so overwhelmed. I can't imagine having to be responsible for 50 patients! So many problems can arise in just one shift. I know I couldn't handle that many patients and I am so thankful for nurses like you that are able to do the work that you do.
I realize this is an old post, but I had to comment.
It hurts my heart to read that you think LTC is lame.
I've worked in LTC for two years now. I absolutely love it. However, because of mentality like yours I have asked my husband and family to stop telling people that I'm a nurse. When I tell them where I work I get asked for clarification, " you're an lpn or an rn? "
I'm an rn with a bachelors degree tyvm
I won't say that I don't have regular panic attacks thinking that I need some sort of acute care experience (I went into LTC right out of school) but then I tell myself that LTC needs good nurses.. And I am good at what I do.
There are several areas of nursing that could be considered "lame"
Those areas still need dedicated nurses.. And less judgement.
As far as the pay goes... I make $5 more an hour than the medsurg nurses at my local hospital.
I work in a small, rural hospital. We have to do it all - Med/surg, ER, respiratory therapy, and until a year ago, labor and delivery/postpartum care (our hospital no longer delivers babies). I have developed quite a skill set. I really like where I work, but I recently applied for and got offered a part-time position at a highly rated LTC facility for night shift. I am really nervous!! I mean, really nervous! I have no idea if I have what it takes. I do know that we have an LPN that is fairly new, and he came from a LTC facility and I have to say, I am impressed at his ability to manage patients. I don't have to worry that when I go to the ER that my patients won't be taken care of. He will take care of my patients and his patients until I get back to the floor. I have no clue how I will manage 60 patients when I'm used to 3-7 patients. I do think that I will learn a lot, and I hope to make a positive difference in the residents' lives.
Those nurses mostly rely on machines, not instinct. Sad for you to feel less of a nurse because of skills. Guess caring for someone that can't care for themselves isn't a skill.
Specializes in Neurosciences, stepdown, acute rehab, LTC.
This is the most insecure post ever. How can you be good at something and yet not be proud of what you do? For me I really couldn't stand long term care. It was too difficult, too many rules that didn't make sense. I love that geriatric population and I really just couldn't stand to see them living in an institution. I had too many residents and I didn't feel I could do my job thoroughly and that's why I wasn't proud. I felt that if I did a good job I always missed my break and had to stay late. I couldnt tolerate that every day. I just was not cut out for this. Anyone can learn the long list of skills you named. Few can really grasp some of the crap you go through in long term care. Of course you can't respect long term care. You don't even seem to respect yourself. I'm personally just proud I survived and have major respect for everyone who remain there to give awesome care to the residents. Just for the record, I blame the crap of LTC on the system of how it runs in this country. This is over a year later but it definitely deserves any answer it's gonna get.
kbrn2002, ADN, RN
3,973 Posts
The first time I heard that LTC pays more than acute care in some places I was shocked. In my area LTC pays less, way less.