Long Term Care Nursing is Lame

Specialties Geriatric

Published

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.

Specializes in retired LTC.
I don't really like passive aggressive and that is what this sounds like to me. You would rather do a different kind of nursing and you feel like those are the cool kids and you aren't cool enough to be one of the cool kids so you will post here about how not cool you are in hopes that people will jump up and tell you no no no, you really ARE cool...or at least, that is how it reads to me.
Came across the same way to me!

I'm not sure we have the whole story here. OP started in another unit but was INvoluntarily transferred out. She continues to post that she may not have all the right qualifications to work in the 'dream unit' with all those 'extraordinary' nurses who do.

She has another current post asking how to work in the ICU that she is so enamored of.

Education and experience is what does it. Maybe just a new start in another facility can re-set her direction.

I've worked in LTC for several years, and while it wasn't my dream job, the longer I work the more interesting and enjoyable it becomes. Not because it serves up exciting developments on the regular, but because I am truly invested in it and take the initiative to develop skills and advocate for better paths of care. You get out of it what you put into it. There are plenty passable nurses in this and other fields with the attitude expressed here. And as long as 'passable' is the highest standard being sought, you have nothing more to concern yourself with - except being exceedingly replaceable.

Specializes in kids.
But you've impressed me, purplegal...

I HOPE I'm sensing sarcasm...

Specializes in kids.
Oh nooooo, Purplegal. Don't do this. Aren't you the one that posted a year ago about something similar and it took *forever* to get people to back off? /QUOTE]

Yes she did...seems to me it might be time to reasses career goals and aspirations...clearly not happy...

Specializes in Critical Care; Cardiac; Professional Development.

I went back and read the thread you started about a year ago in which you also insulted the LTC specialty. You fell over yourself apologizing when you were called on it then. Those apologies don't seem to mean much, as this is truly the way you really feel, about all of those nurses and about yourself. How do I know this? Because here we are, exactly one year later, having the exact same conversation.

Brutal honesty here.....I have no patience for this. If you hate it, go do something else. You are past the year mark. Reapply at the hospital that fired you if you would rather be there, but knock off this "poor me" stuff. It is unattractive and habit forming. You aren't a victim of anything but your own imagination at this point.

My mother just had to be admitted to a LTC facility last week. I can only hope that the nurses that are taking care of this wonderful, 95 year old woman, who took care of others all of her life, don't look at taking care of her as "lame." She has lived her life for others and deserves dignity and respect from anyone taking care of her.

Just because you didn't fit in well in the one PCU you tried, doesn't mean you won't thrive in a different one.

If you are really so unhappy in LTC, try to get into another PCU, spend a few years there to get your skill level up, and then move into ICU.

Its a process. Insulting a crap ton of LTC nurses and not seeing the value of what you currently do will not get you to where you want to be.

It almost seems like you dont actually care about the job or patients itself, moreso, you care about image. Re: "I'd love to call myself an ICU nurse".

Maybe some reevaluation would go a long way for you.

Unfortunately, there may be some truth to that. It's not that I don't care about my patients, but you're probably right about me worrying about my image. When I'm performing ECGs at the hospital, I tend to avoid classmates that are working in "higher" positions. Not because I don't want to see them, but I don't want them to see me. I'd love to talk with them, but I don't really want to talk about myself. I'm embarrassed I haven't advanced the way they have and of my rocky start in nursing. Somehow, I feel that if I were in their shoes, I would not be the same way.

Specializes in Telemetry, Step-Down, Med-Surg, LTC, PACU.

There is nothing lame about LTC/Rehab care... this is a needed, necessary specialty and a VERY special one. Although I am moving to the hospital setting on a Med-Surg floor my heart is in geriatrics and has been before I even became a nurse (thanks to my Great Grandmother who lived to be 99, VERY special lady...) but I have chosen to go acquire other skills and because I think I need this background for what I want to do long term: Nurse Educator (We'll see!)

But being a LTC nurse isn't easy. It's frickin' hard with those ratios. You have no idea what you may walk into. Sure, I've never intubated a patient at the bedside or seen a heart or a pair of lungs but so what? I was there to calm down patients and family members who were concerned. I was there week after week with the same set of patients, and pretty much know them like the back of my hand... (that's what is so cool about LTC) and can notice even a slight change in condition.

These patients have made my DAY when they say cute things, smile at you, or say, "You are my favorite nurse" (and you forget they may have said that to the previous shift's nurse ;) haha) You really have to have IT to be a nurse... and you really got to care about taking care of someone's loved ones to work in LTC. I just remember my great grandmother was in a LTC facility before when I was a teenager. How would I have wanted the Nurse to care for her?

It sounds like you are overly concerned with your "status" in Nursing. I hope that changes. Focus more on building your skills to take care of your patients than competing with your peers.

Oh, and watch this TedTalk. =)

And at about 8:47 she discusses the "hierarchy" of Nursing, right up your alley to watch, OP.

Specializes in LTC, assisted living, med-surg, psych.

I forget who said this---Dr. Seuss, maybe?---but "wherever you go, there you are". Don't think you can escape feeling inferior simply by moving into another specialty. It sounds to me like there are some self-esteem issues here, and they are affecting how you see your own job. Please think about getting some counseling to help you get unstuck so you can either learn to be content where you are, or move on to something "better". Best of luck to you.

I'm gonna throw in my two cents here and just say this post comes off very insulting and I don't even work LTC. Some of the best nurses work in LTC and some of the best also work in ER, ICU, OR, and the list goes on and on. But some of the worst aso work in these areas too so it is not the specialty that matters but the nurse. Every nurse has their own speciality or niche and just because someone works LTC doesn't make them any less than the nurse who works ER. One of the absolute greatest things about nursing is that there are so many endless opportunities for things to do and so many different areas to work in. OP you obviously haven't found your niche but that doesn't mean you have to drag down other nurses. We all do different jobs, none less than or better than the rest. If you don't like LTC or feel that what you do doesn't really matter to you, then find something you enjoy and feel more empowered in. Just don't bring down an entire sector of the working nursing population while doing so.

Signed up just to respond to this. I'm a overnight charge nurse in a long term SNF.

Do I get to do a lot of exciting things? Not necessarily.

Do I have a huge workload with minimal staff? Absolutely!

It's just me and my small crew taking care of these people with no doctors, specialists, or special equipment in house. Sure there's always a tired, condescending ass only a phone call away who really doesn't want to listen to me but has to make all their decisions based on my nursing skill and assesment.

I have to juggle the rapidly declining full code resident, the 4 late stage hospice residents, the umpteen dementia residents thinking it's time to go to work, and the needy princesses who think we need to stand outside their doors to answer their requests for pain meds and snacks within 35 seconds.

Somehow in there I'm also trying to make sure everything is being fixed on that new admit that the docs and highly skilled nurses sent to us with pressure sores, electrolyte imbalance, no labs, and orders for Coumadin and ASA and advil?!

So, no I don't do the highly specialized stuff. What I do is take care of the cases most don't find interesting, and connect with them while giving them the best care I can. And I do this knowing I've made a bigger impact to that resident and done more for their safety and well being than those with the letter salads after their name. Pretty lame.

Specializes in LTC, Rehab.
My mother just had to be admitted to a LTC facility last week. I can only hope that the nurses that are taking care of this wonderful, 95 year old woman, who took care of others all of her life, don't look at taking care of her as "lame." She has lived her life for others and deserves dignity and respect from anyone taking care of her.

I sure would if she was one of 'mine'. I've literally taken care of people 29-99 in my LTC facility.

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