was ltc your first job out of school

Specialties Geriatric


I am currently an RN in long term care. I have worked at current job 8 months. I am a new Rn and am wondering if I should go out and get experience in a different setting.

I get so frustrated some times about getting things accomplished in ltc. I wonder if it would be better elsewhere. I do work for a really good home, and love the residents and enjoy working with the families. I guess I am just wondering if doing the right thing if I would stay in LTC. Thanks, allevi


Whether you stay in LTC should be decided by what your heart tells you. Are you happy there or do you have the desire to try other things? I went to the hospital to work after I graduated and I hated it. I felt like a "fast food" service, get 'em in, get 'em out! I don't like that. I thrive on the relationships I have with my residents. I think I need them as much as they need me. I love the hugs, the good night kisses and the " I love you's". I cannot imagine my day without those benefits. The other night I was having a very bad night. A couple of incident reports, a new admit, you know, the mounds of paperwork that each require. As well as handling all this as the charge nurse, I also pass meds and do treatments on the heaviest end of my unit for 22 people. I was feeling a bit, "put out" because once again, someone had called off, leaving me with only 3 CNA's that were running their tails off. Usually if I'm short of CNA's I try to assist them with their duties but this night I didn't even get a break....again, so I was feeling a little frustrated. I'm passing my meds and I I have my little routine with all my residents during med pass. It's a good chance to do an "eye assessment" from nose to toes to see if anything is different from the day before. Mrs. K. was visiting with her spouse and when I exited the room, she said to him, " You know, I really like her. She always takes the time to see if I'm okay, no matter how busy she is. I watch her all the time and she never sits down but she always smiles." I nearly cried when I heard this. I wasn't trying to listen but I was outside her door setting up meds for the next room and she is HOH and was talking louder than normal. Anyhow....I thought to myself, I feel so rushed and feel like I am cheating my residents but she notices that I care and I do my best. That made me feel so good inside, just the boost I needed to get me through the night. We matter so much to these residents. When I'm off for the day and I go back, I always hear about it. They never fail to tell me that they missed me. I have this routine I go through every night as I'm doing my final med pass. My staff is getting everyone tucked into bed and after I give them their meds, I pull their covers up and tuck them in and kiss them on the forehead. The other night I was tucking in one of my ladies and my CNA called for me to come to a room. I started to leave the room and my lady said, "Nurse, you forgot my kiss." So I gave her two and as I left she said, "I love you." This is why I could never leave LTC. I know I matter to them but it's like any other relationship, you get out of it what you put into it. I have some nurses where I work that run in, give them pills and leave, never even speaking to the resident. This really angers me. If you cannot take the time to smile and let them know you care, then you shouldn't be there. Perhaps I put "to much" into what I do, but it works for me and they feel loved so we're all happy. And I agree that sometimes the wheels turn slowly in LTC and changes do not come quickly but if you keep trying and pushing you do make a difference. If you're not sure you want to settle in LTC, then try something else for awhile. If you're heart is there, you'll know it and you can always return. Good luck and God Bless.

Your reply hit exactly how i feel about my job. I feel that these residents need someone to show that they care. I feel that I do a good job of that. Because like you, i do take that extra time to talk, even if just for a little moment, and to make sure that they are ok.

I have a job interview monday for a different position, but am not sure what will come of it. I may even do both.

I think what is hard is that there are so many options. Thanks for the reply

Hi Allevi:

My first job out of nursing school was LTC. I too wondered if I should venture out somewhere else. My decsion to try general hospital nursing took me to a little town 3,000 miles away where a friend had moved to. She told me about the hospital there and said they were hiring. This town was 90 miles in the middle of nowhere, with a population of 3500. Nutsy thing to do? Know what, it was the best thing I ever did in my nursing career. I learned so much there. It was a 32 bed acute care hospital. I lived there for 3 years. I loved the adventure, but I missed LTD. So, I did go back to LTD where I am presently working. My thinking at the time was I am new at nursing. I will try out another aspect of nursing. If I want to go back to LTD I will. I learned through that experience that LTD is were I belong today. That is what I pass on to you. You are guided by your intelligence, therefore I beleive that you will make the decision that is right for you. The best of luck to you!!


I have been an LPN for 11 years, 10 in which I have worked in LTC. I would not have it any other way. I do believe that if you feel like you should try other areas of nursing then follow your heart, if LTC is for you it will not take you long to find out and return, :rolleyes: I believe that gets in your blood, the residents in my home mean a lot to me they are like an extended family. I know that I will always work in LTC!!:cool:

Specializes in LTC and Retirement Home.

when i graduated 21 years ago, i worked private duty for a year... but got tired very quickly of working on-call and sporadically. i made the conscious decision to work straight 11/7 in a nursing home, and found a fulltime job within 2 days. i've been with the same residents for 20 years, through a change of owner, and a new facility... and i love the continuity and slow change that takes place in geriatrics. there's only one "original" resident left from the start, and she's an extended gramma to my children.

most of my peers from nursing school went out of country, or to a hospital, and most are still working in the field. i'd not change my decision, not at all, i love long term care, and it's challenges and rewards, but i'm getting burnt out.

the erosion of the health care system in canada, the increased time spent on charting, and classification for funding... it's taken over the precious little time a charge nurse has for patient care.

i've given my all over the years, and find that i have little left to give.

would i do it all again? in a heartbeat.

would i advise a new grad to enter long term care? yes.

would i counsel a high school student to enter nursing? no.

i'll be leaving my present facility within a year, the stress is causing health problems too tedious to detail. i'll be leaving nursing completely within 5 years, i fear.... i'm tired of being driven by guilt and emotion.

we care... and that's our downfall as nurses. administration knows we care... and they use that as a reason for extended shifts, working multiple weekends in a row, and to tell us "there's no one else!"

I have worked with the Elderly now for 10 years and I have loved every minute of it. I would never change jobs to another type of Nursing. I am happy looking after the Elderly.:)

Specializes in Med-Surg, Long Term Care.

When I graduated with an ADN in '93, there were very few hospital jobs available in the area where I live. It was a mantra in school that "it's best to start your career in Med-Surg because you can learn so much." I grudgingly ended up taking a LTC facility position, jealous of some of my friends who got hospital jobs, and worked full-time 3-11 for 7 months. It was a skilled nursing floor and I was charge nurse for 30 patients.

After my 7 months there, I took an 11-7 full-time position on the Med-Surg floor of an affiliated hospital. I believe in hindsight, that God was taking good care of me by not having me start my career in Med-Surg. In LTC, I learned how to get organized, to prioritize, to delegate and manage CNA's, and to have contact with a widely-varied resident population-- everything from tube-feedings to alzheimers to CVA's to wound care etc. From nursing school assignments of 2 patients apiece to 30 was a HUGE adjustment of course, but the pressure in LTC is much different from Med-Surg.

If I had started my career in Med-Surg, I know I would've been eaten alive by co-workers and the stress. As it was, I barely made it through my first year in the hospital and continue to battle the pressures of Med-Surg.

I definitely miss the relationships I had with some of the residents (and their families) but there were also some residents (and family members) I dreaded dealing with every day; with Med-Surg, the turnover rate is so high that whether you love or despise a patient, they'll either be discharged by the next time you work or, often, you'll get a different assignment. I personally think the level of stress compared to that of LTC is much higher and intense in the hospital setting. However, when I've considered returning to LTC, what keeps me in the acute care setting is the actual intensity of caring head to toe for 5 or 6 patients and not 30 residents in the more limited manner inherent to LTC. (The sheer quantity of people requires a different level of care.) Although both are challenging in their own right, I have found Med-Surg nursing to be more satisfying because of all I have learned and must apply daily. Although many are elderly, I have also enjoyed the variety of caring for 12-year-old to 100-year-old patients and, on our floor of 65 beds, we get everything from orthopedic to renal to respiratory to peds to oncology to post-op to you-name-it.

I never thought I'd end up in Med-Surg; I always felt intimidated by it and it's taken me a long time to learn and adjust to the demands and pace. It's hard but rewarding-- as is LTC. I can only recommend that you talk to other nurses in the area you're considering while continuing with your current position, and maybe joining the pool in a facility until you see if it's an option you want to pursue.

All the best to you in whatever you decide!

Well it's been some time since first considering that switch. I did make the switch to a med surge floor in a rural hospital. I am glad that i switched. I love the variety of tlhings that i do. But again i still miss the long term relationship with the residents. But I decided that long term care will always be there and i need to get my skills better, and learn the things out there to learn. I think having been a nurse in ltc has been a positive learning experience and feel that everyone should work it for a while, i know that hospital nurses can be nasty to ltc nurses and that isn't right.

Specializes in Med-Surg, Long Term Care.

Allevi, I'm fairly new here and I need to remember to check the dates of the posts-- lol!

I'm glad your new position has worked out for you. I don't understand hospital nurses being "nasty" to LTC nurses. I feel like every job in nursing is a "specialty" and takes certain personalities, gifts and abilities to do them. I have no desire to be an E.D. or ICU nurse, but I admire and respect them. It takes a special person to do LTC, too, and many Med-Surg nurses I've run into don't have the patience or compassion to work with the elderly in LTC situations. That's the great thing about nursing: So many options and job possibilities!

When I first got out of school I went into an acute care setting because I wanted to be a "real Nurse"( I had worked LTC as an aide for 17 years). I did this for 2 years and could not for the life of me figure out why I just wasn't having fun like I did when I was a peon!

Come to find out I love geriatrics! I guess I always knew that, but a lot of "real Nurses" out there make you feel like you are less than a nurse if you work LTC. Heaven knows the EMTs have the same sort of opinion! I don't care. I am happy with my life and I wouldn't change my job for anything. Let them think what they will!!

LTC was my first job out of Lpn school. Its still my job now, 4 years later. I love it. I like being able to see the same residents everyday. I also like having my own routine. When I was in clinicals in school I didn't really like the hospital. When we worked in the VA for our last rotation I loved it, and finally knew which area I wanted to work in. I love working with the elderly, and I like the facility where I'm working. I don't regret not working in the hopital after graduation, I just think everyone has an area they like to work in, and geriatrics is mine. I learn something new everyday, and there's never a dull moment. :)

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