when i started looking for jobs as a new grad i really didn't think it mattered what specialty i started with because experience is experience i told myself. and i had listened to stories about how nurses jumped from specialty to specialty enjoying the variety and flexibility of our profession. however i began my career in ltc and am discovering what an negative impact that is making on my career goals. it appears my experience is not valued at all and that i'm view as the "bottom of the barrel". i even had a manager say to me; "she just a nursing home nurse" as though she had no value at all.
doesn't the healthcare community have any idea what it takes to be a "nursing home nurse"?? i have never worked so hard in my life! my time management is stellar!!! it has to be!! i do more in the first couple hours on my shift than most acute care nurses do all day. i've become very efficient at doing assessments because i don't have the luxury of having doctors and specialist at my immediate disposal. i can educate just about anyone about just about anything. my interpersonal skills are top notch and i can communicate with any discipline with confidence and authority. i don't have phlebotomists drawing my labs or iv nurses starting my iv's...i do it. i can probably pass the wound certification because i've dressed every kind of wound with every kind of dressing known to man. how is that not valued!?!
seems i've joined the most underappreciated undervalued nursing specialty possible. and yet i'm proud of the nurse i've become because of that choice.
I think the attitude is changing, but it will take time. LTCs do many things that in the past would never have been done outside the acute care setting - I hear it isn't uncommon to have stable vent patients in LTC as well now-- and no RT !!!.
I work for a nursing home that is privately owned by a guy who owns several. Some of them specialize in certain things. One specializes in vents. There is not RT. We were supposed to specialize in dialysis (have a whole unit devoted to it so the residents didn't have to leave the building and go to the hospital or clinic to have it done) but there was a problem with the state and they wouldn't allow it for some reason. Not because my place is bad, though! We had a guy during state survey say a few years ago that if he had to place his mother somewhere he'd choose our place out of all the places in the area!
Specializes in MED/SURG STROKE UNIT, LTC SUPER., IMU.
I know what you mean. I graduated last year in August. I couldn't find a job at any of the local hospitals, so I branched out and went to work for a LTC/REHAB facility. Boy Howdy, was that tough for the first few months. It is amazing the hats that are worn and the amount of patients that you have. You have to be the RT, CNA, Wound care, Case manager, Social services, ER, Hospice, and Code team all in one nurse, not to mention dietary, laundry, maintnece and whatever other hat needs to be worn that day. I was always so nervous when I was the only RN in the building because it would all fall to me if anything went wrong. (Pretty heavy stuff for a brand new grad) I finally got an interview at the hospital and they said things like "I guess you don't have any experience with IVs and foleys?" I told them that we maintained IVs, foleys, G-tubes, nephrostomy tubes, suprapubics, and colostomies. Now granted, we didn't start many IVs, but we maintianed and DCd the PICC lines when they were in. They were really suprised that we did all of that down there. What I really wanted to tell them was: Yes, we do all that and with a patient load of 20-30/1 nurse and maybe 2-3 CNAs.
I will never look at LTC the same again. I was always under the assumtion that I would be bored to death down there while I was awaiting my golden 1 year mark to apply to the hospital again. HAHA think again. I have a tremendous amouth of respect for nurses who not only choose this field, but love it and want to stay here forever!
I have been an LTC nurse since 2001. I just graduated in May wth my RN and would love some hospital experience, just as something different, not better. My problem is, I could not take the pay cut, as my LTC starts new grads out at $4-$5 more than hospitals. I feel as the OP does, that LTC is just as difficult and complicated as acute care.
I don't like the facilities, but I respect the nurses that work there.
IMO, most of the LTC facilities don't give the nurses the adequate staff, supplies, and proper equipment to give the residents the care that they deserve. And those nurses make the best out of what they have. That's a hard job to do.
when i was in nursing school i did a rotation in a nursing home where they epitomized the stereotypical "nursing home nurse". i didn't see them doing anything but passing meds and they had the residents come to the nurses station to get them. not having anything to compare it too i thought that was the norm; so i get where the stereotype comes from.
but then when i entered the field i quickly learned that, as a previous poster said, things are changing and we're getting more and more med/surg patients handed down to us. i care for post-surgical patients, unstable diabetics, chf, oxygen dependent copd, blood born infections requiring iv therapy, chemo patients on neutropenic isolation... you name it we get it. who is regulating our patient populations? the reason they say we have such a high nurse to patient ratio is because our patients are supposed to be stable!
here's the kicker! when they were advertising the open position for our cnm the job posting described us as a complex med/surg floor! whaaaaat??? didn't get that memo!!
the next time someone rejects me because i'm a ltc nurse i will kindly remind them to take a closer look!
Does your resume list all of the skills that you use in your job? If not, it should! I think you're probably right that most hospital recruiters have no idea what an LTC nurse does. Of course, I guess you still have to get them to read it, but do make sure the details are in there for anyone who does read it.
I am "just a nursing home nurse" and have been one for 10 years...and you know what? I love it!! I am proud to say where I work. We are a rare breed and it takes special people to do all that we do. Like all of you said, we wear many different hats and we do so much more than pass pills...but in a nursing home passing pills is sometimes so difficult..patients refusing, fighting and spitting..but we manage to get the meds in them through all that. We also get to hear some amazing stories from these amazing people. We are the lucky ones getting to work in long term care. After a stressful night at work just one smile or thank you or I love you is all I need.
Unfortunately the negative reputation of LTC nursing sticks like tar on a hot summer day. When doing research for a novel, I was unable to find anything positive written about LTC.
That negative reputation is detrimental to older people, their families, and nursing facilities themselves. Older people refuse to have needed medical care because they don't want to go to a nursing home. When they have to go to the hospital, their stays are more stressful because of that fear, and should they have to enter a facility, their adjustment is more difficult. A large percentage of hospital patients are older, making all nurses geriatric nurses. This trend will only intensify with the aging of the baby boomers.
The 'lowest of the low' image makes it harder for the facilities to hire and retain good staff, perpetuating the reputation. I'm fortunate to work in an excellent, privately owned, stand alone facility. It is non-profit, and truly exists to serve the community.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I am "just a nursing home nurse" and have been one for 10 years...and you know what? I love it!! I am proud to say where I work. We are a rare breed and it takes special people to do all that we do. Like all of you said, we wear many different hats and we do so much more than pass pills...but in a nursing home passing pills is sometimes so difficult..patients refusing, fighting and spitting..but we manage to get the meds in them through all that. We also get to hear some amazing stories from these amazing people. We are the lucky ones getting to work in long term care. After a stressful night at work just one smile or thank you or I love you is all I need.
Your comment about the amazing stories reminds me of this thread - "Describe Your Dream LTC" if only. . .
It's sad, but one of the best things to recently happen to the LTC facilities is all the new RN grads that can't get jobs. This has forced many, many, many RN's into a speciality they otherwise would never have known anything about.
Someday this economy will turn around. I can only hope that all of you that got "stuck" here with us will have learned what we really do here and how important our job is. Even once you eventually go back to the hospital for employment you will remember that LTC really isn't the bottom of the barrel!
Started in LTC, tried Occupational Health 3 years, decided to go back to LTC because I missed the real nursing I had done there. Then I worked as a dialysis nurse for 5 years and have gone back (again) to LTC where I LOVE my job. "Just a LTC nurse" proves how stupid people can be. This is a very demanding area but a very rewarding area, too. I have been lucky to work in facilities where I am given all the tools and backing I need. They have also furthered my education which actually makes me more marketable. But I am happy right where I am. I think I'll stay this time.
Specializes in Professional Development Specialist.
I do sub acute rehab but get that "just a LTC nurse" from management, other nurses and hospitals. But I have sharpened my assessment skills in a way I never expected. Drs hate to be called at 6am for no reason, so you'd better be sure you have a good one. On the flip side you'd better not miss something just because the doc is not receptive to your assessment even though they haven't seen the pt in 2 weeks, because your patient is the one paying the price. I've learned to trust my gut, know my patients like the back of my hand, listen to family, CNA's and therapy, and at the end of it all convince a condescending Dr to see things my way. I have saved lives and made a difference. If no one else wants to hire me, that's okay. I'm happy where I live.
.thumb.gif.a0171653eaae518ecf728198d692fc48.gif){kind=avatar}
DizzyLizzyNurse
1,024 Posts
I work for a nursing home that is privately owned by a guy who owns several. Some of them specialize in certain things. One specializes in vents. There is not RT. We were supposed to specialize in dialysis (have a whole unit devoted to it so the residents didn't have to leave the building and go to the hospital or clinic to have it done) but there was a problem with the state and they wouldn't allow it for some reason. Not because my place is bad, though! We had a guy during state survey say a few years ago that if he had to place his mother somewhere he'd choose our place out of all the places in the area!