LTC nurses: Can I hear from you, please?

[37changes]

Hello all ~ I am looking to hear from nurses who are currently working or have a lot of experience in LTC or AL.

I'd like to use this thread as a place to get to know you a little better & ask questions as I think of them. And maybe get your opinions on jobs down the road, etc... should I choose to head down this path.

I am beginning the last semester of my ADN program. People have been asking me what I'm going to do ~ and while telling them I'm still not sure, I'm also telling them I think my heart is in LTC.

I have felt this way since before I started school.

I had a great experience in clinicals at the nursing home. I know not all facilities are like this one -- I know that, for sure. But it was good. It was smaller. Homey. If my grandmother needed to go somewhere, I would have no qualms about this one.

I've been in touch with the ADON there, and she's offered to meet with me to discuss LTC vs hospital, as she has had experience in both.

I have an aunt who has worked her way up in LTC management over the years and is pretty high up, over many facilities. She is encouraging me to head this direction, as well, as I already have an associates in Business Administration. She says LTC needs people and I could move up quickly if I can do a good job and manage a team well.

I don't have a strong desire to work in a hospital. My local hospital does hire ADN nurses regularly, so it's not that I can't -- it's that I don't necessarily want to. I think I just prefer a different environment.

I will be almost 40 when I graduate, and I am not dead-set on pursuing my BSN. That would be required to be completed within 5 years at my local hospital. I'm not sure about others. But my kids will be starting college soon, and I'm just not sure if that is the direction I want to head.

I'm also looking for days. And I know, as a new grad, that is limiting. But I also don't need the benefits, I don't have to be full-time, and I'm cool with PRN days, if that is all I can find.

One thing I noticed while looking through the threads in this section is that people were saying LTC pays less than hospitals. I have heard the opposite here, from my aunt, as well as from one of my instructors who worked in LTC. My aunt said her company also pays $2/hr more for PRN employees. I'd love to hear thoughts on this. I wonder if it is area-specific.

Thanks to anyone who responds! I value your experience, for sure. As I currently have none. :)

[Mrsmolina]

• Following this thread. I will be (hopefully) employed by this rehab facility.

[BrandonLPN, LPN]

A few off-the-top-of-my-head thoughts:

the assumption that nursing home nurses make less than hospital nurses is false. In fact, since nursing homes have a harder time attracting nurses, they often offer high wages as an incentive.

a mistake I see new-ish nurses making all the time is having a “the grass is greener....” mentality. Some facilities are indeed better than others, but 99% of all nursing homes deal with similar issues of understaffing, high turnover, large nurse-to-patient ratios, etc. If you think you’re going to find some magical facility without these problems you’re going to wind up being one of those nurses who has floats from one facility to another every year or so until the lack of longevity on your resume begins to limit your career choices.

Its not as hard as it seems at first. Every nurse starting out in LTC experiences shock and feels overwhelmed. Nursing school conditioned us for a very, very different sort of nursing. I long for the day when the people who design nursing school curricula realize that not every nurse in existence works in acute care. Once you get your flow and adjust to the acuity level vs patient load balance, you will be shocked by how what once seemed impossible is more manageable than you believed.

[37changes, ASN, RN]

With the site being down for so long and me still trying to figure out how to navigate everything, I didn't see there were new replies until now. Thanks for the responses!

I have a job lined up at the nursing home where we did clinicals. I have thought all along that I might like to work there, so I'm happy it worked out. PRN day shift (6am - 6pm) with a *great* rate of pay. I don't need the benefits, so this is perfect for my needs at this time.

I was impressed with what they told me in the interview. Orientation is based on how you are doing ~ not a set number of days. ADON said she has one new grad right now, she was figuring a month for her orientation, and two weeks in, new grad feels ready to be on her own. She said everyone learns at a different pace, and she "doesn't want me to feel like I made a mistake becoming a nurse". So clearly acknowledging the struggle in the beginning, for sure, but going to do what she can to ease me into it. Including 8-hour shifts at first.

I passed NCLEX and got my license on January 15. Next week, I go for TB test and physical. If all goes well, I will be starting after that.

Thanks again for all who have responded and encouraged me to follow my heart. So far, it feels right. We shall see. ?

[bryanleo9]

What a great thread. Good luck wherever you end up. Nursing homes vary so much but it sounds like this is a nice one. I would have loved 12 hour shifts when I worked LTC.

[37changes, ASN, RN]

4 hours ago, bryanleo9 said:

What a great thread. Good luck wherever you end up. Nursing homes vary so much but it sounds like this is a nice one. I would have loved 12 hour shifts when I worked LTC.

Thanks! I've been there for about 10 weeks now, and I could say a lot. Maybe someday when I have more time. It's a journey, for sure.

[kbrn2002, ADN, RN]

On 4/13/2019 at 6:48 PM, 37changes said:

Thanks! I've been there for about 10 weeks now, and I could say a lot. Maybe someday when I have more time. It's a journey, for sure.

You are past that brand new hump now, congrats! LTC is a different beast for sure! After 10 weeks you probably know if it is something you think you will like, or maybe even love so much you never you never want to work anywhere else. Or on the flip side you might be thinking LTC is something for you to just tolerate until something better comes along or it might even make you say "oh my God, get me out of here!"

When you have time to breathe a little let us know how you are doing.

[37changes, ASN, RN]

On 4/15/2019 at 11:17 AM, kbrn2002 said:

You are past that brand new hump now, congrats! LTC is a different beast for sure! After 10 weeks you probably know if it is something you think you will like, or maybe even love so much you never you never want to work anywhere else. Or on the flip side you might be thinking LTC is something for you to just tolerate until something better comes along or it might even make you say "oh my God, get me out of here!"

When you have time to breathe a little let us know how you are doing.

Time to breathe a little -- yes! ?

It's been a wild ride. I'm PRN days and they've needed me A LOT.

The (long-time) DON just up and quit with no notice when I was about 2 weeks in. I'm still not sure what that was all about ~ no one told me. No, I mean, no one told me... literally. I figured it out through various clues and looking to see that they'd posted the job on indeed. Lol.

I could type for an hour, but I'll just say it's been one change like that after another, and pretty much what I expected. Some things better than I expected ... maybe a few worse. But I don't know. I think I was mentally prepared for it pretty well.

It's a generally good group of people. I've learned a lot. I still have a lot to learn. And the pace is CRAZY. Nuts. But, again, I knew that going in ... and it sure helps the days fly by!

I decided to also start PRN at one of my aunt's facilities, after all. It's the hour drive I wanted to avoid -- but I just needed another experience, a different one. A comparison. She kept telling me they are NOT *all* like this ~ so I had to see.

I've only been there 2 days for orientation, but so far, so good. It IS different -- very different. I can't even believe how much more QUIET it is. Like you can actually sit at the desk and chart in peace sometimes -- WHAT?! Lol.

So I'll update more about that when I'm a little further down the road. Thanks again to all who responded here and helped me make this choice!

[37changes, ASN, RN]

So I worked at both facilities for ~6 weeks ... my first one where I started as a fresh new grad, and the second one where my aunt is the regional DON and it's an hour drive.

The difference between the two is actually kind of crazy ... and SAD.

I gave notice to the first place, and was done at the end of June. I had such mixed feelings about it. I loved my residents and I loved caring for them. Only *one* guy was incredibly difficult at times, and really added extra stress to my days. Only *one* employee (sadly, my ADON) rubbed me the wrong way, which added extra stress to my days. Otherwise, I got along with everyone ... and a part of me could not believe I'd actually given notice and was leaving.

But such a weight was lifted once I was done. No more 12-hour shifts turning into 15 or 16 ... which had become the norm for me, as more and more work was piled on. I did not realize HOW physically and mentally exhausting that place was, until I'd really been away from it for a couple of weeks.

I have more thoughts to share about that job, my new job, and LTC in general ~ but I'll leave that for another time. I actually have the weekend off, and lots of stuff to do! ?

[garciadiego]

On 8/16/2018 at 7:02 AM, 37changes said:

Hello all ~ I am looking to hear from nurses who are currently working or have a lot of experience in LTC or AL.

I'd like to use this thread as a place to get to know you a little better & ask questions as I think of them. And maybe get your opinions on jobs down the road, etc... should I choose to head down this path.

I am beginning the last semester of my ADN program. People have been asking me what I'm going to do ~ and while telling them I'm still not sure, I'm also telling them I think my heart is in LTC.

I have felt this way since before I started school.

I had a great experience in clinicals at the nursing home. I know not all facilities are like this one -- I know that, for sure. But it was good. It was smaller. Homey. If my grandmother needed to go somewhere, I would have no qualms about this one.

I've been in touch with the ADON there, and she's offered to meet with me to discuss LTC vs hospital, as she has had experience in both.

I have an aunt who has worked her way up in LTC management over the years and is pretty high up, over many facilities. She is encouraging me to head this direction, as well, as I already have an associates in Business Administration. She says LTC needs people and I could move up quickly if I can do a good job and manage a team well.

I don't have a strong desire to work in a hospital. My local hospital does hire ADN nurses regularly, so it's not that I can't -- it's that I don't necessarily want to. I think I just prefer a different environment.

I will be almost 40 when I graduate, and I am not dead-set on pursuing my BSN. That would be required to be completed within 5 years at my local hospital. I'm not sure about others. But my kids will be starting college soon, and I'm just not sure if that is the direction I want to head.

I'm also looking for days. And I know, as a new grad, that is limiting. But I also don't need the benefits, I don't have to be full-time, and I'm cool with PRN days, if that is all I can find.

One thing I noticed while looking through the threads in this section is that people were saying LTC pays less than hospitals. I have heard the opposite here, from my aunt, as well as from one of my instructors who worked in LTC. My aunt said her company also pays $2/hr more for PRN employees. I'd love to hear thoughts on this. I wonder if it is area-specific.

Thanks to anyone who responds! I value your experience, for sure. As I currently have none. ?

Depends where you work but now a days, even in LTC, a BSN is needed or preferred for management positions. Your going to get exposed to a variety of nursing areas in school, you may find something else will grab you other than LTC.

[37changes, ASN, RN]

On 9/25/2019 at 10:37 PM, garciadiego said:

Depends where you work but now a days, even in LTC, a BSN is needed or preferred for management positions. Your going to get exposed to a variety of nursing areas in school, you may find something else will grab you other than LTC.

Thanks for your response ... but I started this thread over a year ago. I’ve been working in LTC for 8 months so far ~ and it’s where I’m staying for now.

I did decide to start my BSN online, and I only have 5 classes left. But it’s definitely not necessary in my area. My ADON at the last facility was an LPN. When our DON disappeared, they had to promote a floor nurse who was an RN up above her to the DON position.