LTC nursing is a nightmare

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

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Dear Nurse Beth,

 After working LTC for years I retired for a few months and travel now because I was begged to return.

But it has turned into a nightmare. All the hospitals now sending pts right from ICU and no RNs and constant complaints about care. I am now so fed up and frustrated. LTC simply now takes anyone no matter if they have staff or not.

The situation is horrible for staff and these kinds of patients need to stay in the hospital not in a nursing home. Patients simply do not understand the nursing home is set up for old people not young people who are rude hateful and mean to staff.

And of course are always right according to managers. One nurse simply cannot care for as many as 60 people. A lot of the staff has been traumatized by these pts and their families who expect to be waited on  like in the hospital and get angry and even hit staff because we simply cannot meet their expectations. Please can someone explain this to them before they come there!

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2 Answers

Specializes in Tele, ICU, Staff Development.

Dear Frustrated,

It sounds like you are dealing with a challenging situation. It can be frustrating and overwhelming to feel like you are not able to provide the level of care that you would like to because of staffing and resource limitations.

There are different levels of care for patients needing inpatient care after acute care hospitalization, including sub-acute rehab, skilled nursing facilities (SNF), long-term care (LTC), and long-term acute care hospitals (LTACH). Sub-acutes provide care based on specialty and intensity of services, not age. 

It is important to remember that you are not alone in feeling this way. Nurses across the board feel the pressure of caring for too many high-acuity patients.

Caring for an unrealistically high patient load can cause workarounds and mistakes, not to mention stress and burnout.

In terms of addressing your concerns about the patients and their families, it may be helpful to have a conversation with your managers or other leaders in the facility about setting realistic expectations for care.

It may also be helpful to educate patients and their families about what to expect in a long-term care setting and to explain the facility's limitations in terms of staffing and resources. A brochure could be an excellent way to provide that information.

Consider exploring resources available to you, such as support groups or counseling services, to help you cope with the stress and trauma of caring for complex patients.

Remember that your health and well-being are important, and it is essential to take care of yourself to provide the best possible care to your patients.

Best wishes,

Nurse Beth

Specializes in long trm care.

I am answering my own question, you can tell mànagers and *** and moan but they do nothing because they work for corporate and they the corporation just cares about more profits. And you can churn out as many RNs as possible but they will never stay in nursing esp LTC! 

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