LTC is not "settling"

Published

Hi Everyone :)

I'm a fairly new nurse in LTC, and despite being very busy most days, I am enjoying the residents, the staff, and the environment. As you are all aware, the work can be stressful, and there is never enough time. However, I am getting into a routine, and as many others have pointed out, knowing the residents and developing relationships with the NA's really helps with overall time management. I try to reflect and provide the best care I can, with what I know, and the resources I have.

I guess the perception that irritates me (and the motivation for this post) is the common one that many nurses working other fields have, is the one that:

1) LTC is not "real nursing". Not true! Let them try to pass meds for 40 people. What about all the IV's, wound care, treatments, etc. And, where does this perception arise from, anyway?! Just what is it that people think LTC nurses do?!

2) Working in geriatrics is "settling" until something better comes along. Well, I actually enjoy LTC, and will gladly remain there over say ICU or emerg. Why is it that LTC nurses have to justify their value within the profession? This just seems very narrow-minded in general, and I like my residents.

Thanks. This is me thinking aloud and venting. I hope that geriatrics will come to be respected as the skilled area that it is as the population continues to age. In my opinion, LTC is acute, psych, and palliative rolled into one. Thoughts?

Specializes in LTC.

I'm not using LTC as a stepping stone, and those who do .. really don't enjoy their jobs and last at the facility I work at. Its easy to pick them out.

But I don't want to be in LTC forever. I want to try other avenues of nursing and maybe find one thats a better fit for my personality. I do like where I work, who I work with and of course the residents. Its just the LTC process that I don't see myself doing forever.. example, the 4 hr med pass, all the stupid rules, babysitting the dining room, 10 pages of paper for 1 tiny skin tear, management locking up resident care supplies(soap, toothpaste, lotion, etc(now why the hell do they need to do that? its just making more work for us.. and I can't get it because they changed the locks and our keys don't work for that closet anymore.. the CNAs have to find the supervisor) I need to start keeping a stash of supplies.

Up Vote Up Vote ×

I started off in skilled and LTC and initially thought I was settling until I got out into the job and realized how complex my patients were and how many strong nursing skills I would need. I later worked on a med/surg unit and felt very well prepared from my SNF/LTC experience. I've worked in different areas of nursing since then and now work in an SNF/LTC where I am challenged every day.

But looking back at the facilities I worked at, I would say that my biggest concern or complaint is that many long-term facilities are owned by for profit corporations that are not really as concerned about good patient care as they are about milking the system for every dollar they can get.

That is very frustrating and something you don't see -- at least as openly -- in a hospital environment. I often felt that my day was nothing more than a mad scramble to just get the basics of the job done and keep the patients alive and well in an environment where no one in management showed any sense of accountability for what happened to the patients. Or the nursing staff for that matter.

Right now I work in a non-profit facility and it is amazing how different the menality is. There's politics wherever you go but I really am very happy at my job now.

Up Vote Up Vote ×
It's great that you are enjoying your position, but everyone has different personalities and temperments, likes, dislikes, and preferences. So you may not feel that LTC is "settling," but it may be for someone who doesn't want to work exclusively with the elderly in that type of setting.

Not everyone is geared to work in LTC and won't flourish there as you seem to have. There is nothing wrong with wanting to work in the OR, ED, ICU, home health, or any of the plethera of other areas of nursing, and it certainly isn't narrow-minded if one feels that they are "settling" if they have to take a job in LTC temporarily until something they are more passionate about becomes available.

Be careful that you don't become the narrow-minded one.

Be careful with your reading comprehension. It was not about the nurses actually working LTC who might feel like they settled. Indeed, that would have been presumptous and narrow minded to tell someone how to feel about their personal circumstances. She was referring to the perception held by nurses working outside of LTC that anyone working LTC was settling and that it isn't real nursing. Two different things.

Up Vote Up Vote ×
Specializes in geriatrics.

Thank you Old Timer and Ruthiegal :) I actually went back to read my original post again, because I wondered whether or not I had worded it the way I wanted to. And, yes, I did. I think a few of these people who responded need to go back and re-read it, too.

Up Vote Up Vote ×

I'm a new "baby" Rn. Just graduated in Jan and my first job, which I'll be starting in 2 weeks is LTC. I have heard the misconceptions of LTC and was worried if I'm making the right decision taking the job. It sure is nice to hear that so many RN do enjoy LTC and I won't lose my skills and I will even learn more. I will have 35 patients and feel very overwhelmed since all my clinicals while in school required me to do assessments on my 5 patients before giving meds. So I guess when I start I'll know more of how this facility passes meds. I read some of the other posts and I will definitely not put my license on the line if I feel uncomfortable with passing meds.

Up Vote Up Vote ×
Specializes in geriatrics.

Hi there tmama 77 :) I'm sure you will be fine, but it is overwhelming at first. The med passes can take a long time sometimes, but once you become familiar with your residents, and how they each take their meds, it will be much easier. Also, you will find that the good NA's will be very helpful. A couple of them where I am have an attitude, and probably shouldn't be there. But those people work everywhere. The good NA's though are awesome. I hope you will enjoy your new job.

Up Vote Up Vote ×
Specializes in Geriatrics, Ambulatory Care.

I'm a new "baby" Rn. Just graduated in Jan and my first job, which I'll be starting in 2 weeks is LTC. I have heard the misconceptions of LTC and was worried if I'm making the right decision taking the job. It sure is nice to hear that so many RN do enjoy LTC and I won't lose my skills and I will even learn more. I will have 35 patients and feel very overwhelmed since all my clinicals while in school required me to do assessments on my 5 patients before giving meds. So I guess when I start I'll know more of how this facility passes meds. I read some of the other posts and I will definitely not put my license on the line if I feel uncomfortable with passing meds.

Find a buddy. Someone who will help you when things get busy. Admit when you need help but don't complain about being it too much. Be willing to help others. At first the med pass will be overwhelming and you WILL be slow. Don't let that freak you out -- better slow and correct than fast with errors.

I work in a state that allows Medication Aides. They are the best trainers because they don't take short cuts and their only focus is meds. The buildings who have the most problems are the buildings where the nurses don't work as a team.

LTC is different because your assessments are based on how you see this person everyday not how you see them one day in the hospital. There are times when you will say "she just doesn't look right" or "she doesn't act right" but you can not exactly say what is wrong.

The best and worst thing about LTC is you have the opportunity to know a resident well. :uhoh3:

LTC is not for everyone. But for some of us it is our calling. It is an opportunity to grow as a nurse and a person. The great thing about nursing is there is something for everyone and we all do not have to like the same things. Thank God some of are going to stay to make LTC better because you can only fix it from the inside.

Up Vote Up Vote ×

Just wanted to say that LTC is not settling at all!!! graduated with my BSN and worked in med-surg/ oncology at a prestigious hospital in my city. I left to figure out where I "belonged" in nursing and have settled in a memory care unit. I LOVE working with the elderly. I think i might want to become a geriatric NP. So forget what people might say about settling, gotta just find your love.

Up Vote Up Vote ×
+ Join the Discussion