LTC vs Assisted living

vintagemother, BSN, CNA, LVN, RN · Jun 22, 2016

In my ALF job, I was the only licensed person in my unit, responsible for 45 residents. Dementia unit, some hospice, nebulizer tx, wound care. No shots: neither IM or subq. They were about to start accepting foleys and diabetics when I left.

And my (the) aides weren't certified. But were pretty good at their jobs.

BSN-to-MSN, ADN, BSN, RN · Jun 22, 2016

Hello! I guess you will have to try it out for yourself. There are better and worse LTCs and ALFs. Expect to do less skills, no ALFs do IVs, some let you do Foleys. At ALF I worked, home health had to come in to change foley, I could not per facility protocol. I know, right?

So, I did ALF while I was LPN for 9 months. It was good, but after getting RN, they would not increase my pay ( why would they?), and I went to SNF. Are you RN or LPN? If RN, expect pay cut going to ALF. For LPN, it may stay the same.

As a new grad, no job seems good for about a year, one has to suffer thru it. Just know that you will be okay, no matter what specialty you will choose. Always try to go level up. good luck. (( :nurse: ))

Mscoleman78 · Jun 22, 2016

I'm a LPN and I did get a pay increase also I was told that I will be doing no wounds, treatments, or Foley. I'll try it and see, if not I will move on to someplace else and hopefully that's RN school!!!!

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Jun 22, 2016

I'm a LPN and I did get a pay increase also I was told that I will be doing no wounds, treatments, or Foley. I'll try it and see, if not I will move on to someplace else and hopefully that's RN school!!!!

Just so you know, in each of the assisted living facilities I've gone into, the wellness director (the nurse>LPN>you) is usually the one responsible for the pre-admission assessment to determine if the resident is suitable for admission, and the admission process itself, in addition to other responsibilities. So, when 'The State' (surveyor>nurse>me) comes in for annual inspections, complaint investigations, etc., you will most likely be the one stuck with me to answer questions regarding files, resident care, ANY and EVERYTHING regarding the residents. It is unfortunate, but a nurse wrote up her resignation at a facility while I was interviewing her. Nerves just got the best of her.

So, stay calm and do what you do to the best of your ability. Make sure your documents are together and that it reflects the care bring provided and that everything is signed and dated. If it's not, again, stay calm. Either it's done correctly or it isn't. Most people screw up when they start making excuses because what they say at that point may or may not send us deeper into what we look at.

You, along with your administrator, will be part of the exit conference. But the whole process is very simple and quick as long as everything is as it should be.

Of course, each facility is different.

Good luck!

quiltynurse56, LPN, LVN · Jun 22, 2016

Here I thought doing wounds, meds and neb treatments were all part of the job of being an LPN. Anywhere you go, there are going to be cliques among the staff and some are going to be lazy.

I guess I am not sure what you thought being an LPN/LVN was all about or what your state's scope of practice entails.

Knute · Jun 22, 2016

LTC is a broken system in the USA with little real oversight. Everyone cleans up and patches up and hides for DOH visits. How can we expect a CNA who is not paid a livable wage and does the majority of nursing's work, to bend over backwards for us when we are the enemy that gets them fired for non-compliancy, etc.. In fact many of us take out our own victimization due to abuse and impossible standards by management on CNA's. I have seen this many times. Elder factories and Nursing as a whole need complete overhaul and regulations in effect now, standardized and better policed across America. SUGGESTIONS for care be replaced with YOU MUST COMPLY with patient numbers, etc.. Assisted Living is also all about making money unless non profit (and even some of these are HELL'S KITCHENS). Worrying about getting off every shift with your license intact due to short-staffing and failure set ups, shouldn't be the norm, but unfortunately is the norm within both groups in many places. Today's nurse needs to be a Nurse SEAL with full capacity to screen for oncoming flak from every direction. :)...all the while loving and protecting the poor soul luckless enough to be in house. Hospital error is now 3rd leading cause of death in the USA. I bet HELL is going to look a lot like LTC.

dixieyid305 · Jun 23, 2016

Its not an easy thing !! in my case, it was so depressing how family members just dropped off their love one and hardly visited and expect the world.Another huge turn off for me was the Admin had no idea what nursing was all about, they just saw $$$ and didn't really care much about the Patients.

NurseSpeedy, ADN, LPN, RN · Jun 23, 2016

Assisted living scared the crap out of me. If you think keaving LTC is going to make things better, you may not like what you find.

There are two big differences. Number one-unless your facility has special licensure, chances are, you cannot do any skilled nursing care. In some cases, it's a bandaide with neospirin. Yep, required a home health nurse (or family member who was willing to do it to save money). Number two- I don't know about every location, but atleast from my experience, the resident care staff do not have to be CNAs-in fact, most were trained with zero experience.

I worked several shifts as the only licensed nurse and supervisor for whoever cared to show up for their shift for over 100 residents (plus a memory care unit). If I was short staffed, I was also med tech with 4 full carts. My last day one other person showed up between 7a and 9a. I broke out in hives every shift.

If if you think assisted living will make things easier, you're probably not going to like what you find. Many of these places do not accept a lot of insurance and can pick and choose who they accept (money). As long as they have money and they don't require 'skilled' care, they're in...but I've yet to see one or two people safely transfer someone who obviously required 3 people or a Hoyer lift to get out of bed denied based on being above the facilities level of care denied if they could pay what they asked.

I hope you found something you can enjoy. i just hope that the term assisted living isn't what made you think the job would be better. It was by far the worse career experience of my life.

Been there,done that, ASN, RN · Jun 23, 2016

You reached your breaking point in 3 months? Nurses perform all aspects of patient care. You were learning wound care, the treatment of the respiratory patient, and medication administration (which is never ending).

My advice? Stay in one place long enough to learn your basic skills and how to gain rapport with ancillary staff.

n_matjushenko · Jun 23, 2016

I love LTC at least you know what your going into. Assisted living they lie. If they are private pay they welcomed in . Many are not fit to be in Assisted living but money talks. Mscoleman78 I too am from the Chicagoland area. I have two job LTC and Assisted living. I'm literally asking my boss to have on the schedule every other weekend because I'm tired of lies in Assisted living

Mscoleman78 · Jun 26, 2016

I absolutely will stay in one place, when I find a job that pays better, where there is team work, and Where I feel comfortable and at place that conducive to a new nurse and my license. There is more to the story that I didn't write, but it's obviously an issue when 4 out of the6 people I began orientation with are already gone, and people are leaving every day. I understand that nursing is challenging and I didn't go to school and fight as hard as I did to become a nurse to walk away because it's hard or I didnt get along with the aides.

Mscoleman78 · Jun 26, 2016

I plan on working part-time in a LTC also to keep and/or gain my nursing skills once I get my schedule from the assisted living facility.