7 Myths of Long-term Care Nursing

You might think long-term care nursing is all doom and gloom. However, this specialty offers challenges, purpose, and even lots of opportunities for collaboration. Read this article to learn about the top seven myths of long-term care nursing. Specialties LTAC Knowledge

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7 Myths of Long-term Care Nursing

What do you see if you close your eyes and imagine the nursing care provided in long-term care nursing facilities? Do you picture a dark and dingy workplace with older adults lined up in beds, quietly waiting for the end of life? Or, maybe you picture a place that offers little to no challenge or career advancement for LPNs and RNs. This couldn't be further from the truth. 

The care provided in long-term care facilities has become more specialized and acute today than ever before. Seniors are living longer with more chronic conditions and comorbidities, making the need for skilled care in these facilities critical. 

So, what is long-term care nursing really like? Check out seven myths about long-term care nursing you might have thought were true. 

Myth 1: Long-term care nursing is easy

Long-term care nurses work in stressful, fast-paced atmospheres that are highly regulated by state and federal laws and rules. Each nurse must have a solid and comprehensive knowledge of these rules and overall patient care. They must also be trained in geriatric care and the needs of people living with chronic and long-term disabilities. Long-term care nurses must also be exceptional at handling competing high-priority tasks and communicating with physicians, colleagues, and family members. 

There's no shortage of challenges in this specialty, and the need to specialize is only limited by your imagination. Long-term care areas of specialty include memory care, wound care, and Minimum Data Set, also known as MDS, which is the assessment that must be done for the facility to get paid by Medicare and Medicaid. 

Myth 2: Nurses in long-term care lose their nursing skills

Many long-term care facilities have units where residents needing higher acuity care can stay. In these units, residents can receive IV therapy, highly-skilled wound care, and other higher acuity treatments. LPNs provide the majority of hands-on care in these facilities, while RNs provide leadership and assist with high acuity skills LPNs might not be able to provide. While it's true that long-term care residents might not need an assessment each shift, nurses still use their assessment skills to monitor for changes in this patient population that can change in a matter of seconds. 

Myth 3: Long-term care offers few opportunities to make a difference

Folks living in nursing homes aren't just sitting around waiting to die. They live some of their best days and connect with those around them. This means that the nurses are spending time with residents who have lots of love to give and stories to share. Nurses might not be making life-or-death decisions all day, but they are providing care, compassion, and empathy to people who deserve it!

Myth 4: Facilities are old and dumpy

Long-term care, memory care, and assisted living facilities have made great strides in recent years to elevate their appearance and overall services. Today, seniors can choose from facilities that offer various levels of care, gourmet meals, and a packed activities calendar that might have you wishing you could attend! Along with services, these facilities offer double and single-occupancy rooms, and many offer apartments or homes on their grounds. Hence, the residents have privacy, also easy access when services are needed. 

Myth 5: Nursing in long-term care is thankless

Long-term care nursing is stressful, and you will make many decisions based on rules and regulations. However, as a nurse, you'll receive much love and appreciation from the residents and their families. You'll also become like family to them. And, if you're lucky, you'll work in a facility filled with many loving care staff members who will be thankful for you too. 

Myth 6: RNs work on their own in long-term care

Long-term care facilities offer an excellent opportunity to work with an interdisciplinary team. The nursing team is often comprised of CNAs, LPNs, and RNs. You'll also get to work with physical and occupational therapists, social workers, dietitians, physicians, nurse practitioners, and administrative professionals. And many registered nurses are afforded a level of autonomy in long-term care that may not be found in other specialties.

Myth 7: Residents go to long-term care to die

Many people think long-term care is depressing. You might be surprised to learn that some residents' overall health improves once admitted. This is often because they weren't receiving holistic care living at home alone. Some residents also improve mentally because they are surrounded by people and have the opportunity to participate in activities and events at the facility. 

Ready to Try Long-Term Care Nursing?

Now, you have a more accurate picture of the care provided in long-term care. You understand the importance of the nurses who work in this specialty and the needs of the residents. Is it time to give it a try to see if this specialty is for you?

Do you have other myths you've heard that you need to know if they are true or false? If so, put your thoughts in the comments below, and we'll do our best to help you learn more about long-term care nursing. 

Workforce Development Columnist

Melissa is a registered nurse with over 23 years of experience. She is a nurse leader and freelance writer who loves challenging the status quo.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

An excellent article that would be especially helpful for new grads as they make first career choices. My first five years in nursing was in a long term care facility and I will always think that they are some of the hardest working people in healthcare. The regular assignment was 30 residents on a shift, but on rare occasions a nurse would call out, especially for nights, and it was sometimes one nurse and one CNA for sixty residents. That meant med pass and rounds with the CNA for many people that required total care overnight. In addition to keeping an eye on anyone who was already known to be sick, or might have a change in condition.

In the hospital I readily have monitoring equipment, or data I can look at. Patients in the facility where I worked only got vital signs done on a weekly basis, unless they were taking antibiotics, post fall, or those with bp meds. So sometimes a change in condition had to be picked up on assessment alone, especially in the non verbal patients. 

And the med passes are no joke! As a new grad, a 30 resident med pass from 4-6pm and then another from 7-9pm, with timed medications that turn red in the EMR if not given in the right window, it was stressful at times. But I learned time management and got to learn lots of medications pretty well.

I worked with some great nurses and CNAs. Sometimes the staffing was awful, and it was due in part to the facility being cheap and in part because many of my coworkers were single moms that needed the flexible schedule, but had the challenge of managing things like babysitters that don't show up or kids getting sick. But overall the residents in my facility were very lucky to have so many committed and caring and nurses and aides providing their care. I have some wonderful memories and stories of the people that worked and lived there and I know that many people would find it to be a rewarding place to work. 

Thank you for your well written article.

Specializes in hospice.

Great article, thanks!

Specializes in Home Health,Peds.

Long term care can be long term acute care, sub acute, and even rehab.

It just doesn’t mean nursing home type long term care. 

Specializes in ICU, trauma.

This is a great article but in the wrong forum... long-term acute care is typically a weeks-to-months-long stay, with acuity usually being less than a typical ICU, but more than a stepdown unit.  

This article belongs in the LTC forum