RN's In Nursing Homes ?

AntFlip7395 · Nov 13, 2008

Many RNs, especially new ones, are not attracted to ECFs due to the associated low acuity. Granted, many nursing homes have skilled areas comparable to a med-surg unit. However, hospitals offer a wider range of experiences.

Also, not every nursing home runs on 12 hour shifts and many nurses like working only 3 days per week. I know for myself that I don't want to have to be at my workplace 5 days a week, it's just too much.

TheChair1 · May 16, 2011

I agree with the post above. I think that if nursing homes had more opportunities to work 12 hour shifts, more RNs might be interested.

caliotter3 · May 16, 2011

Many new RNs buy into the stigma reputation that is so often hyped about working in LTC. They think that a hospital will never touch them once they have that on their resume.

deleern · May 16, 2011

I work in LTC...you need excellent time management skills

cluna11 · May 16, 2011

What part of Ohio are you located in?

Nonick9700 · Jun 17, 2011

The issue that always irked me were how STNA's are handled at the LTC I've worked at. I've been an aide, I know many good aides - this is not an attack on aides in any way. However, we all know or have our own horror stories of the few bad apples. What I hated, is that my license was always threatened and on the line for what the aides did or didn't do. Myself & fellow nurses would write aides up for flat out, to our face, refusing to do work or even threatening us with bodily harm, and they would still be employed. These are conditions I no longer put up with. This was one facility in particular, who threatened the nurses, in hopes we would get the aides to do their work. My opinion: fire all the ones that don't want to work & don't care about people, there's plenty of hard working, caring people looking for jobs!

I think another issue is the ratio. Yes, there is acuity to consider, but a lot of nurses only see numbers. When they hear hospital ratios are 1:4-6 and LTC is 1:32, they balk.

Lastly, it is a lot of work, but very little use of nursing skill. I spent more time redundantly signing my initials than utilizing my skills. Many nurses fear losing what they've learned.

Just my two cents based on my experience in LTC.

abbnurse · Jul 3, 2011

Lots of good points being made here....... I worked in LTC years ago and here is my two cents:

1) One of the biggest concerns of the RN's I worked with was the fact that they were often working in a supervisory position as a unit manager/possibly expected to supervise the entire facility on weekends and nights, AND quite often had to take an assigment of patients if we were short-staffed (which was often!!)....very frustrating for them.

2) Another concern, which was also mentioned above, was the ratio. 25 patients to one nurse was considered an "easy" assignment. And I don't think acuity is as low in LTC as many people seem to think it is! I can't emphasize this enough. I can't tell you how many great RN's I worked with for a very short period of time; the number of patients assigned to one nurse was simply too high, and assignments were just not safe or sensible.

I never heard complaints about rate of pay, though, except in the form of "No amount of money in the world is worth what I have to deal with everyday." But that sentiment isn't exclusive to RN's, or to LTC, is it?

I don't know if either of these concerns apply to your particular facility, but I hope the the information helps. Good luck in your search.

eyknough · Jul 13, 2011

I think it's the staffing to client ratio. I started out in a LTC facility where I was assigned about 15 patients, and I thought it was just too much for me. I like to feel like I'm meeting all of the patients' needs, but there's just no realistic way to do so with such a ratio. I was told it is worse elsewhere. Boy, they were not kidding.

I started at another facility where I have 48 patients. Like the nurses above have said, I spend probably more than an hour initialing on the lines and signing my license away in a place where I can not feasibly provide adequate nursing care for all the patients I am assigned to. And when I check regulations for nursing home staffing, I find that I could, by law, have more than double that patient load.

My head is spinning.

The answer, in my opinion, is more help. Fewer patients to take care of so their needs can be met; so the nurse isn't driving home every day wondering what they were not able to get to... wondering how they will ever get to everybody with an inkling of compassion. The nurses who are successful in this setting, I find, have become assembly line workers. They just don't care anymore if the patients are happy; they don't care if needs are not met. I hear "time management" over and over at work. What that boils down to, in my opinion, is prioritizing, and then telling all of the patients who are not high on the priority list that you don't have time to just hold a conversation with them. Priorities are priorities, but I think everybody's needs are important and deserve some attention. I can not honestly tell them "I have to take care of someone else right now, but I will be back".... because I know that as I take care of priorities, other priorities will arise that will supersede many clients' needs.

I am a new nurse with less than a year's experience (but with 18 years of aide experience). I long for the day when a hospital will call me up and offer me a position.

LovedRN, BSN, RN · Nov 17, 2011

There is no time for a quality of care. I don't want to become a machine.

sm06902 · Mar 19, 2012

Im about to graduate with my RN and currently work as a CNA in a nursing home. I am very afraid that a hospital won't count it as experience...how true do you think that is?

incredibleme · Mar 21, 2012

The problem with nursing homes is that there is no concern for the how acute someone is like in a hospital-if there were, we wouldn't be 1 RN to 40 patients on a skilled unit....and management doesn't really care as long as the beds keep full. I am a machine unfortunately. I try to squeeze in education and one on one time based on who needs it most. If you come in with a second knee replacement...you are not going to see me much except when you ask for pain meds (and I might be late...)