I don't work in a VA LTC but I am in LTC. Personally I love it. I get to connect with the residents and really become a part of there lives. It is very rewarding , as with any type of nursing it can be very stressful. I also worked med surge prior. This job can be physically demanding as well, I help residents with transfers and positioning , I answer all lights and do whatever I can to assist the CNAs. Unlike the hospital in the nursing home you are literally in charge of a larger number of residents and assistive staff as well. With this being said my heart has always been in geriatric care, I worked as a CNA for many years prior to becoming a nurse .