I think that when people say you'll loose your skills by working in LTC, they don't necessarily mean IV, enteral feeding, or wound treatment skills, those are easy to relearn. I think they mean more of your critical thinking and assessment skills will go down the drain. If you have to be responsible for 30 residents, there is not a ton of time to work on those skills and keep them polished. I'm an LPN, and I worked my first year in a step down rehab/vent unit in a hospital in a large city's downtown. I gained a lot of great skills and knowledge there and the nurses were very on top of things. I later moved to another city and began working in a LTC/rehab. I cannot believe some of the errors and detrimental things that I've seen since working in this LTC. A resident that had a well known history of MRSA infection of a rod in her femur stared having signs of reinfection. She stopped being able to ambulate for a few days after previously being able to ambulate independently with a walker for months. Her leg was piping hot, she was confused, and her BP was in the 80s systolically (this was a previously healthy, alert and oriented lady). This went on for three days without anyone spotting it and calling the doc. THREE DAYS! She ended up being septic, and barely lived. This type of thing happens all of the time there. It almost seems like the nurse's main objective of the day is to hand out all the pills to the 25 residents, sign for the meds and treatments, and do another med pass. There isn't very much assessment of the residents or looking into things that don't seem right. I do admit that it is hard to completely assess 25 people in LTC the same way you would assess 6 people on a med surg floor, but it seems as if a lot of the nurses dont even TOUCH the residents, they literally just hand the person a cup of pills and leave. When a resident has SOB, a lot of the RNs really don't know where to start when it comes to interventions even though following basic ABC protocol would get them out of this bad situation. I don't know if it is like this at other LTC facilities, but after I become an RN in a few months I am getting out of LTC and never looking back.