Question about working in LTC

Specialties Geriatric


  • Specializes in Geri and adult psych, hospice.

Hi Everyone,

I have a few questions that I've been thinking about lately and I need some expert opinions. I will graduate nursing school in 2006, and as of now I really feel a strong pull to work with geriatrics as an RN in LTC centers, particularly with Alzheimers patients, as I've done a little bit of work with that population so far and I love the challenge and rewards of it. My question is, as an RN that works in LTC centers, how much time do you actually get to spend with your patients on an individual basis working with them? Whenever I go into LTC centers, it seems like the RN is usually behind the nursing station filling out paperwork, the LPN is passing meds, and the CNA's are the ones that really get to provide the hands on care and work with the patient. I mean, I know that is what CNA's mainly do, but I don't want to be stuck behind a computer all day as an RN! I want to help people hands on! Would I be better off in a home health type enviroment, or am I just totally off base and reading it all wrong? Can anyone just describe a day in the life of an LTC center nurse for me? I know I may be jumping the gun a little :imbar but it's never wrong to be well informed, right? :) Thanks everyone! Louisepug

Specializes in Mostly LTC, some acute and some ER,.

In my facillity the RN's work the floor just like the LVN's. The CNA's do a large amout of the patient care, such as feeding, baithing, and other basic things. The LVN's and RN's do the treatments, pass meds, and both RN's and LVN's do the paper work. There are office RN's who do the computer stuff and the care plans, but I mainly see the RN's doing the same as an LVN. The main difference is an RN can do more than an LVN/LPN can, and the RN basically is the charge nurse, they run the show.

That is how it is in the rural LTC I work at anyway.

I hope that I could be of some help. I'm a CNA, so I don't know all that an RN does.

Good luck to ya



236 Posts

At my facility both the RNs and the LPNs assigned to work the floor function in the same capacity. Most of the office type jobs are held by RNs but we do have quite a few RNs on the halls. Those RNs aren't in a supervisory capacity over the LPNs because all of the licensed nurses have their own section. Each shift has a supervisor...right now all LPNs. How can an LPN supervise and RN you might ask... I dunno but they do. At my facility in particular there aren't any assigned tasks on the floor that require an RN instead of an LPN.

This facility does have a dementia unit and that was my permanent assignment for a year. We had all of the patients that were deemed wanderers. We had a good portion of the SDAT patients. The only SDAT patients that aren't on that unit are the ones in the beginning stages and some of the ones thats health had deteriorated to the point that they are functionally bed/chair ridden and are no longer an elopement risk.

I absolutely loved working with the Alzheimers residents. I hated to leave that unit, but chose to do so because I needed a different work schedule to better suit my home life. I still miss it some and like to fill in back there from time to time.

I worked the day shift on the weekends. I'd come in and after I counted narcs and got report. I'd pass meds from probably 7:45-9:00. The med pass on the Dementia unit is very, very heavy. It also would take a lot of trips up and down the hall because my patients were always on the move. It is a locked unit to keep them from running off. I usually didn't get a chance to help with breakfast. I almost always helped the CNAs to feed certain residents at lunch time. Assisting with meals was very time consuming but a lot of the residents would have no interest in food and some had forgotten what it was I believe. I liked to help because that way I knew all of my patients had consumed as much of their tray as possible. They ate on the unit in their own DR. I did my noon med pass around lunch. We also had to offer snacks and drinks throughout the day because of their disinterest in food and potential for malnourishment or dehydration.

I would have to intervene in their arguments because they will fight. It was something quite different at first to watch these arguments start. One resident would be fussing about something in their past and the other resident would start yelling back at them about something completely different. I would have to calm down the ones that would get physically aggressive with staff. I would have to make sure I saw every resident periodically.

On that unit you wouldn't see many catheters, PEG tubes, IVs etc. It was mostly behavioral and providing their medications and basic needs.

Nights on the unit are either blessfully quiet and boring or either a wild ruckus. Days were a lot more action packed because everyone was up and running.

Around here we do have a lot of RNs on the floors. Mgmt will offer them other "office" jobs from time to time when there is an opening, but we have plenty that won't leave the floors.

I don't know if you'd have time to do this since you are a student, but volunteering with the Activities Department is a fun and educational way to see how the nursing home runs and to get a feel for the patients. In nursing school our teacher required us to do two hours of "community service" for every hour that we missed of class. I did my hours with the activities department. They were ecstatic to have the extra help and it was a rewarding experience.


236 Posts

P.S. Is that your Pug on the avatar?? :)


151 Posts

Specializes in Geri and adult psych, hospice.

FutureRNmandi and Froggylegs,

Thank you so much for your replies! :) And, no, that isn't my pug, but it looks exactly like him! Anyway, it was very helpful to know what your day entailed, froggylegs. It definately sounds like something I'd love to do because I've even thought of going into psych nursing as well. I've always loved the psychological stuff. As far as volunteering goes, I actually do volunteer for Hospice, and my 2 patients are alzheimers ladies in a LTC center. I go every week and spend an hour or so with them which I really enjoy. I guess at this particular LTC center, the nurses don't act so caring towards their patients. I had to tell a nurse yesterday that my client seemed to have a headache/possible fever, and she didn't even know that resident by name. It's not a very big floor either. When I am a nurse, I want to be able to take the time to get to know and bond with my residents. Maybe some just don't really want to do that :o . Or maybe I'm just being idealistic. Anyway, thanks again everyone, and good luck to you all! :) Louisepug

nursedawn67, LPN

1,046 Posts

Specializes in Geriatrics, LTC.

Where I'm at LPN's and RN's do the same duties, with a few exceptions...the RN's can put in IV's where the LPN cannot, and the RN's are on call on the weekends for IV emergencies.

Basically that is the only difference.

As far as our office nurses we have RN's and we have LPN's holding those positions.

Good luck in what you choose! :)

leslie :-D

11,191 Posts

same at my facility...although i worked the hospice section most of the time. i just recently learned after working there 7 yrs. that the lpn works under her own license. on 7-3 you really don't have time for 1:1 w/the patients. unfortunately the only ones you spend any time w/are those that are sick or need rx's. at least when you do meds you get a few minutes w/each. on 3-11 it starts to quiet down after 7 pm but most of them are in bed. it is when you are blessed with one of those rarely 'slow' days that you feel you have been productive, which is btw, getting to finally clean and clip pt's nails, brush their hair, those personal touches that make the world of difference.

This topic is now closed to further replies.

By using the site, you agree with our Policies. X