Questions about RN role in LTC


Hi everyone! I have worked in LTC and AL for quite awhile as a CNA but, I will be graduating with my RN in a year and although everyone tells me to work in a heart is with the elderly and LTC. I want to be able to actually get to know my residents...for more than a few days or a couple of weeks. Anyway, I don't really know what it is a RN does in LTC. Can someone give me the titles and the job descriptions?

Also, if you do decide to get into management: is a Bachelors in Business Administration and an ADN enough or will I need to get my BSN?

Thanks in advance!!:)

Specializes in Geriatrics, Transplant, Education. Has 15 years experience.

I'm an RN working in a LTC facility, and I am a staff nurse. My facility has a mixture of RNs and LPNs working as staff nurses, and RNs in management positions.


1,049 Posts

Specializes in Vascular Access. Has 32 years experience.


As the previous poster stated, you may be a staff RN, or work in a management capacity in a LTC setting.

However, to answer the second part of your question, A Bachelors in Health Care Administration (which will give you a BA) will qualify you to gain entry into the realm of Nursing Home Administrator. Obtaining your "Licensed Nursing Home Administrator Certification" will also be paramount at some point in your career.

Most Directors of Nursing in LTC facilities are RN's, but some have additional schooling on top of that.

Hope that helps.

Jo Dirt

3,270 Posts

Has 9 years experience.

You'll do the same thing LPNs do, only when there is a problem people will come and expect you to do something about it if the DON/ADON isn't there.


255 Posts

Specializes in ED, Rehab, LTC. Has 3 years experience.

I have been both an LPN and an RN in LTC. It depends on your facility, but at mine, if I was working as staff nurse, the job is the same as the LPN's. The major difference I found when I got my RN is that I was expected to fill in as Supervisor when there were no other RN's in the building (usually evening shift).

Most of the management has only associates degrees. That includes the ADON, DON, etc... I don't think you need a BSN, but it probably wouldn't hurt.


13 Posts

I don't see why you can't do both...You need some experience in the hospital setting...and if you u love LTC then work prn ...


219 Posts

Specializes in Med-Surg, Peds, Ortho, LTC and MORE.

My thoughts are a bit different after working the past 28 years off and on in long term care:

The Charge Nurses the role is not simply a shift role with some "extra" duties/ tasks that are done.

It is a professional component of registered nursing care that requires supervison, survellance, and oversight. Charge Nurses have to have a perpective that rises above the bedside.

Charge Nurses have to look at staffing issues, politics and conditions, enviromental issues that impinge on patient safety and care.

They are first responders in emergency situations.

They need to be well versed in politics and proceedures and through constant monitering and survellance anticpate problems before they arrise.

They need to be diplomatics accostumed to address any concerns the patient and the family may have.

Charge Nurses have 100 % responsilbility without 100% authority.

Charge Nurses must rely on other Departments ( housekeeping, dietary, laundry maintaince pharmacy etc.)to have 100 % compliancy with physcians orders and a safe and healhy resident.

The Charge Nurse has a duty and obilgation to practice supervison and leadership over other care givers as a RN.

One of the realities of supervision is doing the paperwork and documentation of any varienaces of care, or violation of the nurse practice act. or of substandard care or medication errors.

This is in addition to working as the medication and treatment nurse , passing medications and doing any treatments, ( dressing changes, nebulizers AND and any other respiratory theraphy etc.).

Just how I see the Charge Nurse role---


achot chavi

980 Posts

Specializes in acute care and geriatric. Has 20 years experience.

For starters: GOOD LUCk in your schooling and I hope all goes smoothly.

To answer your questions, it depends on the facility and the state, why jump the gun- take each bridge as they come, first finish school, pass your RN boards, find a job that suits you- then decide if you want to go into adm. and take courses that will help you develop the skills you will need.

Responsibilities of an RN or LPN differ in each state and facility so remember each answer is reflective of that. In our facility the diferent responsibilities are clearly respected, we all need each other for the patients ultimate good.

You will need some years of experience as an RN in LTC before you should safely try supervision to see if its right for you, by then it will be be clearer to you.



23 Posts

Wow! Thanks everyone for your answers. I am seriously considering doing prn and the other full time or both part time. Here in KS the LTC system is so low on nurses that many times, the person is hired and only has about 6 months before they end up in management. That is kinda why I was worried. I don't want to screw up THAT! Having worked in LTC with both good and bad management I think I can really help make a difference...eventually.

Does anyone here know the best places to work near Kansas City on the Kansas side for LTC or AL?

achot chavi

980 Posts

Specializes in acute care and geriatric. Has 20 years experience.

ok, I don't think 6 months is enough experience to jump into management and I have to question how so many mngmnt positions are available - hmmmm could it be that it is because they are filling them with nurses still green behind the ears- and don't last?

When you start working- find a good place with a good reputation so you can find a mentor to help you learn and grow. Passing my RN boards was just a begining- I had loads to learn and I would have fallen flat on my face had I jumped to mngment after only 6 months!!!

The rate of turnover should scare you.


23 Posts

It does scare me. It bothers me because I know that the residents can't be always getting the proper care. When I say management, I mean charge nurse. Although, I do know that a lot of places have ADON's that only have about 1 year of experience. Go figure. Heck, on my floor at the hospital I currently work at the charge nurse for days about half the time only has a little over a year of experience. I mean, she is a great nurse, but she is not ready to lead to that extent. She has to lead other 7 other nurses and 3-4 techs when she is in charge, with 22 progressive care patients...and usually has patients of her own.

The shortage is starting to make sense though. Why would anyone want to stay when they have to work that hard and only get about $25 and hour?

This topic is now closed to further replies.