Should I try LTC?

I honestly would try outpatient dialysis first. I would have to be tiptoe-ing on the line of homelessness coupled with starvation before i ever work LTC again. It's just not the same any more. Too many residents to take care of, to many backwards policies and the patient demographic in some places is definitely not LTC appropriate. NOT all places are "bad", but it truly is difficult finding a place where the good outweighs the terrible. What i found throughout my years in LTC is most long term care nurses are very smart and i learned alot from them. I just would not want to go back and work in that environment. Kudoes and blessings to all who can!

34 minutes ago, 819Nurse said:

I honestly would try outpatient dialysis first. I would have to be tiptoe-ing on the line of homelessness coupled with starvation before i ever work LTC again. It's just not the same any more. Too many residents to take care of, to many backwards policies and the patient demographic in some places is definitely not LTC appropriate. NOT all places are "bad", but it truly is difficult finding a place where the good outweighs the terrible. What i found throughout my years in LTC is most long term care nurses are very smart and i learned alot from them. I just would not want to go back and work in that environment. Kudoes and blessings to all who can!

Thank you for your response! I've been leaning toward dialysis, although I've heard terrible things about it too. I know each specialty has pros and cons though. The nurse/patient ratio in LTC scares me. The hours with dialysis are long and management is not always good, but that can be anywhere.

I would not recommend LTC at all. I had no idea how bad it was back when I was a new grad LVN. I begged management to let me return to my CNA job at the facility. Yes, I would rather be a CNA then work as a new in LTC. I only made it about 2 months. Places that are always hiring is a massive red flag. People do not want to work there.

It is not uncommon for LTC nurses to have worked at over 10 different LTC's in search of a better place. I worked with so many during my 4 years as a CNA. Burnt out, frustrated, looking for some level of sanity. It's actually pretty sad to see. The grass is not greener. It's the same everywhere.

1 hour ago, bryanleo9 said:

I would not recommend LTC at all. I had no idea how bad it was back when I was a new grad LVN. I begged management to let me return to my CNA job at the facility. Yes, I would rather be a CNA then work as a new in LTC. I only made it about 2 months. Places that are always hiring is a massive red flag. People do not want to work there.

Thanks for responding! It’s sad that work conditions in LTC are so bad! I feel bad for the people that call these places home. What area of nursing do you work now?

I left LTC over 13 years ago and have been in corrections ever since. It is a million times better.

It is sad to see and will only get worse with the baby boomers entertaining retirement and needing long term care. The LTC here is bringing in foreign nurses, paying them peanuts, and signing them to 2 year contracts to earn visas. They can't quit before two years or they get deported. I talk to one who worked at this LTC before coming to corrections.

This is the future of LTC .

Shame on the greedy corporations and administrators concerned only with the bottom line. Shame on the politicians who approved these horrendous staffing ratios long ago for LTC. No regard for patient care.ll

The elderly really are treated so bad in this country. Society wants them out of sight and out of mind.

So they lay in bed in their feces and urine living out there golden years. Staff is overworked, underappreciated, and the elderly have family members setting up hidden cameras in nursing homes all across the country.

The whole system needs shut down and rebuilt from the ground up. Yet families keep putting their parents into these places.

I am one of the few, I think ... a new-grad RN who chose LTC, not out of necessity but because it is where I want to be.

I considered outpatient dialysis, and I too read up on what it is really like to work there, and decided it was not for me.

There is definitely a difference between AL and working in a SNF/rehab. What are you looking for, specifically, in your work environment? What is most important to you? That may help guide responses.

1 hour ago, 37changes said:

I am one of the few, I think ... a new-grad RN who chose LTC, not out of necessity but because it is where I want to be.

I considered outpatient dialysis, and I too read up on what it is really like to work there, and decided it was not for me.

There is definitely a difference between AL and working in a SNF/rehab. What are you looking for, specifically, in your work environment? What is most important to you? That may help guide responses.

I am looking for an environment that has advancement opportunities. I want a position where I can continue to use nursing skills and eventually end up in leadership.

22 hours ago, 819Nurse said:

Kudoes and blessings to all who can!

Yes, bless their hearts.

LTC has huge turnover because of the working conditions. A friend of mine just shadowed at an LTC, I prepared her for what questions to ask. She said all the nurses there were young and everyone she asked had been there one year or less. They are dying for staff. One of the main reasons is that they have high expectations placed on them by regulating agencies and low payments from Medicaid. Also the state sets up what the staffing requirements are, such as 2.2 nurse hours per patient or whatever it is now. They allow administrative and management(non direct care staff) to be counted in the ratio. So there may be 5 nurses for 30 patients, only one nurse is actually doing the care. Do you want to be the ONE nurse? In addition, family members have unrealistic expectations. They just don't have a dang clue what you are up against in LTC.

On the other hand you can develop some great relationships in LTC with staff, patients and family members.

I worked in LTC for over 5 years and the one thing that really stuck with me is the degree of physical and mental deterioration a human being can exist in and still be alive. They can stay that way for years and years and it can be very sad. There is definite room for advancement in LTC because positions are vacated on a regular basis. Administrative positions are salary and you may work 50-70 hour weeks.

I don't know much about dialysis, but from what I understand hours can be very long and the work rather redundant. So, I would tend to go for LTC if you want to advance. Since LTC and Dialysis is so specialized you may find it difficult to get out of.

Now, Assisted Living is not what it used to be, nothing is of course. But many of the AL patients are what we used to have in LTC 20 years ago. So, sicker people on a lower level, your LTC may be pretty acute these days.

Skilled/short term rehab, multiple admits and discharges continuously and therapies all involved too.

I wish you the best of luck in whatever you decide to do.

11 minutes ago, Forest2 said:

LTC has huge turnover because of the working conditions. A friend of mine just shadowed at an LTC, I prepared her for what questions to ask. She said all the nurses there were young and everyone she asked had been there one year or less. They are dying for staff. One of the main reasons is that they have high expectations placed on them by regulating agencies and low payments from Medicaid. Also the state sets up what the staffing requirements are, such as 2.2 nurse hours per patient or whatever it is now. They allow administrative and management(non direct care staff) to be counted in the ratio. So there may be 5 nurses for 30 patients, only one nurse is actually doing the care. Do you want to be the ONE nurse? In addition, family members have unrealistic expectations. They just don't have a dang clue what you are up against in LTC.

On the other hand you can develop some great relationships in LTC with staff, patients and family members.

I worked in LTC for over 5 years and the one thing that really stuck with me is the degree of physical and mental deterioration a human being can exist in and still be alive. They can stay that way for years and years and it can be very sad. There is definite room for advancement in LTC because positions are vacated on a regular basis. Administrative positions are salary and you may work 50-70 hour weeks.

I don't know much about dialysis, but from what I understand hours can be very long and the work rather redundant. So, I would tend to go for LTC if you want to advance. Since LTC and Dialysis is so specialized you may find it difficult to get out of.

Now, Assisted Living is not what it used to be, nothing is of course. But many of the AL patients are what we used to have in LTC 20 years ago. So, sicker people on a lower level, your LTC may be pretty acute these days.

Skilled/short term rehab, multiple admits and discharges continuously and therapies all involved too.

I wish you the best of luck in whatever you decide to do.

Thank you so much for your detailed response! You've definitely given me something to think about. Part of me is drawn to LTC because of the versatility and being able to see so many different things. But the amount of pts to be responsible for is scary.