Should I try LTC?

Specialties Geriatric

Published

Hello,

I've never worked in LTC. I've read so many horrible things about this area of nursing. I will be relocating in a few months and there are several LTC jobs available, both skilled nursing homes/rehab and retirement community. Is there much difference between the two? Is working at a retirement community less stressful? What about assisted living? I'm torn between trying LTC and outpatient dialysis. Thanks!

Specializes in Wound Care, Public Health, Dialysis, Primary Care.
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.

1
Up Vote Up Vote ×

^ what a great post. I do miss the relationships with the residents and some family members. They truly appreciated the hard work. In corrections, there are lines that can't be crossed in regards to what they call "over familiar" nurse - inmate relationships.

And while I enjoy corrections greatly, I do miss the close patient- nurse relationship that LTC provided.....even in it's fast, drive by, so I can get all my work done form.

After I graduate with my NP I may look into caring for our vulnerable elderly population. It truly is something I can see myself doing and it doesn't have the crazy pace like working full-time in the LTC facility does.

I do agree the patient loads are changing. A lot of LTC / SNF are basically subacute care now.

3
Up Vote Up Vote ×

I found a post of my LTC experience from 2006, under my old LVN account. Anyone considering LTC please read this thread. I changed to this account name after getting my RN license.

4
Up Vote Up Vote ×
Specializes in Dialysis.

I may be biased, but I have done dialysis for 27 years. It is a field where people love or hate it, but I was so burned out after 12 years of working in cardiology at hospital , I didn’t even want to be a nurse anymore.

But I needed a job, so I tried Outpatient Dialysis and fell in love with it and the patients.

Yes, it’s a hard technical job to learn, but for me it’s all about the patients. We take care of them for 3-4 hours a day 3 times a week. We may be the

I only social interaction they ever get. We get to know them and their issues very well.

Yes, there are difficult patients as well, and we learn to deal with them, and even win them over sometimes.

My suggestion would be to try to shadow someone for a couple days.

I won’t mention names but try to stay away from the “Big Two” companies, try to find a not-for- profit clinic group, or a privately owned clinic.

Try it, you may fall in love with dialysis too!

I would be happy to answer any question you may think of.

2
Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
14 hours ago, idialyze said:

I may be biased, but I have done dialysis for 27 years. It is a field where people love or hate it, but I was so burned out after 12 years of working in cardiology at hospital , I didn’t even want to be a nurse anymore.

But I needed a job, so I tried Outpatient Dialysis and fell in love with it and the patients.

Yes, it’s a hard technical job to learn, but for me it’s all about the patients. We take care of them for 3-4 hours a day 3 times a week. We may be the

I only social interaction they ever get. We get to know them and their issues very well.

Yes, there are difficult patients as well, and we learn to deal with them, and even win them over sometimes.

My suggestion would be to try to shadow someone for a couple days.

I won’t mention names but try to stay away from the “Big Two” companies, try to find a not-for- profit clinic group, or a privately owned clinic.

Try it, you may fall in love with dialysis too!

I would be happy to answer any question you may think of.

Thank you so much! The Big Two are the only option besides corrections nephrology. I’ll definitely see about shadowing in a clinic.

Up Vote Up Vote ×
Specializes in Dialysis.

I've done LTC, and loved it. The only reason that I left was the acuity of the patients is getting worse all of the time, and staffing doesn't reflect the changes. I too recommend dialysis if you can get in because finding a good LTC is very hard, although they are out there.

Some assisted living will not hire an RN because they cannot do skilled care, so they won't hire at that level if they don't need to. Shadow at a LTC and an AL to see if you like it.

1
Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
On 8/4/2019 at 3:03 PM, Hoosier_RN said:

I've done LTC, and loved it. The only reason that I left was the acuity of the patients is getting worse all of the time, and staffing doesn't reflect the changes. I too recommend dialysis if you can get in because finding a good LTC is very hard, although they are out there.

Some assisted living will not hire an RN because they cannot do skilled care, so they won't hire at that level if they don't need to. Shadow at a LTC and an AL to see if you like it.

Thank you! I’ll definitely look into shadowing.

1
Up Vote Up Vote ×
Specializes in Hospice.

There are some good LTC's but you have to look carefully to find them. I was fortunate enough to work at one as a new grad and gained a strong skill base there.

Currently I'm a hospice nurse so I visit several different SNF's. A couple are provide good care to our mutual patients, one downright scary and the rest middle of the road.

3
Up Vote Up Vote ×
On 8/1/2019 at 11:24 PM, bryanleo9 said:

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 .

Hey not sure if you are still active on here but I would like to ask a few questions about the contact and for foreign nurses and threat of deportation if quit. Once you get a green card, how can they deport you?

Up Vote Up Vote ×
Specializes in Nursing assistant.
On 8/1/2019 at 11:34 PM, bryanleo9 said:

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.

No they don’t sit in their own feces all day. A lot of older people could easily live with family. (Ones that have capacity and take themselves to the restroom). So what does that tell you? That it’s their families that don’t care for them really. We have to take care of them. Which I don’t mind at all. Residents become like your family. Do you know what a call button is? Do you know how annoying the social workers can be that they have to look into any report of any type of thing they can be off? So no they don’t lie in their feces all day every day. There’s always someone there at the facility 2/47 365 days a year. Day after day after day we come into work day after day. So what you say is not true. They live a pretty good life not all facilities are so negative like you try to say they are.

Up Vote Up Vote ×
Specializes in Wound Care, Public Health, Dialysis, Primary Care.
17 hours ago, Cnawork432hs said:

No they don’t sit in their own feces all day. A lot of older people could easily live with family. (Ones that have capacity and take themselves to the restroom). So what does that tell you? That it’s their families that don’t care for them really. We have to take care of them. Which I don’t mind at all. Residents become like your family. Do you know what a call button is? Do you know how annoying the social workers can be that they have to look into any report of any type of thing they can be off? So no they don’t lie in their feces all day every day. There’s always someone there at the facility 2/47 365 days a year. Day after day after day we come into work day after day. So what you say is not true. They live a pretty good life not all facilities are so negative like you try to say they are.

I'm sure not all LTC facilities are bad. I've never worked in LTC and even after initially putting up this post, part of me still wants to give LTC a shot (even if it's just PRN). When asking fellow nurses about LTC, I keep hearing more bad than good in regards to working there. But as a nurse, I feel like there is so much I could learn by working in LTC. Most of my experience is in outpatient care. I'm glad there are people like you that enjoy working in LTC!

1
Up Vote Up Vote ×
Specializes in Dialysis.
7 hours ago, Yellownurse15 said:

I'm sure not all LTC facilities are bad. I've never worked in LTC and even after initially putting up this post, part of me still wants to give LTC a shot (even if it's just PRN). When asking fellow nurses about LTC, I keep hearing more bad than good in regards to working there. But as a nurse, I feel like there is so much I could learn by working in LTC. Most of my experience is in outpatient care. I'm glad there are people like you that enjoy working in LTC!

There is much to learn! Just go in with the attitude that its a learning experience and find a home with a decent reputation. It's my other love, dialysis is my true love

Up Vote Up Vote ×
+ Add a Comment