I get the..well what does a nurse do there? The patients are not sick, not complicated.. do you have doctor rounds? I.v´s ? Isn´t it boring? Maybe you are not able to handle a real med/surgfloor..GRRRGHH.
My patients are complex, I am a damn good nurse, love my job and do the same thing every other nurse do. Geriatrics are not for evreyone but no need to look down at me! Do you find that you have to defend where you work and what do you tell people, to get rid of the myths about working in this specialty??
Sorry just needed to vent. I am of ( happily) to work now;-)
Another thing I've noticed is that how "good" a nurse is seems to be somehow linked to how many pieces of equipment the patient she cares for is hooked up to? No equipment= patient not sick. A simple NS peripheral IV= still easy, PICC Line or Central Line= getting harder, etc. Now if you're lucky enough to have a patient hooked up to IV ABT , blood products, and TPN via there central line, while also maintaining their chest tube and drainage tube and NG suctioning, then you are the absolute epitomy of nursing! Nurses that work the ICU or ER with all those bells and whistles are like the gods of nursing!
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I work in ICU and am truly convinced that LTC nurses are just as "good" as any other nurse. I am also convinved that anyone who disrespects or otherwise 'looks down' on LTC/geriatric nurses are simply ignorant and just dont know what they're talking about (to put it nicely). An earlier poster made mention that she took care of a patient in the hospital who was being discharged to a nursing home with a million meds and treatments, etc. So...this patient's nurse had to discharge this patient while caring for (guessing) 4 other patients.
The flip-side is...the LTC nurse has to admit this same patient while caring for...(guessing) 20 other patients...deal with 20 sets of families...has to coordinate care with QMA's, CNA's etc. Anyone who thinks that LTC patients magically become 'easier' the minute they're strapped to a stretcher and sent off to LTC is stupid.
I know i'm preaching to the choir so i'll stop this rant.... but the reason this a pet peeve of mine is because i have CLOSE acquaintences(sp?) who work in LTC and deal with this stuff...and it irks me...
Specializes in med-surg 5 years geriatrics 12 years.
I am back in LTC after a few med-surg years. I always point out that hospital nursing focuses primarily on an acute episode while LTC sees multi-system failure on a daily basis over and over. My fellow hospital nurses didn't always look at it for that prospective. We all do a tough job no matter the specialty.
When i got my RN, my classmates could not believe that i was actually WANTING to go into LTC. They constantly told me i would miss out on learning my "basics". Exsqueeze me? In my first 8 months i have had countless tube feeds, checking lung sounds included, Iv ABT's, trachs and a crash course in trach reinsertion (thank HEAVEN for the wonderful experienced LPN i work with). Not to mention the everyday antics that geriatrics pull that occasionally end up with a one way trip to the ED and having to be able to tell what is an acute situation and what can be treated in house. What exactly am i missing out on learning? I just chalk it up to people being under informed on what LTC nursing truly is.
As a Unit Supervisor in LTC i will tell you it is the greatest job i could ever have and far bussier than any other Acute care area i have worked. I have a large volume of residents i am responsible for all with up and down days. I have to manage the care provided by the CNAs, i over see and participate in the med. admin. Participate and run care conferences, talked to Drs, pharmacey and many others. We have to deal with family dynamics, and all that that entails. so if somone told me LTC is "less" or that i "can't handle Med Surg" i wuld suggest they come walk a day in my shoes and see what LTC is really about!!!
I have worked both LTC and hospital. I have found that while both have their challenges, LTC challenges are magnified by the nurse to pt ratio. After being in a hospital setting and caring for a max of 8 pts, I find it scary the LTC facilities give nurses 20, 30 even 40 pts!! Also, many of these pts are not little old ladies waiting to die. We get pts with g-tubes, wound vacs, IVF & IV ABTs, trachs, JP drains, and lot of other things that I believe were not a regular part of LTC years ago. Its like the LTC facilities are becoming more and more like exstentions of the hospital, and if DONs are willing to accept these pts, hospitals are willing to D/C them in stable but complicated condition...but the LTC nurses have like 3x the pts!!
Second, I believe the sigma attacted to LTC nursing does wear on the nurses. At least at the hospital we got some appreciation. But in LTC, it feels like you're always getting the stink eye. :coollook:Of course there are families that we get close to, but many look at you like your beating their loved ones. While there were nutty families in the hospital, you definately have to work harder for less appreciation in LTC.
And finally: SUNDOWNING, w/o any restraints!!! (I don't know if this is the same in all states) but in our state, LTC is restraint free!
I am proud that I work in Assisted Living, you should be too! Geriatrics is a SPECIALTY. I heard it in the hospital I used to work at where the "Tele unit nurses thought med surg nurses were dumb or God forbid you give an ICU nurse more than 4 patients or L&D nurses never get dirty". That is non-sense because we all choose which area we love and become well trained in that specific area. Our job as nurses is hard enough as it, so why the competition? A seasoned ER nurse may need help with a patient on a feeding tube because that is not common in ER. Does that make him/her less of a quality nurse? no, we ALL have questions, and are not perfect nurses. Anyways, it is an HONOR for me to take care of an elderly individual who is someone's grandparent, parent, brother or sister. I love that I can be their advocate and treat them with the same kindness and compassion I would as my parents and grandparents. I feel it is an HONOR to work with hospice residents and to be the one holding their hand when they die, so they are not alone. I feel that NO specialty in nursing needs to be defended. Any death or illness is complicated. Taking care of the elderly is very honorable and challenging. If it was so easy there would be no need for LTC facilities. Many nurses and doctors place their families in LTC, so we nurses should be the last to judge and compare of each other!
I am proud that I work in Assisted Living, you should be too! Geriatrics is a SPECIALTY. I heard it in the hospital I used to work at where the "Tele unit nurses thought med surg nurses were dumb or God forbid you give an ICU nurse more than 4 patients or L&D nurses never get dirty". That is non-sense because we all choose which area we love and become well trained in that specific area. Our job as nurses is hard enough as it, so why the competition? A seasoned ER nurse may need help with a patient on a feeding tube because that is not common in ER. Does that make him/her less of a quality nurse? no, we ALL have questions, and are not perfect nurses. Anyways, it is an HONOR for me to take care of an elderly individual who is someone's grandparent, parent, brother or sister. I love that I can be their advocate and treat them with the same kindness and compassion I would as my parents and grandparents. I feel it is an HONOR to work with hospice residents and to be the one holding their hand when they die, so they are not alone. I feel that NO specialty in nursing needs to be defended. Any death or illness is complicated. Taking care of the elderly is very honorable and challenging. If it was so easy there would be no need for LTC facilities. Many nurses and doctors place their families in LTC, so we nurses should be the last to judge and compare of each other!
I can't believe this thread because I have been wrestling with if I should go into long term right out of school. My fellow class mates are not fans of the elderly and can't believe I would waste my education on geriatrics. I was questioning myself till my husband asked me what will make you happy? What a simple question. I love geriatrics. I love these people and that is where I am gonna go. I will hold my head up high! Thank goodness we don't all want to work in the same specialty. Each of us has a talent and should use it.
funny thing I often review paper work before the resident is admitted to are home. we often find hosp mistacks treatments not ness. and they are now putting all of ours in isolation too!! the hosp often send them back untreated or with pressure ulcers we bust our humps too heal. we also have more regs than any other agency more reulated than a hosp. hospice home care md office!
I love LTC it has been my calling for 19 years! first CNA then RNA then floor LPN to treatments now im the medicare mds person! yah! next DON! working on my RN!
I am proud that I work in Assisted Living, you should be too! Geriatrics is a SPECIALTY. I heard it in the hospital I used to work at where the "Tele unit nurses thought med surg nurses were dumb or God forbid you give an ICU nurse more than 4 patients or L&D nurses never get dirty". That is non-sense because we all choose which area we love and become well trained in that specific area. Our job as nurses is hard enough as it, so why the competition? A seasoned ER nurse may need help with a patient on a feeding tube because that is not common in ER. Does that make him/her less of a quality nurse? no, we ALL have questions, and are not perfect nurses. Anyways, it is an HONOR for me to take care of an elderly individual who is someone's grandparent, parent, brother or sister. I love that I can be their advocate and treat them with the same kindness and compassion I would as my parents and grandparents. I feel it is an HONOR to work with hospice residents and to be the one holding their hand when they die, so they are not alone. I feel that NO specialty in nursing needs to be defended. Any death or illness is complicated. Taking care of the elderly is very honorable and challenging. If it was so easy there would be no need for LTC facilities. Many nurses and doctors place their families in LTC, so we nurses should be the last to judge and compare of each other!
You are so right! You have captured the very essence of why i love LTC!
I have to add my two cents here b/c this is an extremely frustrating issue, especially after last weekend. I had a main who had metastatic throat CA with an old, open trach stoma. He'd been with me for about a week and had never had any discharge from the stoma. I arrived on Saturday to hear him coughing and see a bit of mucous. Go back to check on him an hour or so later and he has thick mucous all down his front. Do what I need to do, suctioning, O2 and whatnot. SpO2 is 61...get another oximeter, bump the O2 up...SpO2 only goes up to 65. Call report to the ER I'm sending him to and the nurse really had the gall to ask me, "Did you suction him?" WTH? I really had to fight the urge to say, "No, sorry, I missed school that day!"....But, I'm an LPN who works in LTC so most of the time the hospital nurses assume I have no clue what I'm doing. It just frustrates and irritates me to no end!
I love my job and love my residents. I couldn't imagine having only 4 patients - even if they had central lines and g-tubes and all that stuff because I do that everyday. My case load is 24 right now and some days I still marvel at that b/c my previous job the case load was 36:1!
So, thank you for listening to my rant and thank you to all you wonderful geriatric nurses. Not everyone can do it and without us, some of our patients would be lost.
:saint:MY SENTIMENTS EXACTLY!!!!
Dinith88
720 Posts
The flip-side is...the LTC nurse has to admit this same patient while caring for...(guessing) 20 other patients...deal with 20 sets of families...has to coordinate care with QMA's, CNA's etc. Anyone who thinks that LTC patients magically become 'easier' the minute they're strapped to a stretcher and sent off to LTC is stupid.
I know i'm preaching to the choir so i'll stop this rant.... but the reason this a pet peeve of mine is because i have CLOSE acquaintences(sp?) who work in LTC and deal with this stuff...and it irks me...