slower paced nursing in long term care?

Chrissy Lou · Oct 20, 2011

How long did you work nights?
Seriously, if someplace really was that slow, it's definitely not the norm (for any night shift- acute, or LTC...some places may be slowER but still enough to stay busy)

Can anyone say "full moon"? :eek:

Bruce_Wayne, ASN, RN · Oct 20, 2011

I have a theory that every nurse thinks their own specialty is the hardest and busiest. I've noticed that with medical doctors there is much more a sense of camaraderie and collaboration but with nurses it's competitiveness and arguing about who is busier and what is and is not a real nurse.

One of the things that attracted me to nursing was the fast pace. As a tech I'm very impressed by nurses and what they have to do on a day to day basis and I want to do what they do because nurses are my heroes.

I think people get really sensitive when you talk about this subject because nobody wants to say that "oh my job is easier than that job". That would hurt their pride and ego.

I think different jobs require different skill sets and different people are suited for different jobs. That's not really a comment on somebody's knowledge or intelligence, just that different pegs go into different holes.

beckster_01, BSN, RN · Oct 20, 2011

and yes all the folks the hospital boots out that aren't ready to go home

So true...

Got a needy patient who is physically pretty strong, but just doesn't have the motivation to start doing things on their own? Despite hours on top of hours of education during their 52 day stay? Let's send them to SNF!

What about the terribly confused patient. His sentences make absolutely no sense, and the only reason he is not spitting at, biting, hitting, or pooping on staff is because we are giving him Seroquel BID + 10mg of IV Haldol q6h. Give him 24 hours without a 1:1 and he is so out of here.

While these types of patients are technically medically stable, they are chronically ill and will be in SNF/rehab for a loooong time. One of the blessings of working in acute care is that you know these people won't be here forever. Can't say the same for you LTC folks. That in mind, kudos! I don't know if I could do it.

Beautiful Nurse · Oct 20, 2011

Nursing is overwhelming if you follow all rules. To be a successful nurse you need to know what you have to do all the time and what rules you may egnore from time to time silently, without discussing it with coworkers.

Thank you!! Couldn't have said it any better. :up:

Cat_RN, ASN, BSN, RN · Oct 20, 2011

also if your not opposed to doing nights , you might want to go there , talk about Slow paced easy , easy , easy job , some people may say other wise but from my experiences the hardest part about working nights at my LTC facilty is staying awake some nights, lol, all so try just about any psych unit if that doesn't drive you crazy

Wow, there is nothing easy about nights at my place of work at all. Not easy or slow paced and there are far less resources.

turnforthenurse, MSN, NP · Oct 20, 2011

I would almost think that LTC would be faster-paced because of the patient load alone. The average nurse:patient ratio seems to be 1:6. in LTC you can have 20-30 patients or MORE to ONE nurse and you are responsible for meds (HOW that is considered safe is still beyond me!!!) I have a friend who landed a job in LTC as a new grad (she now works for an endoscopy clinic) but she didn't like her LTC job very much. She stated it was very hard work and was constantly exhausted. LTC's of course deal with more long-term issues as opposed to acute issues where the patient's will usually get shipped out to an ER and/or admitted as inpatient to a hospital (such as if patient starts c/o chest pain and is admitted for an NSTEMI (or worse, a STEMI) or DKA or something).

I applaud those who can work in LTC. The nurse:patient ratio on my floor is 1:4 (sometimes 1:5 if we are short-staffed) and there are some nights where I feel like I am constantly running for the whole 12 hours, but that is enough for me! I couldn't imagine having 20+ patients to myself.

turnforthenurse, MSN, NP · Oct 20, 2011

Wow, there is nothing easy about nights at my place of work at all. Not easy or slow paced and there are far less resources.

Yes, there is always the day shift/night shift rivalry...day shift thinks we just sit around all night and do nothing :mad: I will admit that day shift does more (having to deal with rounding docs, consultations, other disciplines, family members/visitors) but night shift can be very busy, too. It is just a different kind of busy. We still deal with doctors a lot, but it is more so phone communication than rounding. We still deal with other disciplines, just not as much. And we still deal with family members...there are a lot who will spend the night with a patient. And yes to less resources!!! Sometimes getting a doc to answer their page is a pain in the butt (but we try to realize that although we have 4 patients, they have a LOT more that they are seeing), especially if it is something emergent. On weekdays at my facility, we have pharmacy until 11pm - afterwards they are closed and a remote pharmacy has to verify our stuff, but if we are missing medications then our supervisor has to go to the pharmacy and get our meds. And they don't like that, and neither do we. Supervisors have other duties they need to take care of. The patients who sundown, yeah, they sundown at night. "emergencies" (codes and patients who stroke out) happen at night, too. There are some nights where I am constantly running for 12 hours straight with no time to really sit down and take a break while other nights are rather slow. It just depends.

And don't get me wrong. I work nights and I LOVE them!

I do agree that nights are a better option, especially if you are starting off.

beckster_01, BSN, RN · Oct 20, 2011

:twocents: Nights are hard because you are battling your circadian rhythm and doctors who are unwilling to deal with 95% of the issues I have overnight for fear of getting yelled at by the day team in the AM. You have more patients and less support. That being said, I run a lot more on MOST days.

Hopefully this doesn't regress into a day shift vs. night shift thread now...

carolmaccas66, BSN, RN · Oct 21, 2011

I'm in my mid 40s and would never work LTC again. I had 65 patients one night - and I was the only nurse on - and the pace was insanely busy. I had to end up doing virtually everything. It was the longest shift I ever did & I never went back. I will work in places where there are less numbers, or only if another nurse is on the shift - but that is no guarantee - you can rock up for a shift & the other nurse may have called in sick, so they say to you, you must do everything.

I suppose it depends on the place. Go & check some of them out that you apply for. Or are u talking about an LTC @ ur facility?

CoffeeRTC, BSN, RN · Oct 21, 2011

I don't think I implied that walking is sedentary or did I say LTC was slow-paced. Every LTC nurse will have their own experience. According to the ones I have spoken to and observed at my grandmother's LTC, they do state they prefer the pace of LTC to hospital and that is slower, although not slow. They chose to go to LTC in their later-careers for the change in pace. You may have had different experiences but that doesn't negate theirs. I was responding to the OPs question not telling you what your experience was. Perhaps in other places they do run non-stop and never sit down, however this isn't the case at the LTC I have experience with. The med cart has so much on top that if they ran with it, there would be trail of cups, straws and papers on the floor. They walk the med cart to one location and do meds for about 6 rooms then move the med cart and repeat. They stop and chat with residents, the evening nurse actually often sits and watches TV for 20-30 minutes with my grandmother each evening. What they mostly get stressed and upset about isn't the pace or the residents but the admin and the politics, frustrations with CNAs and staffing woes.

wow...sign me up to work here. This place is def an exception to most LTCs

CoffeeRTC, BSN, RN · Oct 21, 2011

You obviously know these nurses in my grandmother's LTC better than I do. I guess I am just naive, ignorant and very gullible because I believed what they told me and despite having spent 3-4 evenings a week at that LTC for 10 years I have absolutely no idea what happens on her unit. I guess they lied and really left acute care for the faster-paced, harder, environment of LTC and just lied to my face when they said they were burning out on acute floors and preferred the pace of the LTC. You are right, no LTC nurse could possibly have a different experience than yours.

I do beleive you. This place could be that nice. Its good that she is in a place where the nurses are not running around crazy. You commented on what you knew to be true.

carolmaccas66, BSN, RN · Oct 22, 2011

Go try all the nursing agencies. I'm sure they will have something to suit your lifestyle.