What exactly is so bad about LTC??

Specialties Geriatric

Published

I'm not a nurse, but considering LPN school. I have read posts on here and other places online talking about LTC is about the only place that LPN's can work, however, most things I have read talk about the horrible conditions of the facility, evil corporate ethic, patient overload, not enough help...Anyone work in LTC or have worked in LTC in the past? What were your experiences? Good/bad or indifferent..I'm just curious to know what I might be walking into...Thanks for your time!

Specializes in Geriatrics.

You have to work where your heart is- for me that is working in LTC. I have had multiple job offers at hospitals but have turned them down- it just didn't feel right. I have always worked in LTC- first as an aide, then as a LPN, then as a RN who even works in the dreaded word on these boards- management. Any position is what you make of it. I love LTC, including the residents I take care of and serve. I am sure there are facilities(and hospitals) out there that are not the best place to work- I guess I am fortunate. Currently my PPD's are running 4.60 to even in the low 5's. I work with an administration that really cares about the residents and staff. Do I have days that I want to run away screaming- yes, but then most jobs do. I want to make a difference and for me this is where I feel I belong. That is what makes nursing unique- we all receive the same degree (RN, LPN, NA), but there are many different venues to work in and what may be ideal for one is not ideal for the other. I guess what I am trying to say is you have to find what works best for yourself and where your niche is, not anyone elses. LTC is demanding(again as in the hospitals that have their own issues), but is also rewarding. I go home multiple nights realizing a small action I made was the difference in someone's day.

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In most facilities - the patient:nurse and patient:CNA ratios are way, way too high and FAR too much of the shift is spent on a ridiculously huge medpass. That is the biggest problem, but throw unprofessionalism and lack of supplies on top of it and it really makes for "fun" times.

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Specializes in Pediatrics, Geriatrics.

just wanted 2 add, my lpn course was NOT 10 MONTHS. my course was 18 months long. and some rns are air heads when it comes to common sense like how to even let down/put up a side rail (yes ive seen it) i sat back and laughed because although she had more training and education and a higher title, the emt/md chose the lil ole lpn to assist them. guess credentials mean nothing when it matters if the basics arent known.too much time at the nurses station delegating and bragging if you ask me........

not to disrespect my rns because i truly love you but a few of them are just plain dingy when it comes to the simplest of things.....FROM MY PERSONAL EXPERIENCE

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Most RN's have a superiority attitude when dealing with LPN's. That has been my experience anyway.

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I am a CNA in a LTC facility. It is my first job...ever. I'm trying to quit complaining about stuff, so I am going to list some "challenges" in working in a LTC facility. (Note: this is coming from a CNA, so it will be different from an LPN's perspective, but at least you are becoming familiar)

1.) Administrative nurses expect you to do so much for each individual patient, yet they give us 10-15 patients (75% are total care) and expect the CNA (not the nurse and CNA) to get every patient up, bathed, clothed, dried, teeth brushed and toileted in one hour for breakfast. I'm sorry, but that isn't feasible. I don't mind doing all that work, but when nurses are pressuring you to run little errands on top of the already given duties, that really makes me angry, especially when they are quite capable of doing that themselves.

2.) Combative patients: I have been slapped across the face, punched in the jaw, crushed against the nurses station, scratched, and have been cussed out every time I go to work.

3.) Family: this one is tough because you have to put yourself in their shoes. If you are a good aide and work hard, you shouldn't have to defend yourself if you know you're giving good care. But sometimes families have a hard time when their relative is not at the top of your list. In the case of being cussed out by a family about something that wasn't even patient related, I can tell you the best thing to do is suck up, tell them your sorry, and that it will be handled right away.

That is just a few things from my perspective. I love my job. It wears me out, makes me question why I am doing this (I mean seriously, who wants to look at 15 peoples private spots every time they go to work?), and also makes me value my health. My patients make me laugh, even when they cuss me out. I love each and every one of them and I think about them all the time. I wouldn't trade for many things...

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Specializes in hospice, HH, LTC, ER,OR.

1. Unsafe patient to staff ratios. 2. Frequently left without critical supplies(lancets, blood glucose strips, soap, needles, snacks). 3. Frequent call outs from other staff, increases your already unsafe patient/staff ratio. 4. Mounds of paper work. 5. Dining room duty, hopefully someone is checking on your patients while you monitor the dining room for 2 hours. 6. Constant calls at home on your off day, about working or something at work. 7. Anxiety 8. Stress. Also I think each state is different, I was allowed to do my own assessments and we did our own admissions. I would often call the RN for assistance with my assessment and they would always tell me " its whatever you say, I trust you". So if you plan to work there just remember this " when in doubt, send them out!"

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Specializes in Med-Surg, Neuro, Respiratory.

I truly disliked management where I worked. It was so disorganized, we had absolutely no support, and we would be constantly threatened (i.e. "I'm turning you in to the State", "Why did you become a nurse?"...things like this we would always hear). The lack of communication and refusal to listen to the nurses led many of us to find new jobs. However, not all LTC facilities/SNFs are like this, I just got unlucky! I know many nurses who love LTC and will never leave.

What I did like about LTC/SNF nursing was my former co-workers and all of the residents. Those people made all of the difference. :)

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I totally agree with the ratios and of course the mentally extensive residents. Two weeks ago I started at an LTC as an RN Staff Nurse. I was really impressed with the initial orientation process, having worked in other LTC facilites in the past and have been "thrown to the wolves". Everyone was so nice and supportive. I was then placed as everyone told me the hardest wing on the hardest shift. I personally enjoy working 3-11, but found I was basically pulling 10 hour shifts without a break. I had a few patients that would know about shift change and wait for the narc count to be over so they could get their meds before going on their "smoke break". I got used to granting those wishes just to be done with them until 8pm. I was on my med cart for 8 hours straight. If something happened like an admission, a fall or a family complaint, it would throw a wrench in my whole evening. I kept telling myself and others "It doesn't take a rocket scientist...is just very time consuming." The idea of helping someone or having a conversation with a resident was not in the cards. Most of the nurses there were LPN's, who knew all about facility operations and handling any problems. One evening, I was swamped again with a resident who cut her foot and required me to try and find supplies to dress it. Nonetheless, the stream of paperwork involving an incident report. I was approached by a housekeeper who fell on her wet floor and she was told to find the RN Supervisor to have her fill out the paperwork. I was never told I would have this responsibility. I resigned the next day. Everyone was still very nice and tried to convince me to stay. I knew "talking" would not change things after I heard the past history. They did not want to have a med aide and a shift supervisor. They wanted that person to be all in one package.

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Gosh, I'm now scared about becoming a caregiver, I will basically help with the same things a C.N.A does if I get this job, but I won't be certified, so I probably will do a lot less then a CNA. I am though hoping the place I will work has great patients, and good nurses. I went there a couple times and didn't hear any one screaming, but this is an assisted living facility, so the patients there are probably not as sick as in the nursing home I applied to for a housekeeping position in which they told me that was one of only two jobs they where hiring that they didn't require a CNA.

I really want to become a nurse. I am just starting out, as I've said several times in other posts of mine. And I really hope that even if its difficult I will be able to get through it. I want a rewarding career helping people. So I am going to stick it out because I have found I really want to do this.

I volunteered in an LTC once. It stank as in smelled, but every nurse, and the people that helped me learn about it where great. They where all very nice. There may have been one or two very serious people there, but you get those.

All of this has opened my eyes. And I will say I think I will just have to experience it for myself. Honestly I may work Group homes or Home health, when I become a nurse. Or I may do something else. I don't know. All I know is I will do my best, and try not to judge myself harshly (because I do that way too much), and try to just handle the stress the best way I can.

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I'm an RN who just started working at a SNF and I feel all your pain! I didn't know so many places operate in the same way. I love nursing, but everyday since I started working I feel anxiety ridden & unhappy to go to work. In our short stay one nurse gets 4/5 patients & the other 1/5 plus desk nurse role. It's unfair since the one w/the patient workload still has to do all the paperwork desk work for all 4/5 of the patients. In a regular day I have 25 patients, passing meds, assessing, calling MD, admits, discharges, charting on all 25 pts, talking to fam/other HC providers regarding patients, faxing, putting in orders, doing treatments, coc, etc etc. (some places have a med pass nurse who also just charts- i would be soo happy to be in that position, i do that plus EVERYTHING else as an RN!! We don't even have a desk nurse..so imagine it all..). Weird since we have echart/emar/etar, but they're that tight w/saving $ to help staff. We don't take breaks, lunch is not lunch..it's clocking out & in 30 mins later while working like a dog to attend to 25patients in 8hrs..I can barely eat my power bar! A good day is staying extra 2hrs & a bad day 4-5hrs (w/no pay!! Just to finish work! And no, its not just the new grads! Its everyone!). The administration discourages overtime, so you work like a dog for free..& not approved unless your doing back to back shifts even under many circumstances. All the nurses call in sick or are just so stressed you can feel it throughout the stations. I was a new grad trying to get a job somewhere, but now I wish I didn't look the SNF route. The staff is treated so poorly. Everyday I'm forgetting the reason why I went into nursing, it's impossible to give all 25 patients the care they deserve. I was recommended to this place by a fam friend & now i wish i never even applied. Currently, i'm still on my 90 day probation period. I have 2months left. What would be appropriate steps to resign? I already feel myself getting burned out and I feel this place is very unhealthy for me...it's so hard because you don't want to burn any bridges, but at the same time your license has to be protected. And its even more difficult because new grads need to have experience to get hired anywhere. I found out us new grads at the facility are getting paid way below the minimum around the area compared to other smaller places too. I wish there were more laws governing LTC/SNF. All my patients are basically medsurg, but X5 the ratio...i'm usually a very upbeat, positive individual but these days not sure how I get by each day being here..

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I totally agree with the ratios and of course the mentally extensive residents. Two weeks ago I started at an LTC as an RN Staff Nurse. I was really impressed with the initial orientation process, having worked in other LTC facilites in the past and have been "thrown to the wolves". Everyone was so nice and supportive. I was then placed as everyone told me the hardest wing on the hardest shift. I personally enjoy working 3-11, but found I was basically pulling 10 hour shifts without a break. I had a few patients that would know about shift change and wait for the narc count to be over so they could get their meds before going on their "smoke break". I got used to granting those wishes just to be done with them until 8pm. I was on my med cart for 8 hours straight. If something happened like an admission, a fall or a family complaint, it would throw a wrench in my whole evening. I kept telling myself and others "It doesn't take a rocket scientist...is just very time consuming." The idea of helping someone or having a conversation with a resident was not in the cards. Most of the nurses there were LPN's, who knew all about facility operations and handling any problems. One evening, I was swamped again with a resident who cut her foot and required me to try and find supplies to dress it. Nonetheless, the stream of paperwork involving an incident report. I was approached by a housekeeper who fell on her wet floor and she was told to find the RN Supervisor to have her fill out the paperwork. I was never told I would have this responsibility. I resigned the next day. Everyone was still very nice and tried to convince me to stay. I knew "talking" would not change things after I heard the past history. They did not want to have a med aide and a shift supervisor. They wanted that person to be all in one package.

I am RN in that position right now! We don't have a med aide or a shift supervisor or desk nurse! It's the most stressful thing i have ever tried to overcome..i'm great at multitasking, but i have 25patients..not sure how to even handle that much!..i want to quit so bad, but i'm a new grad w/no experience elsewhere..i dont know what to do. Theres a few other new grads in my position & we all feel stuck..not to mention tricked by what this place "pretended" to offer & treat their staff! It was just all pretty & smiles at the front door, but on the floor is a different story w/the nurses. LTC/SNF need tougher regulations to protect staff members! At our place, the cna have union but the licensed nurses do not! Weird how the facility has it that way.

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Specializes in Gerontology, Med surg, Home Health.

First off,the facility did not decide to leave the nurses out of the union. It was the union who decided that. Secondly, LTCs don't need any more regulations. We are already the most over regulated industry. And lastly, I suggest you read some of the posts from nurses who work in the hospital. They, too, complain of too many patients and feel they aren't able to give the care the patient deserves. It's the way healthcare is in many places.

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