Why the disdain for LTC?

[klone, MSN, RN]

I'm reading the "New Grad perfect job thread" and I keep seeing the NGs say that LTC is a "deal breaker - no way I'm going to apply to an LTC job".

Why? If I were a NG having difficulty finding a job, I certainly wouldn't have that attitude. LTC is a WONDERFUL way to learn time management and multi-tasking skills. Hell, I have almost six years of nursing experience, and if someone offered me a job in LTC working 8-5, I'd take it in a heartbeat. LTC is a great way of opening up for administrative/management opportunities as well (lots of ADON and DON positions around).

I'm confused about the attitude, and wondering if someone could explain it to me, because surely there must be something I'm missing.

[SpelaD]

I'd love a LTC job!

[NurseLoveJoy88, ASN, RN]

I guess some NG think that LTC won't give them the experience they need to get into the hospital. If the only offer you get as a NG is LTC, I would accept it and embrace it. Some experience is better than no experience.

With that said, LTC is NOT for everyone. It is certaintly not for me but I would go back in a heart beat if I had to.

[whichone'spink, BSN, RN]

Well, it's a way of kissing my nursing license goodbye, when I finally obtain it, because with a high patient to nurse ratio, something is bound to happen. With little to no orientation and often hardly any staff, it's a scary job to have as a new grad. I'm not saying all LTCs are like this, but enough of them are that I really don't want to look to LTCs unless I must.

[VivaLasViejas, ASN, RN]

Nursing homes have a bad reputation for being badly understaffed, and their nurses overworked and underpaid. This is not entirely without merit---a good many facilities ARE understaffed, and they treat their workers like crap. Another factor is that geriatric nursing is not viewed as a desirable field because elderly people are not glamorous; on top of that, LTC is seen by far too many nurses of other stripes as the refuge of those who can't make it in acute care or other, "cooler" types of nursing.

That said: while I can't understand why anyone would turn up their nose at ANY sort of job in this economy, I don't like to see nurses working in LTC who don't want to be there. It's a tough enough job if you love it; it's got to be hell if you don't. And I'm sorry, but the elderly deserve to have nurses who like them and want to take care of them. They are not stupid, and they deserve more than leftover scraps from our health care "system". It makes me angry that they always seem to get the short end of the stick just because their minds and bodies don't work as well as they once did and they can no longer make their voices heard.....but that is a rant for another day. :spbox:

[Murse901, MSN, RN]

While LTC is a good place to get experience, I think it's the bad route to getting that experience - i.e. being overworked to the point that you HAVE to learn time-management or you will sink.

There is very little orientation, very little worthwhile continuing education, and very little backup when things go wrong. This is not the case in ALL LTC's, but it is the case in the larger majority that I have been exposed to.

Having said that, if LTC was the only job offer I had as a new grad, I would take it. When I graduated LPN school, my first job was in LTC. But, let me tell you, it's a SCARY place to learn!

Contrasted against a large hospital system that is going to give you a 3-month minimum orientation (often with a dedicated preceptor), mandatory classes for ACLS/PALS/CPI/EKG/whatever alphabet soup is appropriate for your unit, plenty of help if something goes wrong with your patient -- you can't beat a good hospital job as a new grad.

The bottom line is that LTC facilities in general do not have the resources to adequately educate a new grad. Yes, you will learn skills. Oh, how you will learn skills. But you're so overworked and spread so thin that it's hard to truly learn and comprehend what you're doing.

As an RN now, with 5 years' experience as an LPN (2 of which were LTC) and another year as an RN, I hope and pray that I never have to go back to LTC. It's just too much. It's too crazy. And this is coming from an ER nurse!

It's a tough enough job if you love it; it's got to be hell if you don't. And I'm sorry, but the elderly deserve to have nurses who like them and want to take care of them.

^^^ This. Absolutely this.

[Up2nogood RN, RN]

In the LTC facilities I've worked in I have witnessed terrible care and ethics. Yes, I discreetly have reported what I've found with evidence but nothing ever changed.

Just one example the other day working an agency shift....I open a chart with the pt's wife standing close to report how the vitals have been the last 5 days since admission. There was nothing charted for vitals since admission. The pt also went out for an appt with the wrong pts info packet. ***** This was not just one nurse but many nurses that just didn't seem to notice that they were not monitoring nor have the aides take routine vitals on a recent transplant pt.

I would not want to work as a new grad in a LTC. No resources, crappy house Dr's, shoddy orientation, lazy co-workers. I do love the residents and that is why I still pick up shifts, to keep my favs safe.

[33762FL]

What this person said: "Well, it's a way of kissing my nursing license goodbye, when I finally obtain it, because with a high patient to nurse ratio, something is bound to happen. With little to no orientation and often hardly any staff, it's a scary job to have as a new grad."

Plus the fact that you'll be using fewer skills than you would in a hospital job, and the general consensus that if you start in LTC as opposed to a hospital as a new graduate you won't ever learn advanced skills which will vastly decrease your chances of ever getting a hospital job.

edit: Add lower pay and usually less generous benefits/vacation than hospitals, and more likely no tuition reimbursement for further education.

[ImThatGuy, BSN, RN]

Different people have different interests. I, for one, would not like to deal with the same patient all day, everyday.

[xtxrn, ASN, RN]

Well it's a way of kissing my nursing license goodbye, when I finally obtain it, because with a high patient to nurse ratio, something is bound to happen. With little to no orientation and often hardly any staff, it's a scary job to have as a new grad. I'm not saying all LTCs are like this, but enough of them are that I really don't want to look to LTCs unless I must.[/quote']

With that rationale, no nurse would ever survive LTC. The job is not the same as acute, obviously :), and the acuity is way different. It's an outstanding way to gain experience in delegation skills, and as previously mentioned time management. You get outstanding medication knowledge, and the residents are great :)

My first job was at a large LTC- considered nice in the 80s...The orientation is enough for what you have to do- the rest is about figuring out your own way to get things done. There are other nurses around, and an RN is always on call.

You're eliminating a great way to learn without giving it a chance :)

[xtxrn, ASN, RN]

What this person said: "Well, it's a way of kissing my nursing license goodbye, when I finally obtain it, because with a high patient to nurse ratio, something is bound to happen. With little to no orientation and often hardly any staff, it's a scary job to have as a new grad."

Plus the fact that you'll be using fewer skills than you would in a hospital job, and the general consensus that if you start in LTC as opposed to a hospital as a new graduate you won't ever learn advanced skills which will vastly decrease your chances of ever getting a hospital job.

edit: Add lower pay and usually less generous benefits/vacation than hospitals, and more likely no tuition reimbursement for further education.

Lower pay is not always true. Many large corporations have excellent benefits, including great tuition reimbursement.

These comments are based on not knowing about LTC- OR maybe just not liking old folks....

You get a lot of skills even more than acute care nurses- and your assessment skills have to be good- LTC nurses know their residents and can tell is something is not right....

Sad that the prejudice about LTC is so deep, and with any prejudice, not based on fact.

[Halke]

I love my job as a nursing home RN. I absolutely love my residents and want to give them the best care I can because they are like family to me. You grow such strong bonds with residents because you work with them day in an day out. That being said however....It is getting more and more difficult as we are being spread too thin with the government budget cuts. There isn't much room to grow in LTC unless you want to go into administrative duties. I would not recommend a nursing home to a new grad however. One reason is that most of the time you get hired into night shift or evening shift and if it is a smaller facility you are the only nurse there. Who are you gong to turn to when you have questions? There is quite a bit of experience in a nursing home but not the same as you would get in a hospital. One recommendation I have is that if you take a hospital job make sure you get plenty of training (most hospital train well but some lack) Proper training is the only way you are going to learn. If you get a good set of base skills you will be set to learn much much more.

I kind of went off topic there lol....I just want to put on here that I wish people wouldn't put down nursing home nurses. Hospital nurses look down at us but I don't think they realize how difficult and how many patients I care for each day. More and more acute cases are coming into long term for the rehab stay. I care for 25 to 50 residents at a time and have to be everywhere at once.