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.
There are always bad facilities. Orientation isn't the greatest in most cases. It takes an extremely strong grad to start in LTC IMO. I work with mostly newer nurses (1-2 years in general) and at this point most of us are stuck. Hospitals would rather hire a new grad than a LTC nurse because the stigma is so bad, so you are limited to LTC until the economy changes. On the other hand one of us did recently get a GREAT job offer. But that nurse decided the $6/hr pay cut wasn't worth it.
And, there are always bad acute care facilities :) It's bad facilities that are risks....not LTC vs acute- IMHO :)
I said I would look at LTC as a last resort, but for the most part I see a much heavier weight of unhappy nurses in LTC than in other specialties. And believe it or not, we are listening when nurses talk about such things.
I would not turn my nose up at LTC if it were the only means I wind up with for getting a job. But I am also not eager to work in one. I love the geriatric population. I just don't love the idea of poor staffing, dangerous conditions, hostile environments and unhappy and/or toxic coworkers. Those can happen anywhere obviously, but there is a great proportion of complaints about these things from those who work LTC.
Ok...but why are the posts most commonly coming from acute nurses about LTC? I don't see as many LTC nurses complaining about acute care (which has been very much in the news for crazy nurses killing off older residents in past years)...sure there are some- but a nurse who complains about the type of nursing but stays in it doesn't have much credibility in my book- nor the nurse who doesn't like something she's never done :)
I hated LTC because of the ratios. Why should I kill myself working 5-8s a week taking care of 40 patients when I get to work 3-12s and take care of 6-7? I was an LTC LPN for two years before I finished my RN and toward the end I thought I was going to lose my mind. I work on tele now and people kept scaring me and telling me that tele was going to be so hard. Please! It's a paradise compared to the LTC.
Is the LTC you all are referrring to the same as LTAC ? I believe LTAC is probably in between LTC and acute care hospital in terms of # of pt/r n ratio, pay, etc.
Is the LTC you all are referrring to the same as LTAC ? I believe LTAC is probably in between LTC and acute care hospital in terms of # of pt/r n ratio, pay, etc.
LTAC isn't the same as LTC... the LTAC patients have more acute type problems, but they're going to be that way for a while, are relatively stable, and the acute care hospital isn't really needed- though they need more skilled care than a typical LTC patient. :)
I hated LTC because of the ratios. Why should I kill myself working 5-8s a week taking care of 40 patients when I get to work 3-12s and take care of 6-7? I was an LTC LPN for two years before I finished my RN and toward the end I thought I was going to lose my mind. I work on tele now and people kept scaring me and telling me that tele was going to be so hard. Please! It's a paradise compared to the LTC.
SO it was about you- not the LTC residents...? Did you find you learned anything in LTC that acute care nurses don't get exposed to?
I've also worked both... and found myself going back to LTC when I wanted a different pace. I worked the floor, and MDS/mgmt...so not always on the floor.... did treatments for all 120 beds at one place and LOVED that job.
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.
Time was that hospital nursing was the place to be and anyone who couldn't hack it was banished to nursing homes or similar settings. Mind you for some nurses especially new grads the then slower pace of nursing home duty allowed them to get up to speed and eventually move on to hospital work.
Also as others have posted nursing home care (again at least as it was then seen) supposedly did not require one to use all one's nursing education and skills thus they became rusty.
While some of the above may colour how many think of LTC work, your average patient today there and in nursing homes are much different than yesterday and more is expected of the nursing service.
I would say to a new grad to take a LTC job, and keep looking for another position where they will gain valuable critical care skills. You won't get good clinical skills in LTC, I don't care what anyone says.
For myself I would never go back. I can't tell u the number of calls I get in a day to go to a LTC/nursing home facility cos no-one wants the shift or 2 work there. I told my agency only acute care now. When I was doing LTC before, I lose my clinical skills, & they are precious to me. I absolutely loathe LTC and the dementia clients: I get upset by it, I can't handle the million medications to be done, as a RN u get left with 60+ clients, the Drs don't care & don't come in when u want them to, the carers/PCAs don't do what u ask them to (ie: their JOB), then argue with you. The NUMs go home at 4pm and don't want to answer any questions - they can't wait to get out of there. And I've also got 2 the point where I can't handle any strong smells now - even nice smells - they just make me gag.
No, not for me, I hate the LTC/nursing homes. Thank God I'm going into a nice new, clean job soon!
Time was that hospital nursing was the place to be and anyone who couldn't hack it was banished to nursing homes or similar settings. Mind you for some nurses especially new grads the then slower pace of nursing home duty allowed them to get up to speed and eventually move on to hospital work.
Also as others have posted nursing home care (again at least as it was then seen) supposedly did not require one to use all one's nursing education and skills thus they became rusty.
While some of the above may colour how many think of LTC work, your average patient today there and in nursing homes are much different than yesterday and more is expected of the nursing service.
SLOWER PACE ????? :)
My first job as a GN was taking care of 30 medicare residents on 3-11 (meds, help with dinner, treatments, meds, trachs, etc)...At 11pm, I picked up another 30 patients (I worked doubles 4-6 days a week when I was first out of school) for more meds (all of the 12a and 6a meds , plus tube feeding preparation (mixed our own specialized formulas with basic formula bases), more trach care, nebulizers and percussion treatments (no RTs in LTC), and on and on..... When I got to a 14 patient assignment (28 bed total w/1 other nurse) on an acute neuro floor, my stress level went DOWN It was not a place to be banished at all.... It was a nice facility, and had good staffing = and fewer people talked about how overworked they were, and just got the job done. There were a LOT of long term CNAs who loved those residents, and took pride in their work. So did the nurses :)
I would say to a new grad to take a LTC job, and keep looking for another position where they will gain valuable critical care skills. You won't get good clinical skills in LTC, I don't care what anyone says.
For myself I would never go back. I can't tell u the number of calls I get in a day to go to a LTC/nursing home facility cos no-one wants the shift or 2 work there. I told my agency only acute care now. When I was doing LTC before, I lose my clinical skills, & they are precious to me. I absolutely loathe LTC and the dementia clients: I get upset by it, I can't handle the million medications to be done, as a RN u get left with 60+ clients, the Drs don't care & don't come in when u want them to, the carers/PCAs don't do what u ask them to (ie: their JOB), then argue with you. The NUMs go home at 4pm and don't want to answer any questions - they can't wait to get out of there. And I've also got 2 the point where I can't handle any strong smells now - even nice smells - they just make me gag.
No, not for me, I hate the LTC/nursing homes. Thank God I'm going into a nice new, clean job soon!
You did not get the experience I did- please do not speak for the generic 'anyone' :)
Some places are ECFs- that makes a difference. SNFs are where the acute patients end up when they can't stay in the hospital, and there are no LTACs around. In the late 80s, the facility I started out at began taking vents- and are still considered an LTC, not a LTAC.....
Experience and work are what you make it- and many are 'nice new, clean' places...they're not all pits. Some are- sure....but did anybody see the report about Walter Reed in DC???? That's where the people who need medical help who served this country were sent, and the exterminator should have been the first person in the door every day (it's going to close soon- but not before being a major pit).
Specializes in ED, Telemetry,Hospice, ICU, Supervisor.
Nursing Student Here
I talked to my uncle who worked as Human Resources for a hospital out here in the west coast. I wanted to pick his brain about what would he look for when hiring a new RN. First thing that popped up was if they had any acute care setting experience specifically in a hospital. I asked him about SNF/LTC sites and he told me working in those locations is not the same as working in places like the ED/ICU of hospitals. Critical thinking is most important and nurses with ICU experience have seen more stuff than those that worked in LTC.
So it is not that I have a disdain for LTC facilities it is just that given the opportunity I would rather work in a hospital because it provides me a chance to gain experiences in different specialties. Everything is in house, so if I wanted to go from like MED SURGE to PICU I don't have to apply to an alternate job site. I can further my career more in a hospital setting than sticking it out in an LTC/SNF.
If I couldn't get a hospital job then of course I would work in an LTC, I have loans/rent/car etc to pay. Not my ideal location but you play with the hand your dealt. In the mean time I can still look for employment at a hospital while I'm working at an LTC. I think a lot of new grads think if they work for an LTC its the end of the line for you.
I talked to my uncle who worked as Human Resources for a hospital out here in the west coast. I wanted to pick his brain about what would he look for when hiring a new RN. First thing that popped up was if they had any acute care setting experience specifically in a hospital. I asked him about SNF/LTC sites and he told me working in those locations is not the same as working in places like the ED/ICU of hospitals. Critical thinking is most important and nurses with ICU experience have seen more stuff than those that worked in LTC.
So it is not that I have a disdain for LTC facilities it is just that given the opportunity I would rather work in a hospital because it provides me a chance to gain experiences in different specialties. Everything is in house, so if I wanted to go from like MED SURGE to PICU I don't have to apply to an alternate job site. I can further my career more in a hospital setting than sticking it out in an LTC/SNF.
If I couldn't get a hospital job then of course I would work in an LTC, I have loans/rent/car etc to pay. Not my ideal location but you play with the hand your dealt. In the mean time I can still look for employment at a hospital while I'm working at an LTC. I think a lot of new grads think if they work for an LTC its the end of the line for you.
Yes, of course critical thinking is important....:) But in an LTC, you have to have critical thinking as well. Acute care doesn't own the market on critical thinking..... different situations- of course. But if Beulah starts getting sick at the LTC, do you want a dimwit trying to figure something out (ending with a call to the funeral home)???? Or do you want someone bright, with good common sense to be sure YOUR grandma gets to the hospital to get checked out?
In school, I hated geriatrics, and never thought I'd set foot in one. HA.!!! I spent several years in 2 different LTCs, and learned a LOT.
Should people who can't stand geriatrics and/or LTC work in them- probably not- but don't make assumptions based on something you haven't experienced for YOURSELF You may find things in LTC you didn't know existed- or you may find out that it really stinks for you.... but at least make up your own mind- with an open mind. And then, speak only for yourself
It was not a place to be banished at all.... It was a nice facility, and had good staffing = and fewer people talked about how overworked they were, and just got the job done. There were a LOT of long term CNAs who loved those residents, and took pride in their work. So did the nurses :)
xtxrn, ASN, RN
4,267 Posts
And, there are always bad acute care facilities :) It's bad facilities that are risks....not LTC vs acute- IMHO :)