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.
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
Specializes in Med nurse in med-surg., float, HH, and PDN.
I LOVE working with the elderly! ( tho an Alzheimers Unit is definitely NOT for me! ) What I disliked about LTC's is the sheer avalanche of tasks one nurse is expected to juggle, that you have NOOO time for your patients because the documentation and med pass trumps time at the bedside,and the recreation dept's outing programs, excercise programs, craft programs do NOT address the PERSONAL HUMAN contact that is so IMPORTANT for this disenfranchised portion of our society. I'm glad there are people who love the work in spite of going flat-out all shift. If it wasn't for the bad staffing ratios I'd go back to LTC's, but I don't see that happening any time before I'm retired....and I don't PLAN on retiring any time in the next ten years. A previous poster was correct in reminding us that the LTC patients may be old and have some serious problems, but they are not stupid, and they aren't just statistics (I'm not saying LTC employees see them as statistics; I see that aspect of LTC's as the fault of the way the 'system' has changed to a business mode.) I join VIVA in a soapbox rant; but it wearys me beyond belief to talk about the way it SHOULD be, because I am constantly reminded that that isn't the 'reality' of today, and all I end up doing is kicking dirt and feeling spitting mad.:twocents::twocents::twocents::twocents::twocents::twocents::twocents::twocents::twocents::twocents::twocents::twocents::twocents:I've got alot more than 2 cents to give in this subject, but ain't hardly anybody buyin' these days but the choir I preach with and to. It's already making me depressed again. POOEY-RATS! I'm going to log out and try to decompress so I can sleep tonight.
i personally love having close relationships with the old folk...it felt like family.
where i worked, they accepted anyone as a pt/resident.
we had a fair share of end-stage hiv/aids pts, w/multiple and complex needs.
we took pts because no one else would, thanks to the soft heart of my DON.
my clinical skills were perfectly fine.
but i think the strongest skill i learned, were my assessment skills.
i learned to pick up on the most subtle s/s, and either monitor or intervene accordingly.
and yes, time mgmt, along with prioritization.
the nurses were going all day betw meds, txs AND most of us did take the time for 1:1 with those who were struggling or lonely.
the facility always did admirably on the yearly surveys.
another important point (and my last one), is personally, i believe many don't want to work ltc simply r/t not wanting to face their future...that we all get old, with declining function, independence, and autonomy.
who wants to be reminded of that??
let's face it, elderly are not valued in u.s. society, and have always gotten substandard services and attn.
ltc has a bad reputation.
if you work for a good facility for at least a year, you will leave there feeling as if you've grown as a nurse, by learning so much.
i walked away with superior assessment skills and a boatload of confidence.
most important, i cared for pts that will touch me for a lifetime.
Specializes in ED, Telemetry,Hospice, ICU, Supervisor.
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?
The entire sentence read "Critical thinking is most important and nurses with ICU experience have seen more stuff than those that worked in LTC".
Maybe I should have written RNs working in a hospital environment are exposed to more stuff because of so many different cases they would have to adapt to, as compared to someone working in an LTC. More exposure you have to new stuff the more you have to adapt and learn, theoretically people constantly having to adapt to a changing environment would have to develope their critical thinking skills more. I am NOT saying you do not have any critical thinking skills when in an LTC.
Your right I dont work in an LTC. However I do listen to RNs that have been around in the industry for over 20 years. I take in to account their experiences and listen to their suggestions and thoughts. Some of theses old fogies might be onto something with their wisdom and what not lol. Nah they aren't that old, they have work tonight. I pay particular attention to the one whos responsibility is hiring and firing though.
OMG if mom ever found out I actually take her advice into consideration, I would never hear the end of it.
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.
I hinted to why I didn't want to work LTC or rehab in another thread. I lived it for years in my home, and I was DONE. I sit in on my relative's care meetings at the nursing home, and the topics covered are her risk of falling, a change in diet because she hides her teeth, the bruises on her knees because she kneels down on the floor all the time, and that she is dehydrated because she refuses to drink enough. I dealt with those things at home...I don't want to deal with ONLY those types of things in my new career. They are a part of my work in an acute care setting, but there's more there, too.
I'm sure someone will pop in here to tell me that my experience was limited and it's not always like that. Fine. I still don't want to do it. As VivaLasViejas said, it is best to leave LTC nursing to those who really want to be there...or at least those who aren't carrying bad memories into work.
I also said I didn't want to work L&D or OR because I didn't like my nursing school clinical experiences there, either.
If I had had trouble finding a job, and I still didn't want to work LTC, L&D, or OR, those would be the consequences of my decision that I would accept. You wouldn't have found me whining about it because it would have clearly been my choice.
I have worked in ltc and in a hospital. Unfortunately, I think too many people jump to conclusions without information. I have seen lousy nurses and excellent nurses in both settings. Sometimes this downgrading of ltc is plain snobbishness. When I was a new grad in the mid 90's there weren't any hospital jobs around. I started out in sub-acute, in a ltc. Somewhere in my career, I did hospital nursing. I really prefer ltc. You do learn something new everyday, critical thinking skills are absolutely necessary, and you do meet some very wonderful people. That being said, a new grad in ltc can succeed, if you need more orientation, please ask. I did. And its worked out just fine.
I hinted to why I didn't want to work LTC or rehab in another thread. I lived it for years in my home, and I was DONE. I sit in on my relative's care meetings at the nursing home, and the topics covered are her risk of falling, a change in diet because she hides her teeth, the bruises on her knees because she kneels down on the floor all the time, and that she is dehydrated because she refuses to drink enough. I dealt with those things at home...I don't want to deal with ONLY those types of things in my new career. They are a part of my work in an acute care setting, but there's more there, too.
I'm sure someone will pop in here to tell me that my experience was limited and it's not always like that. Fine. I still don't want to do it. As VivaLasViejas said, it is best to leave LTC nursing to those who really want to be there...or at least those who aren't carrying bad memories into work.
I also said I didn't want to work L&D or OR because I didn't like my nursing school clinical experiences there, either.
If I had had trouble finding a job, and I still didn't want to work LTC, L&D, or OR, those would be the consequences of my decision that I would accept. You wouldn't have found me whining about it because it would have clearly been my choice.
It makes perfect sense why you'd be done with LTC. :)
I work both LTC and acute care. I get paid the same amt of money at both (same employer, union job)
I do very different duties at each job, but equally important. I have to think critically at both, but in different contexts. LTC neeeds good nurses as well!!
I work both LTC and acute care. I get paid the same amt of money at both (same employer, union job)
I do very different duties at each job, but equally important. I have to think critically at both, but in different contexts. LTC neeeds good nurses as well!!
Do a med pass for 25 residents in less than 2 hours, with all the VS, assessments, phone calls, other residents, residents' family members, dealing with doc because the unit clerk left, etc etc etc and call it slow paced.
I'm only done with LTC because I've done it 10 years and I want something different. I loved it for years.
Also we do all our own eye gtts (I've had several people on 4 or 5 apiece at a time) and we don't have wound nurses, IV nurses, or RT. We have PEG tubes, IV's, PICCs, trach's, people recovering from cardiac surgery, back surgery, etc.
I worked in LTC for 9 months b/c I wanted a 9-5 job. It gave me hives. Literally. I freaking hated it that much. I would work the fry machine at MickeyD's before I'd go back. Seriously.
That said, I do think a nurse could conceivably obtain outstanding assessment skills in LTC, if s/he bothered. The problem with all you young whippersnappers is that you are too impressed by the equipment we use in the units. It's just stuff, and it really isn't all that impressive outside of the engineering aspects. Without all those fancy schmancy toys at your disposal, you have to, you know, actually look at, listen to, percuss, palpate, etc. The old fashioned way.
The best diagnostician I ever met was a physician that trained in rural Tanzania, without so much as a digital thermometer at his disposal. He could diagnose pneumonia (for example) without a CBC or CXR, he did with egophony and a $10 stethoscope. No reason LTC nurses couldn't practice those kind of assessment skills. The few I have know have been too lazy, illiterate and disinterested, but they represent a very small sample size and I cannot draw conclusions about all LTC nurses based on their pi$$ poor performance.
LTC nurses can also learn a great deal about pathophysiology, pharmocodynamics and pharmocokinetics, diagnostics and labs, etc, etc, if they want to. Remember, the patients who live in LTC are the very same d@mn patients who come to our glamorous units. Just b/c they don't personally push the button on the balloon pump doesn't mean that the LTC nurse isn't completely aware of the entire medical/surgical history of the patient, and all the implications of same. IME, s/he probably isn't, but that's been their choice. The chart is sitting right there, the opportunity is there.
So if you find yourself unwillingly stuck in LTC hell, make the most of it. It doesn't have to be the dead end some would make it out to be. It can be, but it's up to the learner to put down the people magazine and exercise the little gray cells.
:twocents:
OhioCCRN, MSN, NP
572 Posts
well said!!!!!!