Why dont we get respect as LTC nurses?

[lvs2nrs3535]

Hi everyone,

I am hoping for some input to a questions that has been really burning my butt. I am a new nurse, and recently switched from med-surg at a local hospital (loved the job, hated the 12 hour shifts and the 45 minute commute), to a nursing home in my home town. I have spoken to numerous people about my new job, which I have, by the way, found to be very different but no less challenging than the work I was doing before. I am learning every day, and I truly do enjoy the job. I made the choice to change focus due to the fact that I have small children, 5 and 8, and the opportunity I had was a 7-3 shift, mon-thur. The money was less, but the savings in travel and not having to pay daycare made up for that.

Soooo, My big problem is, why is it that it truly seems that so very many nurses seem to look down their noses at long term care and geriatric nursing? I have even had one of my fellow graduates, (we both graduated May, passed the boards in June) actually say "I'm so sorry.":madface:

I couldnt believe my ears. And after I picked my jaw up off the floor, all the things I could/should have said came to me. Of course.

Has anyone else had this experience, or is it just me? And if you have, how do you deal with it? It is bad enough we undervalue and dont respect our elders, but now, I feel as if I have lost respect in the nursing community, (I am generalizing, I know, and I DO know that not every nurse feels this way, please dont feel that I think all nurses feel this way, cuz I do not).

I have been reading the nursing posts from so many of you on this specialty, and I can see that people who have worked in LTC understand. So sorry, I just needed to vent and get some understanding and hopefully advice from some of you more seasoned LTC geriatric nurses. During my med surg experience I felt more like a waitress than a nurse, it was kind of like 'turn em and burn em', without any time to connect with any patients, you were scrambling so hard just to meet their basic needs. I also realize that as a new nurse, I would have gotten better at the scrambling part, but still, after just two weeks at my new position, I already know almost all my 24 residents names, many of their likes and dislikes and have already been able to forge connections. So back to my question, how do you deal with it when you feel like other specialties look down on us?

I have also had ER nurses from the local hospital be VERY condesending to me when calling. Just twice, same nurse both times. And in case you are wondering, I am pretty thick skinned, I dont get my panties in a bunch over any little comment.

Any input would be sooo appreciated.

Thanks,

KristyBRNfortruenow

[TheCommuter, BSN, RN]

I am a LTC nurse and possess a profound fondness for my career. Prestige is not significant to me, so I am not too concerned that nurses and others in the medical community think so poorly of LTC. Hospital nurses, doctors, paramedics, EMTs, and others have referred to LTC nurses as 'attendants' and 'sitters' when these derogatory labels are uncalled for.

The lack of LTC respect is related to the devaluation of the elderly in America. When emergency departments receive elderly patients I've heard them state, "Get this G.O.M.E.R. out of my ER!" It seems that the elderly aren't worth our precious time. Today's new nurses want to watch life enter this world via working in L&D, yet few newbies want to be there for the end of an elderly person's life.

[Kelly_the_Great]

Every get so frustrated you just want to cry?

You know what I see as really being the problem (aside from the fact our culture reveres youth to an extreme), we do not teach and promote nursing unity.

Why do we not appreciate all of our subsets as equal parts of a greater whole.

You know, they go on and on about holism in theory class and how the patient is part of an interconnected system, la, la, la...Why don't we apply these same principles to our own profession?

Every nurse ought to be respected and get respect from her/his fellow colleague simply because they are...A NURSE!!! We are part of a profession, if we don't respect eachother, how can we expect others to?

IT'S SOOOOO D@MN FRUSTRATING!

[thsnursluvsgeriatric]

Hi, re long term care. I believe taking care of the elderly is a gift, either you have it or you don't, it's a desire to help the elderly that you possess. Those that criticize this choice don't understand as it is not 'their calling'.

I've worked mostly everything and have always loved the elderly. I've worked subacute when the ward was full of the older generation, I never noticed, seems odd but I didn't. However my counterpart would complain, saying something quite disrespectful regarding the aged of the ward. I think people forget that we, as they,will also be old one day. Others have said I couldn't take care of old people, I admire you.

Hey, I love it, the older I get the wiser I get, the more I love the the wisest souls that God has allowed me to care for. God Bless

[Josifek]

When I was in nursing school we had one class in which we broke into seven groups. Each group was given the same case senerio. The senerio was something like "you are stranded in a life boat with seven people... a teenager, a purse snatcher, a rabbi, several other types of people, and finally, an old lady. One of them has to be thrown overboard or else you will all sink, who do you throw overboard?" Would you believe that of those seven groups of future nurses six of them voted to throw the old lady out because "she's lived her life, the others haven't". The instructor mentioned at the end of the class that whenever he does this type of group project, nearly everyone votes to kill the grandmother. To answer the question of the original poster, I'm afraid this mentality is quite common in the medical profession and certainly contributes to the idea that we, as LTC nurses, are worthless. I just look at it like this: one day those with the above mentioned mentality are going to be in the same state as those elderly they currently despise. For their sakes I hope there are still some compasionate souls around to wipe their butts otherwise they themselves may get thrown overboard.

[LoriAlabamaRN]

In response to the hospitals thinking WE give bad care, I have to respond...

At my LTC facility, residents are turned, breathing treatments given, briefs changed on time. We absolutely HATE it if one of our residents has to be admitted to the hospital for any length of time because they will come back broken down and in pain. Every time. Just last week, had to send out a sweet man for exacerbation of CHF. He had no breakdown, skin was perfect. I know because I helped with the body audit the day before. He came back from the hospital six days later with stage II to both heels, stage II and stage I to coccyx, and even a stage I on the back of each elbow. Even worse, the TEDs they had put on and apparently not removed or even shifted had been too tight, and he had a blistered, raw ring around each upper thigh from those.

It's not always the LTC nurses who are lazy. That's simply something ignorant nurses say to feel better about themselves.

[ilostu12]

I'm with you on that one LoriAlabamaRN. I'm am LPN at a LTC (I'm hoping to finish certification in a couple of weeks). I've never been happier with what I do. I've also had some negative comments said about LTC nurses. Once while I was visiting my mother-in-law in the hospital. She was a mess, not given a bath in days,ect......when I asked for supplies to get her cleaned up, turned and so on. The RN asked if I was an aid, I told her I was an LPN at a LTC, she said "Oh, one of those." Well I shouldn't have said it but she said the wrong thing to me at the wrong time, I said "Yes, one of those nurses that has to KNOW their job and not go crying to a doctor evry 5 mins." Needless to say, I didn't have any more problems at that nurse.

On a side note, 95% of the staff at this hospital are outstanding nurses and always treated me with respect as a fellow nurse.

[LoriAlabamaRN]

Great comeback!

See, a lot of ER nurses will judge us by the residents we send out. That's not always fair. If someone has bedsores in this facility, 99% of the time they had them when they were initially sent here. The other times, it's virtually certain that the resident will not allow themself to be turned, which we chart diligently. If a call comes from the ER with questions and whoever answers the phone doesn't know, well, there are 165 residents here. If you get a different nurse than the one assigned to the particular patient, then chances are they are not going to know anything about them.

As for the problems we don't diagnose, we don't have diagnostic equipment here. It's not that we don't know how.

[newLPN04]

I am a LTC nurse and possess a profound fondness for my career. Prestige is not significant to me, so I am not too concerned that nurses and others in the medical community think so poorly of LTC. Hospital nurses, doctors, paramedics, EMTs, and others have referred to LTC nurses as 'attendants' and 'sitters' when these derogatory labels are uncalled for.

The lack of LTC respect is related to the devaluation of the elderly in America. When emergency departments receive elderly patients I've heard them state, "Get this G.O.M.E.R. out of my ER!" It seems that the elderly aren't worth our precious time. Today's new nurses want to watch life enter this world via working in L&D, yet few newbies want to be there for the end of an elderly person's life.

LTC nurse here, almost 2 years...."sitters"...gotta laugh...what nurse in LTC has time to "sit"?:monkeydance: They have no idea, do they?

:groupwelcome:

[smoo]

Something I've never understood is ER gets upset when they call and we don't know that particular patient, or haven't rec'd report yet and don't know what is going on, but when I call ER, I have to wait forever and usually go thorugh 3 or 4 people before I find the one I need to talk to re: the pt I am calling about. Don't get me wrong, I understand they are very busy and can see why this happens. It's the same thing when they call us, though. I many not have the emergencies they have, but I have a whole hall full of pt.'s with issues or families with issues. I think it comes from little understanding of what we actually do in long term care. A good friend of mine who was a paramedic, then became an LPN told me once that he thought LTC didn't do anything or know anything, then he worked in one. Needless to say he ate his words. It was very hard for him to adjust to not having a MD around. Not trying to bash, basically just leading up to the fact that I think it is from not knowing what we actually do. (just like I don't have a clue what they do in OB, peds, ICU, ER, etc.)

smoo

[tencat]

I had a thought......maybe part of the disrespect stems from the fact that a lot of LTC nurses handle patient loads that seem rather unsafe and they put up with a lot of substandard support from the types of facilities who are out to make a buck, thus not allowing their nursing staff to adequately care for the patients in order to keep up their profits. Personally, it would drive me nuts to work for some of these companies and not have the things I need to do my job well. Maybe this perception is a fallacy and the reality is quite different. True or not, I think it's what those on the outside see.

[BoomerRN]

Regarding LTC-no respect: Having been on both sides, acute care and LTC I can tell you that when I first began working as a hospital nurse in the late 70's I had never had any experience working with the elderly, I didn't even have any grandparents while growing up so when I had my first elderly patient I thought all of them were senile (an old word, now it's dementia) and caused more work like this pt. I worked 3-11 on a med-surg hall in a small hospital and it was me and two na's dealing with 30 patients. I made rounds that afternoon and upon entering her room found that she had pulled out her IV's ( receiving blood) which was all over the bed, pulled out her NG tube, and foley catheter. She had wrists restraints but still managed to scoot down in bed and pull out ng one or two times more that night. I remeber what I said to her the first time I saw what she had done: "Why did you do that?" and, of course, she just looked at me. I laugh at it now, but then I was so busy every night I rarely had time to go the br let alone eat. About two years later I got fed up with the hospital system and decided to work at a local nursing home. It was different than the hospital! I wondered if I was going to like it and as time went on I discovered I loved the job. I loved the patients, and most of their families. You always have some that make life miserable for you but overall most were wonderful. I learned so much- (physically, you have to deal with all of the body systems, psychologically, how to deal with diff. behaviors, and you learn that life is fragile and you need to tell people you love how you feel, as you might not get another chance, and etc. etc.), far more than I would have working at the hospital, and made wonderful friends with staff, families and patients. Some people would ask me: "Don't you get depressed working with these "old people?" My reply was: "No, I am learning so much, there are some wonderful people here if you get to know them and they have so many life experiences to share, and I'm helping them get through whatever time they have left."

As far as hospitals returning patients in worse shape than when we sent them out: Alot of the time we received them back with decubiti on heels, sacrum, elbows, hips, etc. and I even received someone back who was lying on a pair of forceps, which I found when we were transferring him to his bed from the amubulance cot. So---- I think working with the elderly has made me such a better person and has taught me a lot about life, people and also--- death and so much more. I was aware of what others thought about LTC nurses, but I didn't care. I felt that they were just "jealous" because I was learning more than they were. I could go on and on but I just had to let you know that geriatric nursing, at least for me, is where it's at!!

Pat

[CoffeeRTC, BSN, RN]

Well, aren't we all lazy and uneducated? LOL.

Really, I think its the whole LTC industry as a whole that helps perpetuate the belief that LTC is where nurses go when they can't handle the hospital.

Why can't we have adequate staffing, supplies etc and good nurses in LTC? Many facilites are already short staffed and underbudgeted that firing the "bad nurse that give us all a bad rep" ain't happening. I don't think its the nurses fault...its the large corps running the facilities.