Why is LTC so hated

TonyaM73, ASN, RN · Jun 22, 2011

I spent the first year of my nursing career in LTC with Rehab. I hope to never return! They gave me 3 days of following several different nurses on all three floors. As a brand new nurse with absolutely NO medical experience except school, this was crazy! As soon as the three days were up, they gave me my very own 30 completely demented patients who used to be in the locked ward, but the company decided that they didn't like that image and opened the door to the rest of the facility!

I worked there a year and got out as soon as the hospital would hire me. The attitude that LTC experience does not count is prevelent at my hospital, but I have shouted it far and wide how hard that work is. My manager was skeptical about my experience until week 3 of training when I was basically doing everything myself. (we get 6 weeks of training) She has commented several times that even when I am haveing a very rough day, I am still out of there basically on time. I told her it was that LTC EXPERIENCE!

They just don't realized how you have to time manage and prioritize at LTCs WAYYYYY more than the hospital, since you have so many more patients.

By the way, to those that think LTC nurses are the bottom of the barrel: I learned so much more from the LPNs at the LTC than I ever have from the RNs at the hospital. Not to say, they don't know the same thing, but the nurses at the LTC have to make due with what you have verses calling someone to bring you what you need. It make a big difference in the way that I think on the floor now and makes me more versital.

Just my 2 cents here. :)

217shana · Jun 22, 2011

To the OP that stated that LTC nurses were not as competent as other nurses I beg to differ. I have worked in LTC for over 27 years as a nurse and went on to become an administrator. I advocate for my patients receiving the best care possible during their stay with us. I have trach patients, wound vacs, picc lines,port-a-caths and other things to deal with. I have also worked in ER, psych hospitals, acute hospitals and the prison system. Yes the patient load in LTC is heavier than that in an acute hospital but I hear nurses working in acute hospitals complain about caring for 5 patients. I did not get into nursing because of the potential salary, I got into nursing because I wanted to care for people. The LTC facilities in our area pay LPN's much more money than the hospital does. LTC facilities are the most regulated. We are way ahead of the game when it comes to wound care, hospitals are just getting into managing wounds. I have seen patients come from the hospital with stage IV wounds that they never had at the LTC facility and they had been at the LTC facility for years and only at the hospital for a week. When I was in charge of orientation, I gave each nurse one week of orientation on each med cart. It was a total of 4 so therefore they received orientation for one month. I gave the CNA's at least two weeks or orientation. Regardless of whether a facility is for profit or non-profit they still have to make money. Non-profit just get a better tax break and they have to put the money back into the facility. Poor patient care can occur in LTC and hospitals regardless of the number of patients a person is assigned. Patients have negative outcomes in LTC as well as hospitals. LTC and hospitals get sued alike. No difference. Its all about ethics.

angeliclpn · Jun 30, 2011

I'm a charge nurse at a LTC/Skilled Nursing Facility and I work the skilled nursing floor with anywhere from 15 - 20 skilled residents and I have to say that I absolutely LOVE IT!! I have learned and do all kinds of great nursing skills!! I do PICC lines, Wound care, Wound Vacs, Traches, Peg Tubes, IV's, injections, I take Dr's orders, do care plans, A LOT of charting (not my favorite thing to) and so on and so on LOL!! This facility where I work is ran by an awesome Administrator and DON!! The great thing is that my CNA's are great and we all work as a team and I even help my CNA's with taking Residents to the bathroom, bedpans, answering lights ect. If I know they are all very busy with other residents or they just need a little help. The key is team work and I have to say that there are many LTC facilities that I have seen that are not nasty and are taken care of quit well and you can't even tell that its LTC. Its like any health care facility it just depends on who runs the place and who works there!!

Heart 2 serve · Sep 15, 2011

I'm a charge nurse at a LTC/Skilled Nursing Facility and I work the skilled nursing floor with anywhere from 15 - 20 skilled residents and I have to say that I absolutely LOVE IT!! I have learned and do all kinds of great nursing skills!! I do PICC lines, Wound care, Wound Vacs, Traches, Peg Tubes, IV's, injections, I take Dr's orders, do care plans, A LOT of charting (not my favorite thing to) and so on and so on LOL!! This facility where I work is ran by an awesome Administrator and DON!! The great thing is that my CNA's are great and we all work as a team and I even help my CNA's with taking Residents to the bathroom, bedpans, answering lights ect. If I know they are all very busy with other residents or they just need a little help. The key is team work and I have to say that there are many LTC facilities that I have seen that are not nasty and are taken care of quit well and you can't even tell that its LTC. Its like any health care facility it just depends on who runs the place and who works there!!

Did you work as charge nurse as new grad or had some experience else where? And what kind of start salary should a new grad be expecting in this position?

Mobiusrain · Sep 15, 2011

Turnover rate for nurses in LTC is relatively higher than nursing positions in acute/hospital settings, so newgrads are hired easily in LTC. Newgrad/no experience RNs here in the Bay Area start at around 31-33/hr.

Heart 2 serve · Sep 16, 2011

Turnover rate for nurses in LTC is relatively higher than nursing positions in acute/hospital settings, so newgrads are hired easily in LTC. Newgrad/no experience RNs here in the Bay Area start at around 31-33/hr.

Bay area of Cali?

Mobiusrain · Sep 16, 2011

Yeah, SF Bay Area.

sexyfire · Nov 21, 2011

You dont know how much this has helped me, I have worked in LTC off and on for 5 years, I feel like I dont know enough to work anywhere else and I wonder if LTC has put a sour taste in my mouth for nursing.

purple10 · Nov 27, 2011

I work in LTC and I dont think its a "warehouse" we dont stack ppl on a shelf and wait for their experation date to come to a close.

We rehabilitate mind body and spirit, we become family. We bring life and meaning to some of the pts. We entertain, laugh, cry, share milestones, share stories, share pictures.

They talk we listen every word counts even if its a moan, murmer or hiccup. We speak for the ones unable to speak we are shoulders to lean on when a pt passes. We celebrate with the family and pt when they return home.

In the LTC (atleast for me) we take care of the pt first and paperwork second. Medicare may be a pain but its nothing a little (lol or a lot) of charting cant take care of.

xInspiredx · Feb 15, 2012

1) Is anyone a LTC nurse who takes care of less than 10 patients?

2) Is the situation worse in for-profit LTC facilities vs. non-profit ones? (By writing "situation", I mean lack of supplies, taking care of more than 20 patients, etc.).

sandygirl123, CNA · May 31, 2014

I don't think that it is hated but, it is hard work and a lot of times workers are working understaffed with unrealistic pay. Well I hate to put it this way but, if a nursing home wants the patients taken care of they NEED TO HAVE THE STAFF TO DO IT!!!!!!!!!!!! too many times I have heard the DON say that they wanted top care, the patients turned and changed every two hours. I even worked in one nursing home that would go around and mark the brief with the time and if the worker did not have the brief returned to administration by the time that they wanted they would write that person up. Changing the residents and making sure that they are clean and taken care is a big deal don't get me wrong. But, if you are short that day or if that patient is a big patient and takes more than one person to handle then you have to wait for help, and sometimes trying to find help is like trying to pull teeth. I am not a big person at all I am about 4'10 and probably weigh about 95 pounds. So trying to remover someone that is over 6 ft. or that weights twice my size was very hard. But, I did a lot of the lifting and positioning by self. But, if I did need help or if the patient was a two person transfer I would get help. That sometimes let me with smart remarks or waiting well over 20 mins for help. So you add that to the equation and if you are working on a unit with a lot of two ppl assists then you are not able to complete everything that they want to complete. If that is not enough to do you have the vitals, feeding the patients, walking the patients, taking the patients to the bathroom, doing all of the other tedious task that you are asked to preform.

hope3456, ASN, RN · May 31, 2014

Good points sandygirl ...you pulled up an old thread. Another point of contention among nurses here on this site is that, after being employed by LTCs, it can actually be a strike against you if you go apply for an acute care job. There is another active discussion going on titled " The bad habits LTC nurses are known for."