Why is LTC Nursing have a bad reputation

LadyFree28, BSN, LPN, RN · Feb 9, 2014

I think some of the bad attitude about LTC nursing stems from the way nurses are educated. All nursing education assumes that the graduate nurse will be working in a hospital setting. There may be one clinical rotation done in a LTC / Rehab setting but it's usually the first clinical rotation, and instructors often take the attitude that it's just "practice" for the real clinical in the hospital. Even the LPN program I attended was taught with the assumption that we would be working in a hospital setting. (For example, LPN curriculum still includes an entire quarter / semester of OB/Pediatrics. Why? There should be more emphasis on geriatrics, since that's where most LPNs are going to end up working.) Long term care facilities need to partner with nursing education providers to give students clinical experiences that demonstrate the LTC / geriatrics is a specialty (and a growing one at that) that can provide a rewarding career in nursing.[/quote']
I agree with your post to a point...as a LPN, I worked in Peds more than I worked in LTC; as well as done well baby visits; and know LPNs that work in maternity in the community; so there is a place for OB/Peds in PN school; wouldn't want to take that away...

Chrissy Lou · Feb 10, 2014

It is true- so many have no idea what LTC nurses do. LTC care nurses must have superior assessment skills, be very quick on their feet (wanderers, falls, aggressive behaviors- they keep you on your toes), and MUST be organized. (20-30 residents, glucs, nebs, g-tubes, drains, dressing changes, and lets not forget all the charting! Hours of charting!) LTC nurses wear many hats, (activities, laundry, dietary, housekeeping). I remember during my clinicals, so many of the other students could not believe I would "waste my time" and go back to the nursing home. I just told them, "I can't believe you would waste your time in OB"! (Not slamming you OB nurses out there, but it's like everything else- you either have a gift for it or you don't- I DO NOT have the gift for OB- I am where I belong! :yes: ) I wouldn't trade my resident's for the world! It is a hard, sometimes heart-breaking, place to be. But it's where I belong.

CrazyGoonRN · Feb 10, 2014

LTC is devalued because most people have no clue what nurses in LTC do. They remember the nursing homes of days gone by when 98% of the residents were alert and oriented and not in need of nursing care other than one or two medications a day. Fast forward to where we are now: 75% of the people in the facility have a chronic disease which requires monitoring. The other 25% are actually acute residents who could have a significant change in status from one minute to the next. Then throw in the demented/psychotic residents who get physically and chemically restrained if they are in the hospital. We have to jump through hoops to give them a smidge of much needed zyprexa. And let's not forget the workload....med-surg nurses complain bitterly if they have more than 4 residents a shift.
Working in LTC requires superior assessment and time management skills. The opionion of people who think we don't work hard, aren't 'real' nurses, or must work in LTC because we couldn't get a job elsewhere couldn't be farther from the truth.
THAT's why we're undervalued.

I couldn't agree more. It's very high stress for me even after 3 years. Compared to med/surg it is no where near as medically complex (chest tubes, etc..), but it is much more nursing complex. I'm not sure if I'm saying that quite right, but LTC is very complex but in different ways.

Shiraz · Feb 11, 2014

LTC is devalued because most people have no clue what nurses in LTC do

I agree also. My resume screams nursing home. Although I spent 10 years in home health, I'm actually glad to be back in the chaos! I am currently at my 4th "B" center and basically they are all the same. Currently we have way to many chiefs and indians are leaving everyday. I must ad that new residents are now very spoiled. My last 3 admissions all complained of not getting a private room. Not to mention a TV and food thats not even in the facility. My superiors want to to "accomodate" every little thing and then want me gone when I finally give up my keys and start charting. Despite all this ...I love my patients...a smile is worth a thousand words.

micstn · Feb 19, 2014

Great point, everybody will be old.

Keepitreal123 · Feb 20, 2014

bec it can be horrible in some places. esp facilities that just care abt the money and not abt the staff or the pts. Where there is never enough resources, supplies, and it is greatly understaffed, disorganized and a non positive environment. Also such facilities majority of the staff has been there so long they dont even realize they are not following protocol and procedure and could not care less if it is pointed out to them. HOWEVER, you will always find a gem working there who is so nice and works super hard and unfortunately us usually taken advantage of.

CoffeeRTC, BSN, RN · Feb 20, 2014

My facility is used as a training spot for 3 CNA programs, two LPN programs and now an RN program. We get first semester RN students. They are only there for a few days learning how to do patient interviews, but even after two days with us, they have a better understanding of what we do as nurses in LTC. I've been working with one of the instructors who is trying to help me convince the dean of the school to send me students who are farther along in the process so they coukd give meds, do treatments and see what it's like to be the team leader.

I would kill to work in a teaching LTC! Not many in out area. Right now there are a few that are tied to a big hospital system. The LTC doesn't rate well and has had alot of turn over/ deficiencies. This is one of the reasons LTCs get a bad rep in our area. The nursing students don't have the choice and get sent to these places and come out of the program saying no to LTC nursing.