Seriously, I just finished responding to a thread on general and a comment about it's a career killer just ticked me.:angryfire
Why isn't it viewed as just a viable career direction?
My DON is one of the nicest, down to earth, supportive, awesome people I have ever had the pleasure to meet, much less work for and she started in an ICU and hated it.
I really thought I would stay in the direction of critical care. I loved my rotation in the burn unit and that was my goal. However I've noticed that it seems to take a certain type that flourishes in the BTU, ICU, ER type environments. It seems they have to lose the compassion since it's a cold, clinical type atmosphere. No matter how much I would love to have the skills that critical would provide, it's in no way worth a trade off to work with those types of people.
I do not work with any backstabbers. All the nurses from all 3 floors will lunch together. It's a place that fosters respect and realizes that if you treat your employees with dignity and optimism, those people will in turn treat the residents and each other with dignity and cheerful attitudes.
So I guess unless I figure away to gain skills in a critical environment on a casual basis, it's just won't be meant to be. Because I'm not willing to lose a really important component of wanting to go to work and really enjoying those that I work with and for. vs getting some really great skills but being stressed out and not liking where I work.
I'm just sick of reading that LTC is a dead end or someplace to go when no one else is hiring. And it seems like there's an attitude that you're less of a nurse if you work LTC I make a difference and I go home feeling good, I don't think that's a small thing or a less worthy career path.
Yes I unfortunately took this place off my radar when I first graduated b/c my school pushed the whole "gotta have hospital experience". Strange blessing for me that the economy tanked and my original plan of the exact place that I'm now working, came back into view. And timed as such that they were willing to hire me b/c of "me" as they're not one of those that has a constant demand for nurses. They retain who they hire.
I just wish the negativity towards LTC would stop. If you are seriously that miserable then look for another direction, Life is far to precious and short to be that unhappy and it's a choice to be unhappy.
Okay vent over, I'm just tired of reading the same thing...maybe I should stop reading!
Ha ha most of the other specialties work with the LTC population! They are the ones with insurance and mostly the ones who are admitted to the hospital, ICU, and surgery...except for the drunks and the drug seekers!
They look down on LTC nurses because they have very little understanding of exactly what all a LTC nurse does. You should have heard the commits that my co-workers and supervisors make when I quit acute care for LTC. Needless to say it just showed their ignorance.
I will say that I am a better nurse now because of my time working in LTC.
I actually want to work in LTC when I am done with school. I was a CNA for many years & I absolutely loved the patients. For so many of them their only interaction is with the staff as they have no active family members. I have gotten some strange looks from some of my classmates so apparently that stigma starts early. I figure to each their own!
I am fairly new graduate and went straight into the ER. I love it and it is where I will likely stay after graduate work also.
That being said...Thank You. While it isn't my career choice I have so much admiration for nurses in LTC. It is often criticized for not being "as skilled" as other nursing roles, but I counter that it requires different skills than other nursing areas that are equally difficult to acquire.
I did spend nearly a year as a LTC nurse's aid while in school. During that time I grew a lot as a nursing student and learned much, including that LTC wouldn't be where I spent my career. Though having the experience in LTC gave me skills in dealing with people in both their light and dark days that I will always carry.
Be proud to be a LTC nurse...not all of us have the skills to do it right.
I must say this. I work in LTC, and I'm a super brand new grad, so I have way too much to learn! But I've been there since I graduated in August, and have noticed a trend.
We have RN's that have worked in acute care who now work with us. More than 1 of them have over 30 years of experience in all sorts of interesting specialties. They teach us about the etiology of what we're dealing with if we don't know it, and they remind us that we really need to be know it all's , instead of falling into the med-passer-person-only routine.
I work with 3 other new LPN's, and we all graduated within months of each other. We had a resident the other day who was on lactulose QID for hyperammonemia r/t hepatic failure. I went to give her last dose of lactulose and one of my fellow LPN's who was charge that evening told me:
-I'm charge, and I'm telling you, YOU MAY NOT GIVE THAT DOSE OF LACTULOSE.
*heh? Why?
-Because, she's already had 6 BM's today.
*Do you know what hepatic failure is?
-I know that I'm charge and she's already had too many BM's.
*o.k. well what I'll do then is hand this dose over the the next nurse coming, (it was the very end of shift) because when we find this resident comatose, it won't be because of me.
-I'm going to make sure she doesn't get it.
--------Fast Forward to Report, 1 hour later---------------
The nurse coming on was INFURIATED. I actually went ahead and gave the lactulose anyway, (my resident, my responsibility, my liability, my license) and explained the situation in report w/the next shift nurse coming on and myself & the charge from our shift present. If we're concerned about excessive BM's, we need to check for sxs of dehydration, encourage fluids in the meantime, and notify the physician if we're seriously concerned. Not change orders.
The point of my story is that for some reason, in LTC, the perspective on patient care is much different. IN MY particular facility. We need to know what these things are! Why do we give lactulose? What is the purpose of the med we're giving? Let's analyze all of the information we have for this resident so that we can measure the progress of the whole patient, not how convenient it'll be to change their beds after they get their meds.
Are you mad at pharmacy? that's o.k. But don't hold a resident's HS insulin because of your tiff w/another department. The nursing process is a science. Collect & analyze data before decisions are made, familiarize yourself w/the disease process if you aren't already familiar with a resident's particular condition...
I realize that it's almost like we're working in someone's home. It feels that way, it really does. But in my facility, and others where I've done clinicals, it's almost as if we know that we're perceived to be "less than" by the rest of the medical community, and thus don't treat nursing as the science that it is.
I hate to sound preachy, but the bible says that true religion is to love and care for the orphan and the widow. I didn't want to work in LTC and I had the luxury of going to school in a state where the geriatric population was so high that LPN's were in use in all sorts of neat capacities and not just LTC.
I now live in Idaho, where it's LTC or nothing, and I'm so grateful. I don't even feel like I'm working when I'm there, and to be able to spend time in the presence of such amazing and beautiful people and get paid to let them know that they are precious and beautiful just tickles me to death. I don't have the language to articulate how blessed I am to be in LTC, and I wouldn't trade it for the world.
I've heard a billion times over that nurses want to work in NICU or Peds. Or ICU. I've heard perhaps 3 people tell me they want to work in LTC.
That hurts my heart, but it's not easy to love people that aren't adorable and easy to pick up and hold. And older folks are so forgotten by our youth driven culture. It's o.k. though because when we're holding the hands of the confused, and singing to them, and making sure that they're able to live the rest of their years in a safe, loving place, we're caring for the orphan and the widow. I'm humbled that I'm able to do this job, but I can see why some folks treat us the way they do when nurses like the one I described above see their jobs in the way that they do.
I agree with JB2007. I also am a better nurse because of my experiences in LTC. I think my assessment skills are better, my time management skills have improved, and I really enjoyed getting to know my residents, having relationships with them rather than seeing people come in and out on a revolving basis as is the norm with acute care.
The biggest downside was the stigma. Nursing management and administration seemed to have an attitude that denigrated those who did direct care, like they were the bottom feeders of the nursing world. The bad attitude and lack of respect trickled down and morale sagged at the LTC facility for which I worked. Turnover was tremendous, even in a small town with few employment opportunities and even with a bad economy. People would rather be unemployed or underemployed than work at that facility.
Unfortunately, I have seen similar attitudes in other LTC facilities. I have been very disappointed in the lack of professionalism I have seen and the whole mentality of cover one's backside rather than make the effort to provide the high quality care our most vulnerable elders deserve. I've also seen a good number of burnouts in LTC, many of whom work in management. This is not to say that every nurse manager in LTC is bad---there are some excellent nurse managers here on AN who appear to care about their residents and their employees and who make sure their environments are safe and professional. It sounds like the OP has an awesome manager as well. Unfortunately, I have not seen many good nurse managers in my experiences with LTC. Most I've known seem to embody the Peter Principle, that is, they are promoted to a level at which they are completely incompetent. The nurse managers and administrators I've known who embody this are woefully unskilled at managing other people and end up hurting the organization. But of course they point the finger of dissatisfaction at the employees and accuse them of having "bad attitudes" when in fact it is management who has the worst perspective.
Getting back to the OP, it sounds like you're in a satisfying, fulfilling work environment. You have an excellent manager who wants to be there and who supports you and other staff. You like what you do. Yes, there is stigma, mostly from ignorant people, but don't let it get you down. When the current oversupply of nurses reverses and there's a shortage again, you'll be able to get any job you want as long as you have a nursing license and a warm body.
i don't care what anyone says...i love my job in ltc:heartbeat... if other nurses look down on ltc so be it. i am more than willing to take care of the elderly, but also consider it a privilege ...a lot of these people have no one else but the staff ...they look up to us and a lot of the time trust us more than their own family....so what it not as skilled as icu or er...its a whole different animal with a whole different set of skills....i have worked with some amazing patients over the years in ltc that have taught me so much....i have cried with these patients, introduced them to my family , laughed with them comforted them....held their hand as they were dying....it is my choice to be a ltc nurse and there is no other place i would rather be.....
denise rn
i just graduated from my lpn program and will probably stop there because i have been working in a assistted living plus facility. there is no better feeling coming home from work knowing you mattered and made a difference in a resident's day. economically speaking this is the area to be in. this kind of nursing requires more then skill and education but also compassion and empathy but most important listining. i love my residents even the difficult ones you nurses in a hospital can you say that most days?
I ve always liked LTC, Im an LPN and if I was an RN I would never ever work in certain areas.....such as a hospital, an office, dialysis, peds, or OB.....LTC is all I know and I enjoy it. What I dont like about it is the politics that come with management.....at least at my place of employment...If we had better managers who cared about US and the residents more....we would have zero turnover. I cant speak for other places, Im referencing my experience.
I was in the hospital ER to have some staples removed after my c-section, and low and behold the er room next to mine was one of our residents, a very confused man with alzheimers and they had him restrained, and I overheard 2 staff one nurse -- said I cant wait until they send him back to the dog pound. I was so sad by that whole thing. I have totally lost respect for this nurse. What is even sadder is almost everytime we send a resident to the hospital, they demand we leave a staff member to "watch" them. but it is not the whole staff over there, because I have been there several times with the baby and they are so great, so yes does seem to mean they feel the elderly dont matter much. I guess since I work for the dog pound I am a real B#####!
I was in the hospital ER to have some staples removed after my c-section, and low and behold the er room next to mine was one of our residents, a very confused man with alzheimers and they had him restrained, and I overheard 2 staff one nurse -- said I cant wait until they send him back to the dog pound. I was so sad by that whole thing. I have totally lost respect for this nurse. What is even sadder is almost everytime we send a resident to the hospital, they demand we leave a staff member to "watch" them. but it is not the whole staff over there, because I have been there several times with the baby and they are so great, so yes does seem to mean they feel the elderly dont matter much. I guess since I work for the dog pound I am a real B#####!
Wow the gall of some people!!!....I'd have ended up getting in trouble more than likely as I wouldn't have been able to bite my tongue on that one!
I make a difference and I go home feeling good, I don't think that's a small thing or a less worthy career path.
aileenve, ASN, RN
169 Posts
Ha ha most of the other specialties work with the LTC population! They are the ones with insurance and mostly the ones who are admitted to the hospital, ICU, and surgery...except for the drunks and the drug seekers!