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!
It's sad that society devalues the elderly, I mean if we live we will all get old, right? Working in the ER I see a lot of septic patients that come from LTC and I wonder why? Are the nurses caring for these people, why the bed sores, why do the patients come to us in such bad shape..........I dont look down on the nurses, I just wonder why?.............................................
I never get someone back from the hospital without a sacral stage II.
We have some who came to us from home with stage IIIs that are actually better than they were. Remember, too, that there is a point at which there simply are no more interventions. Trying-to-die folks break down.
As to the sepsis, same thing. My dad had sepsis for months before he died and the hospital couldn't fix it so he was sent to LTC. Had he had a flare-up the acute nurses would be asking why we hadn't taken better care of him.
Specializes in ICU, PICC Nurse, Nursing Supervisor.
this is a shame...i probably would have had a word with that nurse for being so disrespectful to one of my patients....
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#####!
Specializes in med/surg; LTC.....LPN, RN, DON; TCU.
I also believe that the clinical experiences determine the attitude of many nurses. Some of my classmates were totally upset with the LTC and even after several years still view all LTC nurses as idiots. My friends at the local hospital ask me questions about LTC and I give them honest info. Some are upset at some of the regs that LTC has. The biggest one is the residents right to refuse care. 2nd would be the lack of services in this area for LTC. The local hospital's lab only comes Mon, Wen, and Fri. If we need services at some other time GOOD LUCK!! Another is that hospital nurses/docs think that what the hospital has we have in LTC. I had a doc get mad because I couldn't get an ABT from our contracted pharm. so he refused to admit to the facility and would drop pts if admitted to that facility. I know when I worked at the local hospital it was common practice to use chemical or physical restraints on any admit that had a dx of dementia. At the same time 1 local LTC facility allowed embezzlement of resident's accounts and when the parties were caught one had to repay $1000.00 and the other lost her job when a replacement was found. Decubs from the hospital happens about 1/3 of the time. For every episode of LTC care problem there is one from the hospital.
We recently had to send a resident to the hospital. She receives 100mcg Duragesic patch. Prior to becoming ill, the nurse ran out of her 100mcg dosage and got 2 50mcg patches out of the EDK and placed them on her.
Once she was in ER, there was a HUGE stink that we overdosed this resident because we were such idiots that we had 2 patches on her(they never bothered to verify the actual strength of the patches on her). It went all thru the ER, thru her primary Dr., thru the neuro specialist, thru the EMT's..someone calling us to tell us they were notifying dept. of health "and if she dies it's all your fault". I mean just a HUGE deal.
Once the primary Dr. called to chew my tail and I then investigated the situation I was able to prove by the nurses paper trail that she indeed SHOULD have had 2 patches on & we were NOT the idiots who couldn't read the order.
Sometimes people are just really quick to place blame rather than checking the facts first.
I also applied to a local hospital last year. Was told very rudely by the recruiter at the job fair that they had no interest in hiring someone with "just long term care experience.. we need real nurses". (Your loss honey. I've been a nurse 24 years and a damn good one too).
I also applied to a local hospital last year. Was told very rudely by the recruiter at the job fair that they had no interest in hiring someone with "just long term care experience.. we need real nurses". (Your loss honey. I've been a nurse 24 years and a damn good one too).
Oh, good grief. So did you ask the recruiter if she (or he) was a "real nurse"? :icon_roll
Honestly, we nurses are worse to each other than the nastiest doctors, family members or administrators could ever be. How will others respect us if we don't respect ourselves?
I was an LPN for 14 years working mainly in LTC, homecare and as an agencynurse. Returning back to school for my RN, I anticipated working in a hospital as a "real nurse". The pay was about $8.00 less than the nursing home and I lasted 7 months in our local "brand new" beautiful hospital, before I went back to the nursing home. Why? I refuse to be screamed at by doctors who expect me to read their minds, who don't communicate with one another and those who think they are altogether above you, and take pleasure in belittling others. Also I realized not everyone is cut out to work in the hospital and there is Nothing wrong with being a Geriatric Nurse and I am proud of it. We've had a few agency/hospital nurses come to work at facilities who can't manage to pass medications on a group of 25 or 30 residents that include 2 med passes that last 2 hours and include tube feeders and accuchecks and insulin administration and charting and wanderers or frequent fallers and whatever else may arise. My greatest joy is being able to make another being smile or feel loved. By listening to the same story for the 10th time or by giving them a hug, or just sitting with them and holding their hand or by telling a stupid joke. Yes, I do hug some of my residents. I understand that some days are more hectic than others. At the job I have right now, I do have more time to spend with the residents, and if I can make the last years of their journey here on earth just a little brighter, than to me my purpose in life is fullfilled.
1964nurse, I had to go back up to the top of your thread to make sure I hadn't wrote that post! You sound just like me. I find myself at times wanting to belittle the hospital nurses, but refrain. I think all nursing fields tend to think they're the best, if they love what they do :) I had never in my life been belittled like the doctors did in the hospital. No thank you! I'm hoping it was just a bad experience, and not all are like that. If you love what you do, who cares what others think? I'm an RN, and am proud to be a geriatric RN. Even my mom and sister think I should work in a hospital. What's up with that?
I also believe that the clinical experiences determine the attitude of many nurses. Some of my classmates were totally upset with the LTC and even after several years still view all LTC nurses as idiots.
I first became interested in nursing because, in high school, I worked as a nursing assistant in the local nursing home. I remember my mom telling me, before the interview, to tell the DON that I wanted the job because I wanted to be a nurse and I looked at my mother as if she was crazy. There was NO WAY I was going to be a nurse---I just wanted a job. I worked in the nursing home the summer before and the summer after my senior year as well as during the school year. When I quit the nursing home at the end of the summer, I thought, well, maybe I'd like to look into becoming an OT, but there was no way I was going into nursing. About three months later I was accepted into the December class at an ADN program.
A few years ago, I was a clinical instructor for a BSN program and taught first semester students at a LTC facility. I hadn't worked at that particular facility but was assured by the course coordinator that things "never" change in LTC and that teaching students in LTC would not be that different from teaching them in med-surg. Wrong. While the student:resident ratios were low (1:1 as these were beginning students) there was a complexity in the care that I didn't appreciate until I was working in the situation. LTC was certainly different from when I was a nursing assistant, different from when I was a beginning student nurse doing my own first clinical experience. Teaching in a nursing home piqued my interest in working as an RN in LTC and I once approached the DON about the possibility of working there during the summer or on weekends---which I didn't do because I ended up moving out of that area.
I did end up working LTC after moving. I have to say that it was an extreme experience---I worked hard but enjoyed the type of work I did. I enjoyed being able to have relationships with the residents, to get to know them and their needs, even if I didn't see them very often while working nights. I definitely increased my assessment skills and, as other posters have said, I became able to recognize subtle changes in my elderly residents that might have been easily overlooked by someone in acute care who would not be that familiar with the resident.
The worst part, the soul-sucking part, was the attitude of the management. There was such a prevalent attitude that working in LTC was scut work and that everyone would so much rather be working elsewhere. If someone actually enjoyed working LTC, there must be something wrong with him/her, a lack of ambition perhaps, maybe an inability to "make it" in another specialty. That demeaning attitude wore me down; for a while I wanted to stick it out in LTC and continue to deliver the high-quality care I felt my residents deserved but eventually I got tired of fighting. When it became apparent that management would rather see employees leave than try to support and retain them, I got out. It was frustrating because several people left at the same time I did and the facility ended up being short-staffed. The quality of care suffered. But management felt it was better to hire new people, to spend the money recruiting and orienting, rather than try to retain---and boost the morale---of the staff that was there. When I looked at other LTC facilities, I checked out a county-run facility that was a nightmare as well as a couple of for-profit facilities. I found the level of communication in the for-profit facilities to be unprofessional at best, downright bizarre at worst, and decided that if a facility was going to be flakey during the application process, it might be even worse when one actually worked there.
I thought about management, about applying for a DON position in the hope of being an agent for change, but I see that many DONs are stuck between the proverbial rock and a hard place, dealing with thick-headed administration (particularly on a corporate level). I don't think I have the stomach to put up with the politics of LTC on a day-to-day basis, but I have enough experience with academia to know I can deal with that world. So I am headed back to graduate school, ultimate goal of a PhD and teaching in a baccalaureate or graduate program and pursuing my interest in gerontological research. Perhaps I am idealistic but I hope, as an educator and researcher, to make a difference in the attitudes of future nurses, to take away some of the stigma of LTC and impress upon students how complex, interesting and rewarding gerontology can be.
BTW, yes, Don Quixiote is one of my favorite and most inspirational stories. But unlike him, I hope I am not merely chasing after windmills.
Wow. So many people say they "they love working in LTC" and they "love working with 'those people' ". I work in LTC. It is not something I aspired to do, I went there for the experience and because they had the schedule that worked for my family and lifestyle. You guys have stories about how sweet the "residents" are and how it's just an awesome place to be. I must be missing something. In my facility, if the census gets low I promise you they go and camp out at the mental institutions to rebuild their numbers. It's not even like LTC anymore. It's more like a psych unit with a few geriatric patients mixed in. Some of my halls are filled with the most ornery, aggravating, "I-refuse-to-wear-my-personal-alarm-even though-I-fell-last-week-4-times" people. And yes, I do take the time to get to know them, how can you not? And I have attempted (sometimes more successfully than others) to change my outlook. But wow, when you have people as patients who are there because their own families got sick of their attitudes at home it gets really hard to look forward to going to work. I'm currently pursuing RN liscensure but in the mean time I'm going to stick it out in LTC. Not because they share interesting stories (sometimes they do have pretty neat stories and advice), not because I love the geriatric population (they are just as important as any other popuation, IMO), but because it affords me the opportunity to continue learning some valuable skills while I pursue additional education. I hope someday to find an area of specialty that is a better fit.
I started out in LTC as a CNA, then as a CMA. All nurses provide a valuable service, no matter what your area of specialty. LTC is no different. We all went to school, we all passed NCLEX and we all probably thought we'd never get through nursing school to begin with.
Thanks everyone for sharing your stories and insight. I enjoy reading about everyone's experiences.
Well, while there are things I love about LTC I will be the first to admit it has its drawbacks. But basically, nursing is the hardest job I have ever had, in any environment, and I don't see it getting better.
Even in the hospital. The only ones who get to stay overnight are my patients. You or I go in, get surgery, get sent home with PACU monitoring then - home. You have 5 of my folks sicker than usual and it ain't what anyone expects the hospital to be. Used to be 4 walkie-talkies, 1 goner. Now they're all past their sell-by dates.
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.
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SuesquatchRN, BSN, RN
10,263 Posts
I never get someone back from the hospital without a sacral stage II.
We have some who came to us from home with stage IIIs that are actually better than they were. Remember, too, that there is a point at which there simply are no more interventions. Trying-to-die folks break down.
As to the sepsis, same thing. My dad had sepsis for months before he died and the hospital couldn't fix it so he was sent to LTC. Had he had a flare-up the acute nurses would be asking why we hadn't taken better care of him.