What are the pros and cons of working as an RN at a LTC facility? It seems as though many RN's avoid LTC positions.
Is it the nature of the job (LTC duties)? Lack of variety? Do hospitals look view LTC experience as unfavorable experience?
I'm pretty new to the nursing world, but am learning that hospital jobs are highly sought after, while LTC facility jobs the ones to avoid. (Not necessarily my opinion, merely an observation.) Just looking for some insight/opinions!
It's been done. What happened? A little of paper shuffling, then a lot of nothing. Indiana currently is "investigating" accusations of mishandling during this pandemic. Sadly, we all know nothing will happen.
Most states have minimum staffing ratios for LTCs. Most LTCs only supply the bare minimum. It sucks, but until someone makes a legislator TRULY care, nothing meaningful will get done
It's been done once. Maybe make it happen a few hundred more times until something actually gets changed. You're a college educated PROFESSIONAL. Stop being OK with this.
Specializes in Mental health, substance abuse, geriatrics, PCU.
The problem though is that when it comes to the elderly, the mentally ill, the homeless, the incarcerated, the general public does.not.care. The plights of these groups of people isn't sexy enough for people to give a crap. That's the problem with going to the media, it's not a hot enough story for them. And nursing homes they just blame any poor outcomes on the nurses. The state of nursing home care isn't a secret, the lack of mental health services for people isn't a secret, but no one cares.
It's been done once. Maybe make it happen a few hundred more times until something actually gets changed. You're a college educated PROFESSIONAL. Stop being OK with this.
I don’t know why you think its only been done once, or that I'm OK with it. It's a vicious cycle that has been going on for years. As another poster mentioned, the public is well aware of the lack of resources for the elderly, infirm, and mental issues. They want something done when a loved one is involved, as long as it doesn't take any money out of their pockets. But I stand by my original comment. Until someone who holds power in legislation cares, and rules that owners (corporate and individual, etc) of LTCs have to staff better and keep less profit in their own coffers, and reinvest in staff and the business, not much will change.
I applaud your enthusiasm with the subject, I used to feel the same way. But this has been going on for years, and government turns a blind eye, as long as there is no large dollar fraud. In the end, staff gets blamed for the issues. Not the owners, not lawmakers, not anyone else.
As you progress through your career, you will find that it exist in every healthcare setting, to varying degrees. It's all about the bottom line
Unless it is them or one of their own, they won't. I'm talking about legislators, boards of nursing, policy makers. But those folks can usually afford to go the private route.
I agree, it's not sexy or cool enough to discuss. These things get swept under the rug-out of sight, out of mind. Years ago, Joan Lunden helped spearhead "A Place For Mom". Of course, again, this has resources for those who have funds to afford the best. For those average folks like us, the luck of the draw may, or may not, be in our favor
Nobody in legislature cared that black people had to be segregated in this country. But they were persistent about demanding equal rights until they gained enough support behind them that changes had to be made. If we wait until a senator wants to make a change because something happened to his mother, it's never going to improve for us. We have to be loud and persistent.
I get that all of healthcare is going to have a focus on their profit, all business in every field is like that. But this is not my first job that requires a professional license. I have never seen anything as bad as this. The difference between truckers and nurses is that truckers will refuse to put their license at risk for their company that would just replace them within a day if they lost theirs. Nurses, on the other hand, risk their licenses every day that they go into jobs that staff this dangerously short, and just brush it off as "it's part of the job."
30 patients is the norm right now, with some places pushing to 60. It's only a matter of time until 60 becomes the new norm. Nurses need to grow a pair.
It's been done. What happened? A little of paper shuffling, then a lot of nothing. Indiana currently is "investigating" accusations of mishandling during this pandemic. Sadly, we all know nothing will happen.
Most states have minimum staffing ratios for LTCs. Most LTCs only supply the bare minimum. It sucks, but until someone makes a legislator TRULY care, nothing meaningful will get done
Sadly, legislators don't really understand the healthcare industry. Unless a legislator happens to be a physician or a dentist or is an experienced, degreed, credentialed nurse, they don't understand. They don't know how to look past all the 'pretty gloss' to see the real 'down & dirty' stuff that WE all now is out there. It takes an experienced 'eye' to see what really exists.
It is equally sad that the elderly, homeless, mentally ill, incarcerated, PTSD vets or otherwise institutionalized are the unprotected and voiceless, not being seen as they are the 'disenfranchised'. They rarely exercise their voting power. It's that 'constituency' voter power that motivates legislators, esp when they are experienced enough to really SEE the issues.reveal
A 'walking tour' with a white lab-coated higher upper Admin will not demonstrate any deficiencies to a legislator unless s/he knows to look deeply. The gaps to providing good care are there (we all know it). It's just how do we get the right folk to know about it and intervene.
Sadly, legislators don't really understand the healthcare industry. Unless a legislator happens to be a physician or a dentist or is an experienced, degreed, credentialed nurse, they don't understand. They don't know how to look past all the 'pretty gloss' to see the real 'down & dirty' stuff that WE all now is out there. It takes an experienced 'eye' to see what really exists.
It is equally sad that the elderly, homeless, mentally ill, incarcerated, PTSD vets or otherwise institutionalized are the unprotected and voiceless, not being seen as they are the 'disenfranchised'. They rarely exercise their voting power. It's that 'constituency' voter power that motivates legislators, esp when they are experienced enough to really SEE the issues.reveal
A 'walking tour' with a white lab-coated higher upper Admin will not demonstrate any deficiencies to a legislator unless s/he knows to look deeply. The gaps to providing good care are there (we all know it). It's just how do we get the right folk to know about it and intervene.
Unfortunately, as we both know, most in the positions to do anything helpful, are paid very well to turn a blind eye.
I visited a friend in Georgia a couple of years ago, her sister is a corporate nurse for a LTC system there. I met her and we discussed the state of LTCs. She laughed about cutting staff to the bone, and told me that it's lucrative, and she really doesn't care about the lives she's compromising-staff or patient. She sleeps well with the 150+ grand a year she's making. I asked her during pandemic how it was going. She told me she simply doesn't care about staff. They either make it work or go elsewhere. She told me she got a huge raise and bonus with her new cuts/cost cutting ideas during the pandemic. She says my indignation are hysterical. These are the people who are there. We know that more of them exist in these positions than not. It's greed, and until the greed stops, care won't improve. People aren't going to give up their gravy train.
I'm an RN and I worked a year in psych and after that have worked exclusively in long term care. I love it! There is much better work life balance working 8 hour shifts and I love how most of it is just protocol and procedure. As others have mentioned, there is a lack of "status" compared to working acute care, and there can be issues with moving from LTC to acute care. Once you get to know your residents, you can predict a lot of things about your shift and learn how to prioritize very easily.
I, however, don't care about any of that. I love knowing my residents well and I like the lower acuity and think that it translates to lower levels of stress. I also make more in LTC than many RNs in my area working acute care. I'm not sure what that's about, but I think it may be because most RNs would rather work in acute care.
There is a big push to get RNs into leadership roles in LTC settings. I worked as a shift supervisor for a while, but they let me go back to working the cart after I pitched a fit about management trying to write me up for their mistakes and a general lack of transparency. I might not be able to be at my current job much longer because there are rumors that corporate may not be allowing RNs to work the cart (aka not in a leadership role). That doesn't stop LPNs from still viewing me as a resource or someone to solve complex problems, LOL.
There is definitely a lot of chaos and bad management in LTC. However, that can work in your favor because if you're an actual good employee who shows up on time and does your job well, you generally can work there as long as you want to. There can be some stress and hesitancy at some places wondering if night shift is even going to show up.
Specializes in Progressive Care, Sub-Acute, Hospice, Geriatrics.
11 hours ago, Purple_Clover said:
I'm an RN and I worked a year in psych and after that have worked exclusively in long term care. I love it! There is much better work life balance working 8 hour shifts and I love how most of it is just protocol and procedure. As others have mentioned, there is a lack of "status" compared to working acute care, and there can be issues with moving from LTC to acute care. Once you get to know your residents, you can predict a lot of things about your shift and learn how to prioritize very easily.
I, however, don't care about any of that. I love knowing my residents well and I like the lower acuity and think that it translates to lower levels of stress. I also make more in LTC than many RNs in my area working acute care. I'm not sure what that's about, but I think it may be because most RNs would rather work in acute care.
There is a big push to get RNs into leadership roles in LTC settings. I worked as a shift supervisor for a while, but they let me go back to working the cart after I pitched a fit about management trying to write me up for their mistakes and a general lack of transparency. I might not be able to be at my current job much longer because there are rumors that corporate may not be allowing RNs to work the cart (aka not in a leadership role). That doesn't stop LPNs from still viewing me as a resource or someone to solve complex problems, LOL.
There is definitely a lot of chaos and bad management in LTC. However, that can work in your favor because if you're an actual good employee who shows up on time and does your job well, you generally can work there as long as you want to. There can be some stress and hesitancy at some places wondering if night shift is even going to show up.
I agree about RN being in the cart and management forcing them to be in a leadership role. I am on the cart and I like bein on the cart and taking care of my patients. I was suggested to take shift supervisor role and I refused because my workplace is too disorganize and 90% of staffs are agency, not a lot of them works with ethic, and facility policy is not concrete. Looking for a better place to work for.
Facilities are losing money hand over fist on their medicaid patients, so they truly can't afford to staff better. They USED to make a lot, but things have changed significantly.
People think you have to document on things you haven't done, but I don't find that to be the case. My CNAs can help me with things like barrier cream, skin prep etc. You don't have to be licensed for those. Aside from that theres just vitals, skin assessments and wound care - both of which are not super complicated.
On my sub acute unit I have time to do all I am asked to do - and If I can't complete something I just document that it wasn't done. Treatments can be deferred to the next shift, etc. It's only an issue if you say you did something you didn't do.
That being said, it takes exceptionally good time management and delegation skills along with teamwork. It's also really, really hard work. I find it to be one of the most rewarding careers I've ever had.
Not only do I get to help my patients recover and eventually go home, but there are always a mixture of long term patients on almost all sub acute floors. I get to participate in their care and help them stay as healthy as they can while they live out their lives. I also get to participate in end of life care fairly often and I find it really rewarding to keep my patient comfortable and be there for the family. I find educating them and letting them know what to expect/whats normal is really helpful for them.
TheDudeWithTheBigDog, ADN, RN
678 Posts
It's been done once. Maybe make it happen a few hundred more times until something actually gets changed. You're a college educated PROFESSIONAL. Stop being OK with this.