Will I ever get out of LTC or am I doomed?

Specialties Geriatric

Published

I am a newer grad. Graduated last summer. Only job that even gave me a chance is LTC/sub-acute rehab. I hate it. I want a hospital job, desperately. Even a clinic, anything but this kind of nursing. All I do is pass meds, do basic, and rushed assessments, irrigate foleys, change bedsore dressings, chart, do fall work, and get yelled at, and the population I care for (elderly, dementia, or rehab and very needy and frankly a lot of them are abusive and drug-seeking) feels like glorified babysitting. Will anyplace besides this type of nursing facility ever consider me? I'm doing my BSN now so will that even help? If i am gonna be stuck in LTC forever with no hope I may as well go back to school for something else. I LOVE nursing, and I love my patients, but I have way too many (50 by myself) and not enough time, help, or supplies and I am quickly being burned out. Well, I am burned out. Less than a year in LTC and I can feel the compassion fatigue so much, I try to stay compassionate but it is hard when patients kick you and punch you, scream, call names, and have very annoying and disruptive behaviors but you have such a heavy med pass and treatment assignment you don't have 5 minutes to spend with them, and they beg for attention through behaviors. I NEVER wanted to work in LTC but I have to pay my bills. Any advice appreciated.

Specializes in Oncology.

Nurse of2012-

At my facility when narc count is wrong they drug test the nurse to make sure she didn't "steal and divert it"

You shouldn't kill yourself over it though. Accidents happen.

And I HATE when everyone else I work with constantly talk extremely loud and gossip in a foreign language... very rude and disrespectful.

Not that you can hardly understand then when they do speak English though.

(I'm not racist I just can't understand what they say and it kind of makes work a lot harder)

Oh good heavens JZ! You are absolutely not alone. I graduated last summer and took my boards in October - got a job in January in LTC and I could have written your post word for word. Most days I want to cry on the way to work and coming home from work. We have the same policy that we're not allowed overtime but if I try and pass on anything to the next shift they're extraordinarily angry. It's absolutely dreadful. I'm trying to stay positive and apply at various places but the economy is no bueno right now, so I'm not holding my breath, and hoping I can keep my license. Keep your chin up!

Specializes in ER, geriatric, med-surg., rehab., DJJ.

Reading these posts its as if I wrote them. I have been an LPN for 25 years the last 10 at a SNF. Where on the midnight shift one LPN may care for 60 patients and God help if a patient goes south. instead of complaining about our work conditions is there no way we can make our voices heard at the government level? Is there any organizations or lobbyist for our cause? Its not our patients or even the facilities we work at. Its the government and all their cuts. That's who we should be complaining to. How do we do this in a legal yet fruitful way?! Any suggestions?

I TOTALLY understand. I am in my 3rd year as a nurse....and some days want to leave nursing all together. I do believe that LTC and rehab facilities need a serious overhaul. Hospital nurses cry about nurse to patient ratios...but no one seems to care that these people who are leaving the hospital are NOT stable and going to a facility where they can be one of 50 patients to one nurse. Its soo sad..

Tempting as it is to join the ongoing debate, I prefer to answer the question posed by the OP. I want to encourage you not to lose hope of finding a job outside LTC coming from someone who has been there. My advice is to get all of the experience you can on the skilled or short term rehab unit of your facility, if that is an option. Then carefully edit your resume to play up your skills and experience that will be helpful to a hospital seeking to hire. When looking for positions in a hospital focus on SNF units or sub-acute. While some of these type of units are actually run as a separate facility as the hospital, and may not be the most desirable, just being connected with the hospital can be a foot in the door and a resume builder. This is the route I went; I worked in a hospital's SNF after starting my career in LTC. I could have gotten another hospital job after that but chose home health instead. Good luck!

I haven't read the other comments but the only thing I have to say is please find something else to do that will pay your bills. The residents who live in SNF's do not deserve to have nurses who feel like you do caring for them. I have worked in LTC for 14 years and see it as so much more than glorified baby sitting. I wouldn't change the path my career has taken for anything.

Specializes in Oncology.

Iceprincess492- I love each and every one of my residents, it's the work environment I despise, so get off your high horse and stick your judgment where the sun doesn't shine.

To the OP.....

It seriously sounds like you're suffering from burn out. I hope you get time off soon so you can take care of yourself as well. If we don't take care of ourselves, we can't take care of others. Our pt/residents DO sense the stress and frustrations that we all have when we get burnt out (and we've ALL been there at one time or another no matter what setting we work in) whether we feel we are hiding it well or not. Dementia pts pick up on this VERY well and they will act out because of it!

I love working LTC and wouldn't change my setting! However, I understand you're frustrations all too well!!! Unfortunately with the economy all healthcare facilities, including both LTC and hospitals, are cutting back on staff. I left my last job because they not only were cutting back on staff, but were admitting the most acute pts and expecting us to do medicare assessments, change of condition assessments (there were many days that I had literally 15 full assessments), 2 admissions, a discharge or two, 6 different IVs, a tube feeding or two, 15 treatments/dressing changes, 2 med passes, new MD orders and taking care of the crashing resident, the fall, the low BGT, the new skin tear, etc all in 8hrs. I think you get my point. Its places like these that you need to do your best while your there and look for something new.

One thing I encourage you to do is really concentrate on your assessments. You actually can gather a lot of info in a short amount of time. It is in LTC that you will really learn to hone into those assessment skills as you are literally the eyes and ears for the MD. It is YOUR assessment that gets the residents the care they need. There is no MD in house to come check out a resident when things start going wrong. I also find that in LTC you do learn a lot about many different disorders/illness. And you get to see the disease in progress. many times start to finish - You can learn A LOT from this.

I wish the best of luck to you! I hope you find your niche. Don't count LTC completely out - there are good facilities out there!

Iceprincess492- I love each and every one of my residents, it's the work environment I despise, so get off your high horse and stick your judgment where the sun doesn't shine.

JZ-RN Thanks for the advice but I prefer to keep my judgement where it is. As long as I am able I will continue to make sure SNF residents are treated with the dignity and respect they deserve. If that means that I'm on a high horse then I hope my horse only continues to get higher. :yelclap: Some day you will realize that the way you really feel about your job is quite clear to the residents you supposedly care for and again I say they do not deserve someone who feels as though they are a "glorified babysitter" caring for them. They deserve a nurse who enjoys caring for them and sees them as something more than a way to pay their bills until something better comes along...

Specializes in Geriatric/Sub Acute, Home Care.

As a New Grad I know you are full of the pee and vinegar to get out there and cure the world, I dont mean that viciously, but the trend of Baby Boomers coming into full swing into the Nursing homes in coming years is going to be a major Job demand in this area for nurses of all ages and backgrounds. The aged are difficult. however if you are finding yourself impatient on this job, what are you going to do when you hit the other field you are interested in. LTC takes MAJOR patience, self control, and the ability to NOT get annoyed with the people because they are old, have dementia and very sick. Afterall, think of it this way. I know you are young now and believe me enjoy every minute of it, but your own aging process will catch up to you one day and you will realize how vital and necessary you as a nurse is needed for these people. We are all getting older. If you feel that deeply about being in the backseat(LTC) dont be. IT is a steppingstone. The elderly in the US are not looked up and respected like they should be....they are the reason we are all here today living in a free country. But, if you honeslty hate the LTC scene by all means go to another field. Being Happy in nursing is vital to your peace of mind and contentment for the profession.

Specializes in Oncology.

I am not annoyed with the patients, though their behaviors can be frustrating. I am annoyed that I have 50 patients and no assistance and am always the whipping post for the doctor who refuses to return phone calls and the managers who want us to spend 3 hours checking carts for expired tylenol instead of patient care. I love my residents. I hate my work environment. if you cared so much about your residents, you'd be angry at the situation as well, so seriously, your judgment is unwarranted. If you want to be on a high horse, get on the same one as me and expect decent ratios and levels of care for these residents, not more abuse for nurses and higher profits for nursing homes at the nurse and patient's expense!

Specializes in Oncology.

If anything, I feel guilty that I cannot spend time with them because I do care about them, but with 50 people and constant med pass, angry families who don't know what's going on, and admissions who scream, kick, punch, spit, pull hair, throw poop, etc., when can you spend any time with a patient besides a few pills or a dressing? My original post was from a point of rage after a horrible night. Maybe you work in an ideal nursing home but I've found that the nurses who are content with sub-par care are really the ones the patients do not deserve. Please think about the fact that you are okay with this ridiculous assignment, what does that say?

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