Working in LTC


I graduated with my RN in may 2012 and received my license in June. I started a job in LTC/SNF in December. I work pool on the 11-7 shift and care for 60 patients a night. Med pass takes me from 4 am until 6. I normally have no time for a break and end up staying at least a half an hour late. I feel bad for the patients because when I do morning med pass, a lot of then want to get up to use the bathroom or be changed and I just dot have time to do it, so all I can do is put the call light on for the cna's, who at that time ate doing their morning rounds so they are usually busy with other patients. Even on a good night, when nothing comes up i feel like there is just too much, with all the Medicare charting, MDS's, the chart checks, treatments, lab and appointment paperwork, making sure the patients who triggered for not having bowel movements get there suppositories in the am, and the med pass being so heavy. The facility is unhappy when you don't take a lunch or you stay past your shift, but they won't give any more staff to relieve the load, even though it has been suggested to them by supervisors. I really like being busy and always having something to do, but there is just too much. Are all LTC facilities like this? I really enjoy the elderly population, but I am not sure that its worth it to continue on there. At this point I am only staying for the experience on my résumé. I want to cry every time I walk out of there. Any advice would be appreciated, I just hate feeling like this and hating going to work, but without experience it's not that easy to just find another job. Is this really worth my sanity?


7 Posts

Is it for profit? If it is it won't ever change. Start looking now . The bottom line is not the residents and not the staff but the 6 figure salaries for the corporate executives and the bonuses for your administrator for saving money . It's true!

Esme12, ASN, BSN, RN

4 Articles; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 43 years experience.

Welcome to AN! The largest online nursing community!!!!

moved to LTC nursing for best response....:)

Sound like my LTC. They even told me on the first day it is a norm that nurses stay 2-3 hrs after their 8 hrs shift without pay. You will never get OT here. One nurse I know works like crazy and stays after hrs. He is a good nurse. I hope he can work some where they appreciate him. There are at least 2 nurses I know that get off after 8 hrs. How did they do it? Pass only psy meds, BP meds, and insulin. Or meds that are in a package. If meds are in the bottle they won't pass it. Then use those free time to do paper works. I hope I will get out of this soon. I say start looking for a new job. I hope you and I find the new one soon. The better one!


60 Posts

Specializes in LTC, DD.

Hi there,

I am a LPN and graduated in June and began PRN work at a (for profit- never thought that this would make a difference) LTC in September. The last true shift I worked was Christmas Eve where I stayed late to help out as an aide. My orientation was about 10 days total, scattered over a few weeks. Not nearly enough for a new grad, but I'm told this is normal. However, I have two friends from my class who found jobs with significantly longer orientations (7-8 weeks...heaven)- so I'm holding out hope to find work at a facility like that. Although they feel safer, better oriented, and more comfortable with their workplace- they list all of the same stressful things that I did- so I feel like it is the reality of LTC, unfortunately.

And I HAVE cried in front of the DON- so embarrassing. Luckily it was in private in a charting room, but I couldn't stop it, I was talking normally and the tears just fell from the exhaustion/feeling of being overwhelmed/stressed.

While I felt like I should have stayed longer (I'm still technically on the per diem list, but I explained I wanted to focus on finding a different job/volunteering for the time being), I also felt like walking into work feeling like I was about to lose my license wasn't worth it/wasn't good for the residents that I cared so deeply about.

Like you, I really enjoy and love working with the elderly. I was recently offered a part time job working with individuals with developmental disabilities- which is a total change of environment for me, but I'm looking forward to it. I still want to get back into LTC, but I'm doing a lot of research this time looking for a place that is more ''new grad'' friendly. I realize that many LTC's are short staffed, there seems to be never enough time, way too many meds, etc...but I really do love the elderly and I just hope to find a better fit for this stage in my career. Best of luck to you, I'd love to hear what you decide to do!


87 Posts

This is how i feel it too.I m also a new grad. I felt the exact way ..I m also looking new grad friendly place. Best of luck.

I work not for profit and the first post describes our place. We do get paid for the hours we work past our schedule. If ur not getting paid for the hours u work u need to contact the labor board.


39 Posts

In LTC, it is normal to stay late to catch up on documentation but it is illegal for them to make you do it without pay. I would stay long enough to gather what you need to prove your case, find another job and on your way out the door call the state to report them and an attorney. I heard of someone that did that and the facility was fined and had to back pay based on the average amount of time everyone spent over the last two years. (it may have been two years maybe longer i don't remember)


34 Posts

I am a new grad and my first full tiem job was an LTC and I was thrilled i landed a job but i quit after three days..For the same exact reason and then some..the nurse training me was an LPN. there were 40 pateints and two nurse both LPN's and i was the only RN..the supervisor was an LPN as well. There was no time for anything and they would fronw on staying late..i quite because i felt my license was on the line. I am currently working at anothe rplace that is so called "not for porfit" same deal. only difference is that i now refuse to work the morning shift as that is way too overwheleming and too mnay eyes waiting for you to make a mistake. I am doing the 11p to 7a shift and find it eaiser. 23 to 35 patients and about 7 peg pateints..admissions by the hospital next door at all hours of the nigth..but there are nurses who work after hours and they wont pay them..I heard that the first day from the nurse that they wont pay you and you have to punch out and work off the clock..and my response to her was you are a fool if you are doing that. if is illegal to work for no pay..and thye know it..So i spoke to HR about that right away cause i wont and refuse to work off the clock. thye know the situation and if they wont provide additional staff then they will pay me at least the extra hours I work..

LTC is sad because the patinets are the most vulnerable and dont get the attneiton or care they need and deserve.

Anyways i need the job but i am activiely looking for something or mental health..


4 Posts

I am sorry to hear about your experience in LTC. It IS busy, I was very overwhelmed too, however I feel that given some time you develop a good system and can get everything done. I truly enjoy the geriatric side of nursing, too so I stuck with it awhile and am now in my groove 98% of the time. Hopefully they will stop pressuring you about lunch breaks and OT if you remind them you are new and still learning. Other nursing jobs I have had were equally stressful in different ways. Take care of yourself, it's awesome that you care so much for your residents :) If you are crying when you leave work, that is not a good sign.


7 Posts

I highly advise a State or Federal job. These are the only places that have pay and benefits and staffing that makes it worth it.

BrandonLPN, LPN

3,358 Posts

Has 5 years experience.
I highly advise a State or Federal job. These are the only places that have pay and benefits and staffing that makes it worth it.