You will lose your skills in LTC

NamasteNurse, BSN, RN · Feb 12, 2009

you go egglady! Agreed!!! Who said that anyway? Someone who doesn't work in LTC for sure! wow...ignorant.

egglady, LPN · Feb 12, 2009

A hospital nurse said it to me. She is a fairly new grad, 1st job. Whatever!! Oh and in the vent, I forgot about the damn wound vac- I HATE them damn things!!!! But the good news is i have one day off- tomorrow, and i am going shopping!!!!!

inthealth · Feb 12, 2009

You know what ,I have heard that by many RNs who have advised me not to apply for a job in LTC, they say you'll get stuck and can't further your career... and hospitals won't even look at you if your experience comes from LTC because the acute experience is not there, that's just what I've been told, and is new to me... where I come from a nurse is a nurse wherever...

Wishinonastar, BSN · Feb 12, 2009

Long term care today is a whole lot different than it was 25 years ago. Back then many of the patients never went home. Now lots of them are there for IV therapy, rehab, complex wound care, etc. These are things that they once stayed in the hospital for. It is like home health- people think home health is going around pouring meds. We have tons of IVs, central lines, chest tubes, post-ops, wound vacs, etc. Where do the hospital floor nurses think these people go when they are sending them out on IVs? To long-term care or home health!

LHH1996 · Feb 12, 2009

Totally agree with the above responses..i used to laugh at comments such as this when i worked at an ECF facility that was seperated by double doors to the acute care hospital. We often would hear the same comments and put downs for working in ECF because it wasn't "real nursing." (i even got denied training in ACLS because i didn't get pulled enough to the acute care side) anyway....when those same nurses would have to float to the ECF side for staffing, they would pout like a two year old because it was too hard..

Also myself and several other nurses i knew would get pulled all over the hospital and do just fine.

travel50 · Feb 13, 2009

Many yrs ago, I thought the same thing...that the only nurses who worked in LTC were ones who could not get a job anywhere else. 12 yrs ago, a nsg home offered me so much money to be their weekend supervisor that I could not turn the job down. I so dreaded it that I got sick the first day. But I fell in love with it, am now a DON, and they may have to kick me out. But I work my fannie off most days. Now get this....a few weeks ago we sent a lady to the hospital (trach, that dreaded wound vac mentioned above, central line, peg tube, etc). The hospital sent her right back stating, "She is beyond our ability to care for"!!!!! So, who is minus skills here, and who has the dead end job????

But, hey, egglady....why do you hate wound vacs so bad? I got a laugh out of your comment.

aCRNAhopeful · Feb 13, 2009

It sounds like you all work in some fairly high level LTC facilities. However my experience is quite different than most of yours. I am finishing up my ADN this semester (so yes I realize I have very little experience to comment) and working at a LTC center. I would have to say that nurses at my facility are probably way behind as far as acute care knowledge. We do no IV's so a PEG tube is about as invasive as it gets. It seems that in a situation like mine, if I were to go directly to LTC as a new grad RN (which would be unlikely for a "CRNA hopeful") that I would definately lose much of the knowledge of acute care nursing. My facility may be the minority but the headline of this thread caught my attention so I thought I would comment to further the discussion.

asun21ta · Feb 13, 2009

My best friend is in school for LPN to BSN. The first thing her instructor told the class was that you will loose your skill in a Nursing home. Thats not to say you are not a good nurse, just different areas require different skills. There are some procedures that are not allowed to be done in a Nursing Home that are allowed to be done in the hospital and vice versa. In all honesty, if you don't have to do something, you won't remember it as well as someone who does it daily. That doesn't make you any less a nurse. I think the statement "if you work in a nursing home you will loose your skill" is taken out of context.

Wishinonastar, BSN · Feb 13, 2009

My best friend is in school for LPN to BSN. The first thing her instructor told the class was that you will loose your skill in a Nursing home. Thats not to say you are not a good nurse, just different areas require different skills. There are some procedures that are not allowed to be done in a Nursing Home that are allowed to be done in the hospital and vice versa. In all honesty, if you don't have to do something, you won't remember it as well as someone who does it daily. That doesn't make you any less a nurse. I think the statement "if you work in a nursing home you will loose your skill" is taken out of context.

That is true, and if you work in any area you lose skills from other areas over time. It has been ages since I did a newborn assessment! You also gain skills in your specialty. It is a tradeoff. You cannot remember everything you learn in school forever. I don't remember anything about the stages of labor, but I remember enough about pregnancy to work with pregnant teens as a school nurse. The point is that there are a lot of skills used in LTC today- with the exception of a select number that do not have or accept highly skilled patients. It is a good way to gain confidence and develop as a nurse. It is nothing to fear and not a dead-end job. If you like it- it can be a great specialty and nurses can rise through the ranks to some high level positions. They also have wound care specialists, rehab nurse specialists, hospice nurses, infection control, and the lovely paperwork specialists that do their required assessments. In good LTC facilities nurses stay a long time. You have your patients longer and develop close relationships with them. They become like family. You can't have that luxury in hospitals anymore- they are in and out like an assembly line of admissions and discharges, faces and numbers, names are quickly forgotten.

There is something in nursing for everyone and the main thing is not to assume that anyone has a cushy job with no skill involved. You have no idea until you have been there.

caliotter3 · Feb 13, 2009

Our subacute cases offered lots of excitement and variety of skills requirements. I never felt that I was missing out on anything when I worked in LTC.

Thornbird · Feb 13, 2009

That crap is so out of date. Back in the day when LTC's really were convalescent/rest homes and patients stayed in the hospital til they were "all better", it was true. Not so anymore. Patients in the old days couldn't go to the nursing home until they were totally stable, no IV's, drains, etc. The world has changed. You just feel free to let anyone that ignorant have it. These days you've got to do all the stuff in LTC that we used to do in Med-Surg but without the benefit of a whole hospital full of staff and resources. And still find the time for your poor little wanderers that are mixed in with your more acute patients.

When I first worked in LTC, 25 years ago, I stayed with the hospital per diem pool, so that I wouldn't lose my skills. That was necessary then. Definitely not the case anymore.