Long Term Care

What is it about Long Term Care facilities (aka "Nursing Homes") that makes nurses run screaming in the other direction? Why is it new grads and seasoned nurses want to only work in hospitals, and consider LTC facility nurses "less than" in the nursing world? I am honestly asking this only as being curious, no other hidden agenda!

Good question! The way I see it, in hospitals, you see the person for a short amount of time. Do we really see the person over an extended time in the hospital? No, we don't. But guess what? In LTC, we do.

I've worked LTC for the majority of my career; when I got my degree, it seems like the 'job to have' involved OB. Mind you, I am NOT knocking OB. We all are gonna 'grow up and get old', for the most part.

No, no-one wants to be in a nursing home, but there are many reasons why people are there: They, or their families, are unable to care for themselves, and need help. Home care may not be an option.

I wish we had more people who really CARED, lalach!

LTC care has too many people requiring too much with too little resources. It also attracts a fair amount of people whose workplace behavior would not be tolerated elsewhere. Most people who have any kind of work ethic look elsewhere after exposure for any length of time to workplaces that offer so little in terms of job satisfaction. There comes that breaking point.

Ouch! That was rather harsh! Since I have worked in LTC since I was 16, and am now turning 47, I take that as a slam to a large number of people who have GREAT work ethics. Thank you for your opinion though.

cali510 wrote:LTC care has too many people requiring too much with too little resources. It also attracts a fair amount of people whose workplace behavior would not be tolerated elsewhere. Most people who have any kind of work ethic look elsewhere after exposure for any length of time to workplaces that offer so little in terms of job satisfaction. There comes that breaking point.

Cali, I speak from experience when I say that I hear what you are saying. HOWEVER (and I don't want this to be a war amongst the Mods), there are times when there IS job satisfaction. I had that in my one job of umpteen years. Why did I leave? Well, lalach, it was my DON who changed. We won't go into particulars, but either I left, or I'd have done something pretty out of character. Let's leave it at that.

Yes, Cali, there are some lou-lou's out there, but when you get ones who really make a difference.....Upper Brass should do whatever it takes to keep them. Sometimes, if there is a Union, that may or may not help.

Remember, too, that LTC costs MUCH money. [B] I saw it firsthand with my own family. Money runs out quick, and Public Aid is a beast. Can you say :moosekick: ? I am not in it for the money, not by a long shot. [/B]

In a nutshell, you are both right. As 'The Bird' said, we need people who care.

I work for a not for profit stand alone SNF. Yep, I can say I am honestly not in it for the money. This was not meant to start an argument, I was only looking for reasons nurses go to hospitals instead of LTC facilities. I would never make a good hospital nurse, I care too much to just take care of "the hip" in room 417.

I know you aren't trying to start something here, lalach. I was refering to another Mod on the site, cali510.

We tend to pride ourselves here at UN that we pretty much can 'agree to disagree'.

I think this thread has alot of potential, to be honest. Perhaps we can get some good out of it! What say YOU, cali?

I do not steal psychotropic or narcotic drugs from the workplace, nor do I physically assault residents, or smoke pot on the job, make up a geri chair into a bed for the night shift, or leave residents in the same condition in which I found them, or do any of the other offensive workplace behaviors I found in each and every LTC facility where I worked, so why would I care to work in places like this, around coworkers who act like this? Just because the medicaid reimbursement rate is low does not require the DON to steal controlled drugs from her employer or the nurse who supplied her from her med cart to beat up on defenseless residents. I did not use the word "all" in my previous post, so I can not see why anyone would choose to personalize the observations I posted. The need to be politically correct does not change reality. I would have liked to have found a decent facility to work at.

Hi folks,

It would be good to take a breath now. We all come here with varied backgrounds and sometimes unpleasant work experiences which lead us to certain preferences and opinions. The statements being made in this thread reflect that experience and although they may not be shared by all, they should be honored so long as they remain impersonal. We're professionals here and many of us are burned out and looking for a place of refuge so, let's offer it.

R

For new graduates, I would stick with and recommend hospitals strictly for the benefits of experience and learning.

You see much sicker patients, more conditions, are in direct contact with doctors, the lab, hospitals, see much more of your patients and do a lot more for them.

Practically, after you have hospital experience, you can go to home care, long term, rehab, dialysis, and many other career options.

Practically, after working in long term care, you career options will not be as varied. A hospital or surgical center or homecare agency may not want to hire you over someone with acute care experience.

I've worked in both acute and long term, and at different times of my life I've preferred one over the other.

Both are necessary and give nurses different experiences/opportunities. It is up the individual nurse to decide what environment they'd prefer.

In the current job market, there are much more jobs in long term, than acute care. Especially for new graduates, to get their feet wet, ltc may be their only option.

It doesn't mean you need to stay their for the next 30 years. It doesn't mean you can't learn anything in long term care, or that your time there is wasted.

Any experience in direct patient care will help you down the road. My distinction in acute care is that you can learn more that will open more doors later on.

Hope that is helpful.

Andrew Lopez, RN
http://www.nursingentrepreneurs.com

OK! Before more fireworks get set off.......I see the problem! You are both right AND wrong......and that is a good thing!

Cali: Yo do have a point about the 'too much to do, not enough resources' bit. Please read my first post there.

Perhaps I should clarify it, too: Private pay is good, but there comes a time when the $$ runs out. SueBird mentioned quite a few of her classmates wanted OB. Guess what?! Insurance pays for that; when insurance runs out.......When money runs out over here, Public Aid pays much less, and is often late in getting sent, due to State budgets. LTC facilities have other bills, too (heating, lights), and often salaries are skimped on. Unfortunately, some people will do anything for money, and I am sorry you have had to deal with that first hand.

Lalache: After reading Cali's post a few times, it appears that the DON where she worked didn't really give a dang. Unfortunately, this does happen, and quite often, apparently. From the little bit I have dealt with you, you sound like a decent supervisor, and I doubt you'd put up with that crap.

And thank you, too, Ricu. Yes, we all have varied backgrounds, and have been hurt before. I also agree that we can learn from one another.

Perhaps we can turn this thread into a productive thread? Such as what are common behaviors when 'The Bosses' leave? I have seen where 'The Bosses' come in unannounced during different shifts.....

Let's make a DIFFERENCE!

Andrew, thanks for your insight, also. One point that was made is that, in LTC, it is just that: Long Term! Those nurses see every day how the patient responds. Send them to the hospital, and their 'routine' is really disrupted.

Remember, a hospital stay may have been 1 week for PostPartum at one time; now it's 2-3 days. I have worked both sides of the line. I won't know what is really 'the norm' for the little old gent with pneumonia. He'll be out as soon as he gets over 'the hump'.