I've experienced many things throughout my life but nothing can compare to those in my years of nursing. I have been a nurse 6 years and I have seen my share of gore, patient abuse and goodness. These years will be etched in my memory forever. I became a nurse so that my mothers dream could come true through me. I started my career taking care of kids on respirators for home health, from there I found myself working on the Med/Surge floor, and finally long-term care. Of the three, the kid's were my favorite. Unfortunately pay cuts forced me to move on. Med/Surge was a nice change of pace but the hospital in which I worked housed a long-term care facility and we often were floated there during dips in the census. I had been floated enough times that I decided I might as well move permanently and finally found my passion. Long-term care is not for everyone. It is demanding, both physically and mentally and with short staffing and overcrowding there are always less than perfect environments.

As a long-term care nurse you are usually (which is the case with me), a charge nurse. You are responsible for assessing the patients, calling the doctor's for orders, processing those orders and implementing them. Calling for replacements during sick calls, passing meds (sometimes up to 40 patients on one med pass), evaluating wound care, changing dressings, overseeing any work done by the CENA and documenting anything you've done or seen. It is common for your documentation to take an hour or more per shift. You have to dictate who does what and a lot of times the CENA can be very resentful and insubordinate. At the end of the day your feet hurt, the CENA's are angry because you've stepped on too many of their toes, the doctor's are yet again absent and you are ready to leave. Then comes the call that your replacement is sick, in which case, you have to stay until they find one and sometimes that doesn't happen. I've worked two long-term care facilities; the first was on 12-hour shifts the second had 7's. It was nothing short of common to find myself working mandatory doubles on the 12 hour shifts and fortunately the second facility would never require more than 16 hours. The mandatory overtime will depend on where you work and who your management is. Keep in mind that you are legally liable for anything that happens to these patients during your shift so being tired and overworked isn't a very good mix. Mistakes happen but are the worst when you are tired.

You may also find that these people really need you. I found that listening to the resident’s stories would put a smile on my face, and theirs. The wealth of knowledge that they possess is staggering. Most have been places and done things that we will only dream of doing and they have only the story to tell if someone will listen.
If you are willing to put a lot of time into them and your job, you might have a fulfilling career with long-term care. Putting in the extra time sometimes means that you listen to a story instead of having your lunch break, or staying after your shift is over to catch up the documentation you would have had done had you NOT taken the time. It can also come at the expense of your health and family, when you opt to work that extra shift or all of your days off because the facility is short staffed.


Government’s cuts sometimes make it impossible to work in positions for home health because your pay will be very low. Med/Surg nursing will put all of your skills to work but often you will feel powerless against insurance companies. Long-term care nursing can be very rewarding but doctors don't always see the patient often, some family members don’t visit much and as a result many of the elderly are abusive, confused, angry and depressed.

The pay is low despite the amount of responsibility you will have. (How much is a life worth?) You also may feel unappreciated and abused. The abuse often comes not only from the patient but the family, doctor, staff and your boss as well.

The upside of nursing is that there will always be sick people so you will always have a job, you truly do make a difference in the patient’s lives even if they don't see it, and you'll be a step ahead of everyone else in that you will know who the "good" doctors are.

Holding the hand of a patient while they die, or bringing a smile the face of a stranger when they are sick; it takes a special person to be a successful nurse, You need a wealth of patience, a sense of humor and a heart the size of Texas.

Do you still want to become a nurse…. good luck:)

Tami Skinner, LPN
AOL- Tami49736


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