Long-Term Care: A Rewarding Career Path

Fact: LTC offers a diverse range of roles, from direct patient care to leadership and advanced practice. Many LTC nurses transition to roles in policy, education, and research. Additionally, LTC offers RNs the ability to more quickly move into leadership and management roles. Finally, nurses looking to become nurse practitioners (NPs) have a great deal of opportunity in LTC. In LTC, NPs provide primary healthcare services to residents with complex medical needs, focusing on chronic disease management, and overall quality of life, while collaborating with other healthcare professionals within the facility. Estimates suggest approximately sixty to seventy percent of medical care in LTC is directed by NPs or models of care that include NPs.

“If you are willing to work, you can work your way up to being the director of your building.” – Linda, RN in Assisted Living

“I LOVE when an executive director has a nursing background. This uniquely positions them to bridge the gap between clinical and operational priorities. They fully empathize with the challenges nurses face and can better advocate for resources and policies that support the clinical team and ensure high-quality care. This shared understanding fosters trust and collaboration between the executive director and the nursing staff, creating a cohesive and supportive work environment.” – Paula, RN in Skilled Nursing

Fact: LTC nurses manage complex care, including medication reconciliation, chronic disease management, and acute care during emergencies. They also play a vital role in end-of-life care and advance care planning.

“One misconception is that in long-term care was helping people toileting, you just clean up poop all day… which is definitely a misconception because that’s just one part of helping some with ADLs, and you do it exactly the same in hospital settings.” – Zoe, Nursing Student & Nurse Tech in Skilled Nursing

Fact: While this does depend on the specific facility and management practices, the work environment in LTC is often uniquely compassionate and collaborative. Nurses have shared that they are surprised by how collaborative staff are, and how they have the opportunities to connect with colleagues and share tasks throughout the workday.

“I feel like wherever I’ve worked, there’s always a really close-knit community among the staff, and there’s always a helpful environment, like everyone wants to support each other … It’s more collaborative.” – Zoe, Nursing Student & Nurse Tech in Skilled Nursing ‘]

Fact: End of life is an important part of life. Nurses have a nuanced, vital role to play in communicating with families and patients about palliative services and end of life care. Though nurses in LTC do manage end-of-life care, many patients enter LTC for transitional and rehabilitative services, and nurses play a key role in ensuring a smooth transition from acute care back into their lives at home. 

“Long-term care is not depressing. It is filled with joy.” – Linda, RN in Assisted Living

“There’s such a misconception out there that nursing homes are just passing meds, and they’re dreary, and they’re sad – and they’re not! The patients can be vibrant and fun and there’s a lot to do for skilled nursing.” – Marianne, RN in Skilled Nursing

Fact: LTC is not easy. While the specific skills nurses use depends on the type of facility and patient needs, LTC requires nurses to have a breadth of critical nursing skills and requires unique skills such as building long-term trust with patients and families, navigating memory care, and operating independently to guide patient care.

“One important skilled aspect of care in long-term… is wound prevention and management. This is a critical clinical skill for nurses in this setting… The expertise required to assess, prevent, and treat these conditions is a cornerstone of nursing practice in long-term care and highlights the advanced clinical skills needed in this field.” -Paula, RN in Skilled Nursing

“I would think that other nurses would want to work in long-term care if they are looking for something that’s challenging as well as relational… Long-term care is not an easy type of nursing…. We have extensive wound care, we have IVs, piggybacks, catheters, central lines, pick lines. I actually have a lot of fun at my job, there are so many things that I laugh at, so much joy that I get interacting with my patients. I look forward to seeing them every day, and they look forward to seeing me.”  – Marianne, RN in Skilled Nursing

“The biggest misconception I also had walking into the experience of long-term care is that you’ll lose nursing skills, but I see a lot of those skills being performed every day in the long-term care facility – Like blood draws… in long-term care that’s a day-to-day thing. Folley catheter insertions, accessing ports, all those skills we think we might lose in long-term care, isn’t necessarily lost.” – Tiffany, Nursing Student & Nurse Tech in Skilled Nursing