Long-term care (LTC) nurses are Registered Nurses (RNs) with specialized knowledge in caring for people with disabilities, the elderly, or people with long-term chronic illnesses that need management. Some long-term care facilities cater to people who are recovering from surgery, heart attacks, strokes, or car accidents – there are many areas of care for these nurses to be in.
With the rapid advances in medicine and technology, people are living longer, but our elderly population is still dealing with multiple chronic conditions, and the need for specialized care for these people has escalated considerably.
Long-term care facilities offer prolonged healthcare solutions for people who cannot care for themselves. Caring for people with specific medical or mental support needs is not always easy, and often family members do not have the skills or physical capacity to care for their loved ones.
Long-term care facilities
Facilities established for long-term care include nursing homes and residential care centers, day care centers for adults, rehabilitation centers, hospices, and home health agencies. They may be run by government departments or non-profit organizations, or they may operate as private businesses.
A nurse’s involvement depends on the type of facility. In assisted living facilities, Certified Nurse Assistants (CTAs) and sometimes LTC nurses provide basic care such as the administration of medication, helping patients dress themselves, and giving advice and emotional support. These facilities generally offer a level of independence where the resident has their own unit comprising a bathroom and bedroom, kitchen, and lounge. When the need arises for more intense nursing care, the resident may move into a nursing home environment, where they receive similar care under a higher level of supervision.
At the other end of the spectrum, nursing homes that cater for patients with special needs such as Alzheimer’s disease require nurses to have additional qualifications relevant to mental health issues. LTC nurses working in homes for the elderly are advised to attain qualification in gerontology and the management of chronic illnesses.
An important part of keeping people healthy involves an exercise routine and mental stimulation. Even people in wheelchairs need exercise, such as throwing balls, playing board games with others, or building puzzles goes a long way to keeping patients happy and healthy. LTC homes should clearly indicate what they are offering to residents in terms of medical, nursing, and personal support also in addition to recreation, diet, and even spiritual care.
The safety of patients is of great importance to family members, the facility, and their staff. The LTC organization should have policies in place, and these need to be revisited on a regular basis to ensure measures are still valid. The practice of safe nursing involves evidence-based practice – methods and routines that have been implemented as a result of research and experience in specific medical situations. The enforcement of evidence-based practices in the nursing environment ensures that nurses abide by rules when administering care and have more confidence when uncertain situations arise.
Home-care agencies offer a different form of nursing for people who prefer to stay at home or with relatives. Nurses visit the patients in their homes and help them to bathe and dress, take vital signs, dress wounds, and administer medication. Often an emergency response system is in place in these situations for times when the nurse is not present.
The demand for LTC facilities is escalating as the population ages and people search for solutions that offer daily care, companionship, and a guarantee of safety and medical competence when more intensive nursing care is required. This creates a need for staff with the appropriate expertise to step in and take over the daily care of residents and their additional nursing requirements.
Often set in homely environments, long-term facilities allow people to continue with their lives in comfortable surroundings with quality care. Weather permitting, they can take part in outdoor activities such as walking, swimming therapy, and more. Patients can socialize and form close friendships – a lifestyle that is conducive to improving their mental and physical wellbeing.
The benefits of working in a long-term care facility
For a nurse, LTC facilities offer job stability and the benefits of working with permanent residents with whom they can form caring relationships. In this environment, nurses and patients are generally together long enough for nurses to appreciate the improvements in the health of their patients, reaping the rewards of seeing their patients thrive and be happy. LTC facility nurses devise treatment plans for their patients, including exercise regimes, daily medication schedules, and dietary and therapy requirements. They form trusting relationships with the patient’s family and involve them in the planning and treatment of the patient where possible.
Any RN who is interested in gaining knowledge in a field that offers diversity and opportunity should note that long term care nurse salary prospects and job outlooks are extremely positive. This is due to the growing popularity of LTC facilities and the general shortage of nurses and medical professionals in the US. Ongoing training is an accepted way of life for nurses as they strive to keep up with modern technology and practice methods. To start, Marymount University offers a range of accredited nursing courses that can teach nurses the skills required for a successful career in long-term care. With the availability of online courses in today’s technological climate, the next step in many nurses’ professional careers is now more easily attainable.
The employment of specialized long-term care nurses is a strategic move
Long-term care organizations may employ CNAs to address the basic care of patients such as feeding, bathing, and dressing, as well as assisting with walking and toilet use. However, there are many good reasons why these facilities should also employ the better-qualified RNs as part of their staff contingency.
RNs who have specialized in long-term care spend much of their time coordinating healthcare plans and seeing to the wellbeing of residents. Through interactions with medical professionals and trained therapists, LTC nurses ensure that patients receive appropriate and effective medical care. They may also be responsible for supervising nursing assistants by drawing up work schedules and providing training and assistance when needed.
LTC nurses must have a thorough knowledge of the medication they are administering and to identify and react promptly to any adverse effects on patients.
Aside from administering medication, LTC nurses are responsible for a range of medical roles. They monitor and record the vital signs of residents, dress wounds, manage chronic pain, provide diabetes care, administer intravenous therapy, manage continence and bowel issues, and assist visiting physicians with examinations.
Mental health, family support, and specialized care
Anxiety and depression play a large role in elderly people’s lives and managing them is an important part of their general wellbeing. Anxiety leads to other health issues, such as insomnia or stomach ailments, and if unchecked, will lead to further health problems. Besides administering medication to help patients overcome anxiety, encouraging patients to participate in organized recreational activities will go a long way toward improving their condition.
LTC nurses provide family members with care plans for their loved ones, explain symptoms, discuss treatment options, and involve the family members in decision-making around medical interventions. Modern technology makes communication with family members easy and instant, and regular reports on the patient’s health status should be part of the care plan.
Patients who have Alzheimer’s or dementia eventually lose control of their bodily functions, and the interventions in these cases require specialized nursing training. These patients cannot communicate when they are feeling unwell, and nurses need to be particularly observant to pick up underlying health issues.
In many instances, patients recovering from surgery need specialized nursing care. Patients who have physical disabilities and are incapable of standing or walking are heavy to handle, and this places physical strain on the nursing staff. Nurses are trained in the correct methods of lifting and turning patients, and a good level of fitness is a requirement.
People over the age of 75 usually have at least two chronic ailments that need care plans, regular medication, and consistent monitoring. Diabetic patients need special diets, and many residents require regular checkups in the form of blood pressure and lung function tests, for example. Nurses in this environment monitor vital signs, administer medication, treat illnesses, manage chronic conditions, and offer emotional support.
Essential technology and skills
Trained nurses have a thorough understanding of the technical equipment in use, what it is used for, and how to operate it. They are required to attend courses when new technology is introduced into the environment.
LTC nurses give advice on healthy eating habits based on patients’ special dietary needs, give suggestions for exercise regimens based on their physical status, and give tips on hygiene for patients with specific problems.
In addition to their professional nursing skills, LTC nurses need empathy, patience, and resilience in stressful conditions. In time, LTC nurses develop critical thinking and analysis skills, enabling them to identify the early onset of problems and intervene promptly. Caring for elderly and disabled patients often presents stressful situations as patients with whom they have close relationships reach their end-of-life stage. LTC nurses must be emotionally strong in these circumstances as they deal with the patient and their family members.
The constant changes taking place in the medical environment regarding improved medications and methods of treatment require nurses to maintain their level of expertise. This can be done through continued study, attending seminars and conferences.
Patients with limited mobility tend to pick up infections if they don’t have sufficient exercise, and unless these problems are picked up early by a nurse with a trained eye, infections can spread quite quickly among residents. RNs are trained to identify these illnesses and infections to treat them accordingly. The Centers for Disease Control and Prevention (CDC) estimates that between 1 and 3 million serious infections occur annually in assisted living facilities, and they provide guidelines and training on how to prevent these infections. The knowledge and interventions in their guidelines are specific to nurses and would be difficult for laymen to implement.
A good ratio of nurses to patients equals better patient outcomes. Staffing shortages can lead to higher rates of infection and bedsores, weight loss among patients, and ultimately, higher mortality rates. Elderly patients are prone to falling, and a simple fall can lead to fractured bones or open wounds that become infected. In these cases, recovery is slow, and sometimes the fall indirectly leads to the death of a patient. Patients should not be left alone at any time of the day or night, as there should always be at least one qualified nurse in attendance.
Skillset requirements for long-term care nurses
The wide range of illnesses and disabilities that present in these settings require nurses who have a thorough knowledge of nursing, are emotionally and physically strong, and are passionate about their work. The hours are long, and the physical nature of the job can be tiring. Nurses in this environment need to take time out to care for themselves as well – a healthy lifestyle with correct eating habits and exercise is recommended to cope with the demands of the job.
Emotional strength and maturity are also important requirements, as nurses in a long-term care environment are more likely to become attached to their patients. There is always a sense of loss when a patient passes away, and it may leave a temporary void in the daily care routine.
LTC nurses need critical thinking and problem-solving skills for weighing up and analyzing the facts presented. This is particularly true in emergency situations where they need to think and act with urgency. They must be analytical and observant. Many elderly patients cannot communicate effectively, and nurses must accurately assess the patient’s needs and intervene accordingly.
Leadership skills are important in the LTC environment, as nurses are frequently required to lead teams of certified caregivers and other nurses. Nurses coordinate multi-disciplinary medical teams when a patient’s condition requires simultaneous treatment by a medical doctor and a therapist, for example.
The LTC nurse may be required to deal with suppliers of medical equipment and medicines, supervise the creation of menus and the preparation of food, ensure that hygiene standards are met, and more. To survive in busy environments, LTC nurses must learn how to prioritize tasks and delegate as much as possible.
Nurses are, by nature, empathetic and caring. However, their patience can be put to the test in this environment. They sometimes need to be kind but firm when dealing with a difficult patient or handling someone who is no longer of sound mind.
Communication skills are important as nurses interact with a range of people from all walks of life. This includes healthcare providers, nursing staff, kitchen and cleaning staff, and a diverse set of patients with their sometimes-unhappy family members. LTC nurses may also be called upon to advocate for better conditions on behalf of staff or patients. In these cases, good communication is key to successful negotiations.
Long-term care facilities need qualified nurses
As this article has explored, long-term care facilities would find it extremely difficult to provide adequate care without the services of an RN with sufficient experience and additional training that is relevant to their specific field of practice.
Long-term care is not easy, but it is interesting and often challenging, and the rewards are many. Seeing a patient’s face break out in a spontaneous smile, despite their battles, is enough to brighten anyone’s day.