1. Time Management is Key. Even more so than in hospitals! Nursing homes have way higher patient to nurse ratios. Although the patients are supposedly more medically “stable,” that doesn’t mean it takes less time to care for them (or that they are actually stable at all). Nurses and CNAs in long-term or post-acute care are masters at time management. Preparing, planning, and executing your day with deadly efficiency is the only way to get by when you have 15+ patients all to yourself.
2. It’s More Heavily Regulated. Those who’ve never worked in nursing homes may stereotype it as the “Wild West” of nursing. Not true. There are tons of paperwork, documentation, and standards to follow. Not to mention, the reviews from organizations like the Joint Commission are frequent, exhaustive and iron-fisted. DONs and ADONs are always keeping you on your toes. Sounds more like the cold-war era Russia than the “Wild West!”
3. It’s Getting Tougher By The Year. Calling Nursing Homes “Nursing Homes” is so 90’s. Nowadays they’re called “Skilled Nursing Facilities.” Many nursing homes have patients with PICC lines, tracheostomy, actively infectious diseases, mechanical ventilators, and severe wounds. As hospital stays shorten, many patients “step-down” to nursing facilities. There’s no such thing as Ho-Hum Simpleton nursing – that doesn’t exist.
4. Beware the Comfort Zone! If you’ve ever worked at a long-term care unit for more than a few months as a regular staff, you’ll understand this. You will be in this sweet, sweet comfort zone – knowing every patient’s needs, knowing exactly what time you should have this and that done – the master of your domain. You’ll never want to leave.
5. LPNs Are Unsung Heroes. The highest concentration of LPNs by far is at skilled nursing facilities – and they do a lot. Many new graduate RNs who start out at nursing homes will recall LPNs who showed them the real-world ropes for the first time. I certainly do.
6. CNAs Deal With A Lot of Crap. I’ve worked as a CNA in both a hospital and nursing home. I have to say, being a CNA in a nursing home is tough. You have a heavy workload, lots of manual labor, and often little recognition (in terms of pay, too!).
7. Rotavirus And Norovirus Suck. Beware of these viruses who must not be named – once these strike your facility, all will suffer. Outbreaks of Norovirus and Rotavirus, two devastating “stomach-flu” like infections, spread like wildfire amongst patients and staff alike. They are wickedly transmissible – and you will know when you catch it.
8. You Love Your Patients Like Family. When you work with the same set of patients month after month, you will come to love them like family. You’ll share laughter, hardships, and spend more time with them than a lot of your relatives. And it will hit you hard when they decline. All nurses care about their patients and none more so than those that work at nursing homes.
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