What Does It Take to Become a Long-Term Care Nurse?

What is a Long-Term Care Nurse?

A long-term care nurse provides health care to patients that are in need of services over a long period of time. Though many patients that need long-term care nurses are older adults, they aren’t the only group that requires this kind of care. Instead, many long-term care nurses oversee the care of individuals that have mental and physical disabilities, those that have severe injuries that require a long rehabilitation period, and individuals that have terminal illnesses.

Due to the lengthy nature of care, nurses in this field often work with just a handful of patients, and many times work with just one patient.

What Does a Long-Term Care Nurse Do?

To some extent, the tasks of a long-term nurse are dependent upon the working environment. The larger the facility, the more patients the nurse will work with, and more than likely, the more specialized the nurse’s work will be. To some extent too, a long-term nurse’s duties will depend on his or her licensure level. An RN (registered nurse) will have duties that involve more critical thinking and autonomy. An LPN (licensed practical nurse) or LVN (licensed vocational nurse) will have duties that involve less specialization and less autonomy.

In general, a long-term nurse assists patients in their daily routine and tasks of daily living. This might include such things as bathing safely or dressing if the patient has handicaps or is unable to dress on their own. This could also include changing a patient’s bed pans, bandages and catheters.

For the most part though, a long-term nurse will assist a patient in their healthcare needs. This might include medication compliance, monitoring of vital signs, assessment of a patient’s physical, psycho-social and emotional condition, implementation and evaluation of nursing interventions, and maintaining patient records.

Related Reading: Acute Care Nurse Practitioner Careers

A long-term nurse may also provide education regarding the patient’s condition to family members if needed. This may include advising the family regarding adjusting to a patient’s growing physical needs if the patient is elderly and declining physically. Safety issues involving daily tasks may be of increasing concern for the patient and family. This may also include education for the patient and family regarding physical exercise and rehabilitation to gain strength, balance and movement.

Depending on the work setting, a long-term nurse may spend long periods of time with fewer patients, or even with one patient if the patient is at home. A long-term nurse spends time talking to the patient and the patient’s family, listening to their concerns and addressing health issues with them as their concerns arise.

A long-term nurse must work collaboratively with other medical professionals. This may include developing and implementing patient care plans, performing routine diagnostic tests and administering treatment when appropriate and needed. A long-term nurse gets to know his or her patients quite well and can often be the first person to notice subtle changes in a patient’s condition that can signal either improvement or another health concern. A long-term nurse can alert other medical professionals and staff regarding these changes.

Why Do We Need Long-Term Care Nurses?

A long-term nurse is a specialized nurse. In this day and age of longevity, long-term nurses are needed in all sorts of situations in which extended care is an issue. The elderly and infirm, those needing rehabilitation and others who have long-term medical needs can benefit from employing the services of a long-term nurse.

Some patients with long-term medical needs are working toward rehabilitation. This can be true for car accident victims, people recovering from surgery, and the like. Others need long-term help as they move through their declining years into further infirmity and death. These can include cancer patients, Alzheimer’s patients and the elderly who need monitoring and both physical and medical assistance.

Some patients remain in their homes for as long as they can, others give up their homes and move to long- term care facilities. Still others move in with children or other family. In all these situations, the patients and their families need help.

The specter of Alzheimer’s disease or other dementia issues is very present for many elderly over the age of 65. As patients move into dementia, the family must make difficult decisions regarding the elder’s care. In most cases, the burden of care must be shifted in whole or part to professionals so that patients remain safe and so that families can remain supportive without feeling overwhelmed. Tiered services can help a patient stay in their home longer. Tiered services require the help of long-term nursing staff.

In addition, those with physical disabilities and patients who are frail require help with physical needs. A long-term nurse, whether working with one such patient or many, gets to understand those needs and can readily help.

Finally, we are in the midst of a culture change in the medical profession. Care is becoming more person-centered and less institutional. Patients fare better when they feel listened to and valued. Long-term nurses are instrumental in providing the services needed to provide a more person centered experience for the patient. The result of this is that patients are hospitalized less frequently and for shorter periods.

Where Does a Long-Term Care Nurse Work?

A long-term nurse can work in a variety of settings including a nursing home, rehabilitation and treatment centers, retirement or assisted living communities. Long-term nurses often work in skilled nursing facilities with both elderly patients and with those who have joint replacements or other medical conditions and who are not ready to return to their home. Some long-term nurses work directly in patient’s homes, either daily, or checking in with the patient in their home on a regular basis.

What are the Core Long-Term Care Nursing Competencies?

Great Communicator

Good communication skills are paramount in this field. Not only must a nurse be able to communicate in an empathetic manner with a patient, a nurse must communicate clearly and concisely with other medical staff. While these two communication styles seem at odds, an effective nurse must be proficient in both styles.

Excellent Judgment

A nurse often has to make quick decisions that have lasting implications. Not only must a nurse think quickly on his or her feet, but making the wrong decision could cause harm to a patient. A nurse must be able to make these types of decisions, often on a daily basis.

Cardiac Care

A long-term nurse must know how to use cardiac monitors and how to listen to and assess heart sounds. In the case of cardiac arrest, a nurse must know how to properly administer CPR and other medications such as atropine, digoxin and the like.

Pharmacological

A long-term nurse must be comfortable and knowledgeable regarding medication. A nurse must know what a patient’s medications are, and how to administer them. A nurse must also know typical dosages in addition to a patient’s particular dosages. A nurse must know about drug interactions and how to spot an adverse reaction to a drug.

Orthopedic Care

A long-term nurse must know how to help a patient walk safely and properly with crutches, canes and walkers to increase a patient’s self-sufficiency and mobility.

Managerial

Whether a long-term nurse is supervising other nurses or not, a nurse must be able to organize and prioritize his or her time in order to work efficiently and with attention to the details that are required. If the nurse supervises others, the nurse must be comfortable with delegation and follow-through in order to ensure that patient services are delivered in a competent manner.

Physical Capabilities

Long-term nursing involves a large amount of physically demanding labor. You must feel comfortable working on your feet for 6-8 hours a day. In addition, much of the work involves handling a patient physically. Adjusting a patient’s position in bad, helping a patient get out of bed and to the toilet or shower is often a part of the job. You must be able to pick up and carry a significant amount of weight.

What are the Requirements to Become a Long-Term Care Nurse?

A long-term nurse is a medical professional. As such, in order to work as a long-term nurse you will need specialized medical training, including licensure. Most positions require that a long-term nurse be licensed either as a licensed practical nurse (LPN), as a licensed vocational nurse (LVN), or a registered nurse (RN). LPN and LVN are equivalent licenses.

Educational Requirements

An LPN/LVN usually has one year of medical training, culminating in a certificate. An LPN will often be required to report even small changes in a patient’s condition to a supervising RN. LPNs often work in long-term care facilities.

Each educational level opens additional work opportunities. For most administrative and management positions, an RN is usually required. Most positions that require more critical thinking will want an RN for the position. These positions have more responsibility for developing and implementing patient care plans.

An RN may have a Bachelor’s of Science degree in nursing from a 4 year college or university. Alternatively, an RN can hold an associate’s degree in nursing (ADN) from a two year college. Finally, an RN may hold a diploma of completion from a formal nursing school. Any of these will allow a nurse to sit for licensing exams. However, many employers may require at least a Bachelor’s degree.

An RN will take classes in psychology, physiology, nursing fundamentals including hands on experience, microbiology and gerontology. In fact, geriatric care is one of the areas of specialization open to long-term nurses. In addition, most nursing programs on a Bachelor’s degree track offer classes in leadership management. These classes allow a nurse to advance in his or her career.

All nursing curricula, regardless of the educational level, have classes in nursing, biology, pharmacology, clinical theory, and supervised clinical care.

Licensure Requirements

Licensure is mandatory for all nurses, regardless of level. The process allows a person who has graduated from a nursing program to demonstrate competency. All states will verify that you have graduated from an accredited nursing program. Often fingerprints and a criminal background check are completed. Then a candidate must take and pass the appropriate licensing exam, the NXLEC-RN or NCLEX-PN exam.

A licensed nurse must know and adhere to the laws and rules which govern nurses in the state in which you are licensed and in which the nurse will work.

What Soft Skills are Needed to Be a Long-Term Care Nurse?

Empathy and Compassion

Perhaps first and foremost, a long-term nurse needs empathy and compassion toward his or her patients. Patients whether expected to recover, or those who are moving through their last years of life, are suffering. It is important that people working with those in need and who are suffering, understand their needs.

Service Minded

Those people who tend to have the desire to be of service to others often do well in the nursing field. They tend to report more job satisfaction over the longer term and also tend to be more attuned to the needs of their patients.

Adaptable

A nurse’s routine will vary quite a bit from day to day even in a long-term situation with a single patient. As a result, a long-term nurse must feel comfortable going with the flow of work as opposed to following rigid rules.

Detail Oriented

Like all medical professional positions, the long-term nurse needs to ensure a high quality of patient care. That includes paying particular attention to medications, to notes within a patient’s chart, and the timing of treatment so that treatment remains timely and correct.

Patience

Patients are not always easy to work with. They can be grouchy and are often in pain. Tasks that would ordinarily take a minimum amount of time to perform, such as dressing themselves, may take a long time or may be impossible for the patient. Patience is needed to continue to focus on patient care.

Sense of Humor

A sense of humor in the face of difficult health situations in patients can be beneficial to both the nurse and to the patient. Laughter can often make a difficult situation more bearable, and helps solidify a positive outlook for both patient and medical staff.

Intuition or Sixth Sense

Intuition is based on experience, education and attention to detail. Learning to trust an intuitive prompt that tells you to check a medication dosage or chart entry or vital sign, has saved many a life.

How Much Does a Long-Term Care Nurse Make?

According to the Bureau of Labor Statistics (BLS), the 2016 median pay for an RN is $68,450 per year or $32.91 per hour. This is a growing field, with growth at estimated at about 15% from 2016 to 2026. In contrast, according to the BLS, am LPN’s median pay in 2016 was $44,090 per year or $21.21 per hour.

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