Is Being a Long-Term Care Nurse Right for You?
Curious about what it’s like to work as a long-term care nurse? About 6% of registered nurses and 37% of licensed practical/vocational nurses work in nursing and residential care facilities, helping patients with limited mobility or functioning maintain quality of life. If you’re looking for a different pace compared to most acute care jobs, and you’re interested in getting to know your patients, consider long-term care nursing.
Most Americans will need long-term care services at some point in their lifetime, and the probability of needing assistance increases with age. About 61% of surveyed Americans say they’ll likely use long-term care services in the future.
The needs of this population will also grow more complex, with more illnesses to manage and more care required per person. If you’re interested in pursuing this nursing specialty, your skills will be in demand. Learn more about what makes this nursing career unique.
What Is Long-Term Care Nursing?
A long-term care (LTC) nurse provides a variety of services, most commonly to elderly patients, to help them stay healthy while retaining as much independence as possible. These patients are not acutely sick, but have chronic and ongoing needs.
A nurse in a long-term care facility is caring for patients with a variety of issues, and uses a broad array of skills each shift. These may include:
- Diabetes management: Interpreting blood-glucose levels and administering insulin per a sliding scale.
- Post-stroke mobility issues: Ongoing assessment and assistance with activities of daily living.
- Urinary or fecal incontinence: Maintaining cleanliness and implementing skin protection.
- Falls risk: Implementing falls risk protocols, such as frequent checks, bed alarms, non-slip socks, and more.
- Dementia and confusion: Frequent re-orientations, calming bedside manner, and ongoing family education.
- Wound management: Assessment, wound dressings, and woundvac management.
Long-term care nurses work alongside nursing assistants (CNAs) and medication aides (CMAs), who help carry out non-nursing tasks. Together, these team members may care for dozens of patients per shift. If that sounds like a lot, remember that the needs of these patients are generally much lower than those of patients in acute care settings.
Where Do Long-Term Care Nurses Work?
Long-term care is an umbrella term that can refer to a variety of residential facilities. These can include nursing homes, assisted living communities, memory care, continuing care communities, and even in-home care. A long-term care nurse may work in any of these settings, but there are some key differences between them.
For example, you might be wondering what the difference is between a long-term care facility vs. nursing home. A nursing home is a type of long-term care facility that provides more nursing and medical care, and is typically covered by insurance or Medicare. On the other hand, an assisted living community typically provides little to no medical assistance and is not covered by Medicare.
Learn more about the nuances of these settings in our comparison articles:
- Assisted living vs. nursing homes
- Assisted living vs. skilled nursing facilities
- Skilled nursing facilities vs. nursing homes
The Pros and Cons of Long-Term Care Nursing
Considering this role as a nurse? Long-term care roles can be rewarding, but they can come with challenges like any other job.
| Benefits | Drawbackss |
|---|---|
| Autonomy: LTC nurses work in a small team, with less oversight than in other specialties.
Patient relationships: Nurses can get to know patients in long-term care more deeply than in other settings. Pace: Shifts are generally more predictable and steady, though still busy. Location: LTC jobs can be found in rural areas, while hospital jobs are more common in cities. |
Staffing issues: With many facilities understaffed, nurses may face heavy workloads.
Patient death: LTC nurses may witness more death than those in other settings, and this can make the job emotionally heavy. Fewer on-site resources: Long-term care facilities tend to have fewer diagnostic tools, specialists, or rapid-response resources if a patient deteriorates. High nurse-to-patient ratios: LTC nurses often care for a large number of residents at once, which can limit time for individualized care. |
LTC Nurse Salary Expectations
Several factors contribute to salary, including location, experience, certifications, and additional training or responsibilities you take on. See nationwide salary averages in residential care:
How to Become a Long-Term Care Nurse: 4 Steps
1. Complete a Prelicensure Nursing Program
First, you’ll need to complete a nursing program that prepares you for licensure. Both registered nurses (RNs) and licensed practical nurses (LPNs) can work as LTC nurses, but RNs have a broader scope of practice and earn a higher salary on average.
- LPN diploma program: Typically takes about 1 year to complete and prepares nurses to provide basic patient care, medication administration, and support under the supervision of an RN or physician.
- Associate Degree in Nursing (ADN): Usually takes 2 years and prepares graduates for RN licensure, opening the door to a wider scope of practice and broader career prospects.
- Bachelor of Science in Nursing (BSN): Takes around 4 years to complete and provides more leadership education and analytical skills that can support advancement into supervisory or management roles in long-term care.
2. Gain Licensure
Once you graduate, you must pass the National Council Licensure Exam (NCLEX) to become licensed in your state. LPNs will take the NCLEX-PN, while RNs take the NCLEX-RN. Take your time to prepare, and consider taking an NCLEX prep course. If you don’t pass, most states will allow you to retake the exam after 40 days. Learn more about how many times you can retake the NCLEX.
In addition to the exam, your state will also have an application process, which typically includes a fee, background check, fingerprinting, and submitting your final school transcripts. Don’t delay in completing these essential steps, because depending on your state, you won’t be able to begin working until you’re fully licensed.
3. Apply for Roles in Long-Term Care
Many nursing students start applying for and accepting roles in the final semester of nursing school, with job offers contingent on passing the NCLEX. Use our tips on writing a new grad resume that highlights your clinical experiences and shows off your skills. Apply for roles in skilled nursing facilities, nursing homes, memory care, and other long-term care settings.
Consider tailoring your resume to the role you’re applying for, to make it easy for hiring managers to see why you’re a good fit. And when you land the interview, use our common questions to prepare.
4. Begin Your Career in as a Long-Term Care Nurse
Once you’ve accepted a role, check out our tips on surviving nursing orientation. You can expect a review of facility protocols and other setting-specific knowledge areas.
Once you’ve gained some experience, consider pursuing a long-term care nursing certification. While they’re not required, certification shows your commitment, and in some facilities, can lead to a pay bump. See some of the most prominent ones below:
- The National Association for Practical Nurse Education and Service (NAPNES) offers certification for LPNs/LVNs.
- The American Nurses Credentialing Center (ANCC) offers a Gerontological Nursing Certification for RNs with 2 years of specialty experience.
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