Long-term care nurses tend to patients who need medical treatment over a long period. Unlike their acute-care counterparts, long-term care nurses treat the same patients for months, years, and even decades. Long-term care patients may include:
Children and adults with disabilities
Patients recovering from a severe illness or injury
Patients with dementia
Whatever their patient population, a long-term care nurse must possess compassion, critical thinking, and be able to advocate for their patients.
Where Do Long-Term Care Nurses Work?
Long-term care nurses work in any setting that houses chronically ill, disabled, or severely injured patients who need care for a long time. As a result, long-term care nurses can find employment with:
Assisted living facilities
Home health agencies
Hospices
Memory care facilities
Nursing homes
Rehabilitation centers
Residents of an assisted living facility or memory care may still be able to do quite a lot for themselves. In this setting, a nurse may have more patients since they are medically stable and can attend to some personal grooming and self-care.
A long-term care nurse who works in a nursing home or in a hospice may have fewer patients. These patients are likely to need more assistance with repositioning, getting out of their bed or chair, and can be a higher fall risk.
Home health long-term nurses sometimes visit patients a few times a week, but some patients need full-time nursing care. In this case, long-term care nurses will spend all their time with a single patient in their home. They may also help the patient get out of the house to doctor appointments, physical therapy, and the grocery store.
What Does a Long-Term Care Nurse Actually Do?
Long-term care nurses work with patients that have continuing or lifelong medical needs. Like acute care nurses, they give meds, complete assessments, and collaborate with the healthcare team. Unlike acute care nurses, though, long-term care nurses have to look at a patient’s care from a higher level. Because they treat patients for such a long time, they can see how the nursing goals they set and work toward play out and succeed or don’t. Here are some common long-term care nurse daily tasks:
Administering medications
Collaborating with physicians, nurse practitioners, patients, and families
Collecting laboratory samples of blood and other bodily fluids
Dressing changes
Emergency resuscitation
Head-to-toe assessment
Inserting and managing foley catheters
Inserting and managing NG tubes
Keeping patients clean and comfortable
Managing central lines like ports and PICCs
Managing tracheostomies and ventilators
Monitoring and taking vital signs
Patient and family education
Patient repositioning
Wound care and prevention
Different levels of care can mean a mix-and-match of the skills above. Some low-acuity settings, for example, don’t take patients with IV access. In these facilities, a long-term care nurse may focus more on activities of daily living, repositioning, medication management, and comfort.
How Much Does a Long-Term Care Nurse Make Per Year?
A long-term care nurse earns an average of $81,220 per year as of 2022 (the same as a registered nurse), according to the U.S. Bureau of Labor Statistics (BLS). They can make a little more or less depending on the work setting and cost of living in the area. The low-end average is $61,250, and the high-end is $129,400. Different employers may be able to offer higher or lower compensation depending on which type of facility they work in:
General Medical and Surgical Hospitals: $90,600
Home Health Care Services: $82,920
Nursing Care Facilities (Skilled Nursing Facilities): $77,190
Salaries also vary depending on which state a long-term care nurse works in.
The west coast, New England states, and Alaska pay their long-term care nurses the highest wage, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
Long-term care nurse practitioners can earn more than registered nurses (RNs). The average annual salary of a nurse practitioner is $121,610, according to BLS data from 2022. The low-end average is $87,340, and the high-end is $165,240. Salary can also change based on employment type:
General Medical and Surgical Hospitals: $129,330
Home Health Care Services: $148,960
The location of employment can affect long-term care nurse practitioners as well, in a similar pattern to RNs.
For a GN to become an RN, they must take and pass the nurse licensing exam, the NCLEX. Once a nurse passes their NCLEX, they will be a licensed nurse, either a licensed practical nurse (LPN) or a registered nurse (RN).
If a long-term care nurse wants to pursue a career as a nurse practitioner (NP), they have to earn a Master of Science in Nursing (MSN). A master’s degree takes about two years to complete if full-time hours can be devoted to study. Nurses can get their MSN all at once or spread it out over a longer period while they also work full-time.
Since long-term care nurses can work with all ages, they can also get certified in many different specialties. For example, if a long-term care nurse works with the elderly population, they may want to pursue the Gerontological Nursing Certification (GERO-BC) offered by the American Nurses Credentialing Center (ANCC). Nurses working with this age group may also want to become a Certified Dementia Practitioner (CDP), a designation offered by the National Council of Certified Dementia Practitioners (NCCDP).
Long-term care nurses in a pediatric setting can earn their Pediatric Nursing Certification (PED-BC) from the AANC or the Pediatric Nursing Certification Board. Most certifications in any specialty ask for some requirements. For example, to be eligible for the PED-BC, a nurse must have:
A current, active RN license
Two years of full-time experience as a registered nurse
A minimum of 2,000 hours of clinical practice in their specialty within the last 3 years
Completed 30 hours of continuing education in their specialty within the last 3 years
Other specialties may have slightly different requirements for hours and years of practice, and these prerequisites can be found on their websites.
Are Long-Term Care Nurses in High Demand?
According to the Administration for Community Living, the 65 and older crowd made up 16% of the U.S. population in 2019, but are expected to be 21.6% of the population by 2040. The 85 and older group is expected to reach 14.4 million in 2040 (a 118% increase from 2019). As Americans age, their health needs may cause them to need long-term care, and create jobs for nurses in this specialty.
All nurses are in high demand in the United States. According to the U.S. Department of Health and Human Services, 24% of U.S. hospitals have reported critical staffing shortages, and at least eight states have had to call in help from the military for staffing. The BLS predicts nursing jobs will grow 6% from 2021 to 2031, with about 203,200 openings each year. Long-term care nursing is set to offer strong employment opportunities for years to come.
Additional Resources About Becoming a Long-Term Care Nurse
To learn more about becoming a long-term care nurse, these websites offer additional resources:
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