Nursing is a diverse field offering myriad career paths and opportunities for those driven by a passion for healthcare. Yet, despite the critical demand for skilled nursing care due to aging populations worldwide, long-term care (LTC) facilities often need help attracting and retaining Registered Nurses (RNs). Many RNs bypass LTC facilities as a viable career option, citing various factors contributing to their reluctance.
Among the primary reasons RNs may opt for hospitals and other healthcare settings over LTC is the demanding workload, compounded by additional duties and paperwork necessary for regulatory compliance. Inadequate preparation in schools and colleges for LTC practice, alongside lower wages and perceived limited opportunities for career growth, further dissuade RNs from pursuing careers in LTC. The lack of resources, support systems, optimal work environments, and societal perceptions exacerbates this challenge, presenting legitimate barriers to entering the LTC nursing sector.
Interestingly, the recent issuance of Minimum Staffing Standards for LTC Facilities by the Centers for Medicare & Medicaid Services (CMS) aims to enhance care quality by establishing comprehensive nurse staffing requirements- 0.55 hours per resident day (HPRD) for Registered Nurses (RNs) and a requirement to have an RN onsite 24 hours a day, seven days a week among others. However, this mandate has ignited a critical debate within the LTC landscape, particularly amidst a staffing crisis marked by soaring turnover rates and facility closures.
While compensation and wages undoubtedly influence RNs’ career decisions, there are additional factors contributing to their preference for hospital settings. Hospitals often offer robust support structures, including dedicated nursing education departments, structured orientation programs, and opportunities for professional growth through certification and continuing education. Efforts to foster healthy work environments, such as zero-tolerance policies for workplace violence, further bolster RNs’ job satisfaction and retention rates.
While LTC facilities may need more resources available to hospitals, practical interventions can significantly enhance the appeal of LTC roles without straining budgets. Implementing trained and dedicated facility educators, establishing zero-tolerance policies for violence and abuse against staff, and offering structured orientation programs with clinical immersion, trained preceptorship, and mentorship components can elevate LTC careers while improving care quality.
In conclusion, closing the gap between RNs’ preferences for hospital settings and the critical need for skilled nursing care in LTC facilities demands concerted efforts from stakeholders. Addressing workload concerns, enhancing support systems, and investing in professional development opportunities can make LTC careers more appealing to RNs, ultimately advancing care delivery and meeting the escalating demands of aging populations. It’s imperative to take proactive steps to ensure the sustainability and success of our LTC workforce.
Further Reading
Heiks, C., & Sabine, N. (2022). Long-Term Care and Skilled Nursing Facilities. Delaware Journal of Public Health, 8(5), 144–149. https://doi.org/10.32481/djph.2022.12.032
Perruchoud, E., Weissbrodt, R., Verloo, H., Fournier, C. A., Genolet, A., Rosselet Amoussou, J., & Hannart, S. (2021). The Impact of Nursing Staffs’ Working Conditions on the Quality of Care Received by Older Adults in Long-Term Residential Care Facilities: A Systematic Review of Interventional and Observational Studies. Geriatrics (Basel, Switzerland), 7(1), 6. https://doi.org/10.3390/geriatrics7010006
Shin, J. H., & Shin, I.-S. (2019). The effect of registered nurses on nursing home residents’ outcomes, controlling for organizational and health care market factors. Geriatric Nursing, 40(3), 296–301. https://doi-org.ezproxymcp.flo.org/10.1016/j.gerinurse.2018.11.004
