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LTC Nursing is Honoring Our Elders’ Rights, Dignity, and Choices

I started my career as a nurse in 1972 in a small rural hospital where nurses were generalists and often learned by trial and error. I first learned that I did not want to be an OB nurse or care for pediatrics. My first OB patient was having her fifth child and thank goodness told me everything that I needed to know. I mention this experience because it taught me to listen to my patients, because they know their body and what is happening to it. “Listen and learn” is a message I have carried with me all the years of my career. 

After working in the generalist role, I realized that I wanted to be good at something and not just kind of good at everything. This led me to taking a position as the Emergency Room and Operating Room Supervisor at a Regional Trauma Center in Oklahoma. This was certainly my dream job. I became an excellent technician and could start IVs, intubate, and assist in these amazing trauma cases. I was happy, young, and full of adrenaline from these experiences. But my husband’s career took a turn and we had a great opportunity, so I left what I was sure was the career I wanted.  

We moved to Texas, and I tried to be a “stay at home” mom but that only lasted for about two months before my husband and children were telling me to get a job. I found a job at the local nursing home, because that was what was available. At the time, I didn’t even know really what a nursing home was, much less what the challenges of being a nurse in that field would bring me.  

This job humbled me. I remember going home after the first day and crying, reflecting, and trying to understand what my role in life was really all about. I realized that the nursing I had practiced in the past had been technical and not really touching and promoting quality of life.  I was thrown into this new field of nursing, which at the time was not even recognized as a nursing specialty. I began to learn from my residents what it meant to live with chronic disease and disability. I was now practicing the “art” of nursing with all its rewards.  

I vowed after my first experience that I wanted to make sure I had an impact on residents that lived in nursing homes. I wanted to improve the care, because there was so much that could be better. My first experience was before OBRA 87, so restraints were common and resident rights were unheard of. My career quickly advanced and I became a Director of Nursing in 1983. I never worked so hard but felt such reward. I was part of the implementation of a new day in long-term care – where side rails, and restraints both chemical and physical, started to disappear. 

My leadership opportunities allowed me to challenge staff to think in different ways about caring for the awesome individuals we were entrusted with. Every day, I impacted the quality of life for a resident either for the long term or for the few hours they had left on this earth.

Now some forty plus years later I continue in long-term care, grateful for every resident I have been able to hold, talk to, or medicate for comfort. I continue with my career choice even though an operating room nurse makes more than I do as a Regional Nurse Consultant and even though many nurses can go home after eight hours with no responsibilities. The long- term care career I chose has improved my life, made me a better person, and allowed me to learn about life. It has made me an individual that can face life’s challenges with confidence because I have seen what humans can do. I have seen and heard our veterans and what they have been through for our freedom.  I have talked to women who have struggled to be seen as equals. I have experienced how families deal with death and illness.

All of these things overshadow what I personally have done or accomplished in my career. I am so thankful that fate took me into the first nursing home in New Braunfels, TX in 1983. I have since been a Director of Nurses most of the years since then. I was a consultant for Pathway Health Services for six years where I worked as interim DON for many facilities. I have now settled with a small company in the Chippewa Valley of Wisconsin. I found the owner who believes in quality and investment in our elders and disabled. His commitment has captured me and I am finishing my career with this company for that reason. 

I also have the gift of being the Executive Director of the Wisconsin Director of Nurse Council. This position allows me an avenue to encourage and mentor others in this career choice. The only thing that saddens me is the fact that our nursing education does not recognize long-term care nursing and its rewarding opportunities. If only nurses could know that this is true nursing where you practice advocacy, care planning, team leading, and resident education every moment of the work day. I am reminded of my early nursing days where I thought the technical skills I had made me a great nurse, when in reality anyone can be taught to start an IV, intubate someone, and provide complex medication regimens. Not every nurse can be a long-term care nurse that needs to be the eyes and ears for the Physician, needs to be the advocate for the resident when they choose to reject treatment, and needs to be the family supporter as they lose their loved one to disease or disability.  

I hope this brief story reminds long-term care nurses what a valuable asset they are and what a rewarding career is ahead of them. There are challenges for sure, but as my father reminded me as he talked to me about my work, “The only things worth anything in life are those things you have to fight for.” Every day a long-term care nurse fights to assure that the rights, dignity, and choices of our elders and disabled are honored.   


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