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Tell Your LTC Story: What Brought You to Long-Term Care (LTC) and Why Do You Love It?

AAPACN asked members to share their long-term care (LTC) story – what brought them to LTC and why they love it. Below is a collection of stories from AAPACN members who are passionate about their careers and wanted to spread their love for caring for the elderly and everything in-between in this very respectable field. Happy Valentine’s Day to all from AAPACN! We love LTC nurses, staff, and residents. Thank you for caring for and supporting residents in our nation’s nursing homes. 

“If you change one person’s life, then you are successful.”  

Let’s start by saying I’m ancient! I will never forget being handed the RAI manual and told “Here, you are in charge of this project.” That was with the very first MDS that came out! I did figure it out, and I’m still here after being in long-term care (LTC) since 1987. I found LTC while reading my local papers classified. The ad was seeking help, and I thought, “Here is my chance to learn something new.”

I started as an NA, then grandfathered to a CNA position. I did that for a couple of years and then earned my LPN certificate. I held every position in nursing that was available, (most of them) griping and loving every minute of it! But RAI coordinator was my favorite position. I have been involved with LTC for almost 30 years now, and it’s where I am meant to be.

The work we do is vital to improving the lives of those who live in our buildings. I’m a nurse manager now for my state. I supervise nurses in one-half of our regions. When my nurses are feeling down or discouraged, I share my mantra with them. “You may not change the world, but if you change one person’s life, then you are successful.”  

LTC gives me stress, frustration, and anxiety, but it also gives me joy, happiness, and hope. That’s why I’m still here!

– Shelly Nanney, RN, RAC-CT

“I love being part of a caring, respectful, dedicated leadership team where I feel like I make an impact every day.”

As a second career nurse, I came into long-term care via a circuitous path. I started in acute med-surg bedside nursing, became a quality manager at a hospital, and then took a hybrid quality manager position in both acute and long-term care, and from there became a DNS. When I started my career, I could not have seen my future in long-term care with even a crystal ball. In fact, I saw my future in pediatrics. It took several years for me to find my nursing passion and I found it in long-term care. I love being part of a caring, respectful, dedicated leadership team where I feel like I make an impact every day. While taking a leadership role as a bedside nurse is important, it does not have the same impact. While I enjoyed it, I felt there was something different I was meant to do.

In 2021, my passion for long-term care led me to become a certified DNS. This path was as rewarding as it was challenging, but I felt that the certification would help me become the best resident advocate and leader I could be. Being a resident advocate is one of the most important roles a DNS can have, because if we do everything with the resident’s best interests in mind, we cannot fail.

I have found that long-term care is rewarding in many ways. I love listening to the residents’ stories of their lives, past and present; and it means a great deal to both of us when they share their memories with me. I have learned so much from each of the residents I serve and love coming to work every day, even during the most difficult times. Working in long-term care is what I was led to do. It is rewarding on multiple levels, and I cannot see myself doing anything more satisfying or meaningful. I know in my heart, this is where I belong.

– Michelle LaVallee, RN, BSN, MEd, Sixth level Director of Nursing

“The challenge of balancing nursing skills and experience to benefit Veterans in long-term care”

What brought me to LTC and why do I love it? The challenge of balancing nursing skills and experience to benefit Veterans in long-term care in order to provide outstanding care management from assessment to care planning and still impact their day-to-day living. I am a Veteran, so I am honored to help Veterans maintain their quality of life after their service to our nation. The MDS coordinator position allows me to continue to serve Veterans in a most meaningful capacity using nursing, Veteran experiences, and skills as one.

– Gail A. Smith

“I fell in love with the RAI process, but first and foremost, providing the best possible care for the best outcomes for our population!”

Why do I love LTC? Well, at first, I didn’t! Nursing school clinicals caused me to shudder at the thought of working in LTC. That is until two years of working in the hospital and 70% of our patients were LTC patients! I grew very fond of the geriatric population, so much in fact, that I left the med-surg world and stepped into my first job in LTC as assistant director of nursing. At that time, that entailed doing MDS(s) and care planning among many other duties. I fell in love with the RAI process, but first and foremost, providing the best possible care for the best outcomes for our population! That relationship began in 1992 and I’ve been at it since then! I did have a short two year hiatus working at the local health department but soon returned to my first love, geriatrics and the same LTC company, albeit a different role! I have since received my certification in Gerontology through ANCC and love constantly learning better options of caring for our greatest generation! The lengths we’ve come is mind blowing in how we care for them! My role allows me to stay ingrained in the RAI process for our company’s MDS coordinators and be a support in whatever they may need to make their jobs better and easier! LTC gets a bad rap sometimes, but oh the joy and history this population exhibits! I LOVE my job!

– Christy Beard, RN, GERO-BC

“Let me count the times that make me fall in love with it over and over.”

We all have our stories to tell of our personal journey in the world of long-term care. Let me count the times that make me fall in love with it over and over. It may resonate with you too.

For me, long-term care is where clinical skills, quick assessment, and judgment calls at a snap of a finger or in a heartbeat unfold right in front of one’s eyes following a reported resident change in condition. It is an arena where everyone is vital from the line staff to leadership. The adrenaline rush of a code blue in the overhead page, a crash cart being wheeled in by a certified nursing assistant whose actions like clockwork speak of facility competency trainings and experience of having witness to similar situations, while the team inside the resident’s room initiates the process of honoring the resident’s wishes and care decisions. Outside, management staff are clearing traffic for the EMTs and paramedics. The five-minute debriefing after the fact, often attended by the facility administrator, supports the union of clinical and reimbursement. The high-fives, the pats on the back, the hugs during times when outcomes are not as we expected continue to remind the team of self-care and preserving the value of teamwork.

I love the Dementia/Secured Unit programs that combine therapeutic exercises and sensory experiences where residents are safely allowed time to experience being out to enjoy the sunshine, the seasons, the sound of the birds, and the smell of flowers in bloom. The team also goes above and beyond in helping residents reminisce, such as with Candle Light dinners—residents are waited upon by uniformed servers from the leadership staff upon careful consideration of their diets and can “order a meal” tailored to textures and consistencies compatible with physician prescriptions. The residents look forward to these events and they come dressed up in their best for the occasion.

I also loved when the team rose to a challenge when the facility accepted a resident that no other skilled nursing facility in the area was able to receive from the acute hospital. The resident entailed complex nursing care following a failed orthopedic surgical procedure. After deliberation, the facility sent a clinical team (an RN lead, a wound nurse, and a therapist) to receive a day’s training of the necessary treatment protocols from the acute hospital. The resident was eventually discharged home walking with assistance and the facility opened its doors to SNFs in the area in a Grand Clinical Case Presentation to share the experience. To date, that acute hospital has remained a great partner and has referred residents to the facility.

The stress and challenges of surveys, complaint visits, facility reported incidents, adverse events, staffing, Five-Star rating, quality measures, infection prevention and control concerns, balancing the financials and achieving the so-called Big Hairy Audacious Goals—all these and more happens in long-term care. One just needs to be mindful and embrace it in its own seasons.

– Maria Dulce M. Posa, RN, BSN, MSN

Member, Sigma Theta Tau International