“I love seniors,” says Cathy Misener, a nurse practitioner at a long-term care facility in Halifax, Nova Scotia. “The have so much to offer and so much history to share.”

The ability to build relationships with patients is what can make the long-term care environment rewarding for a nurse. Unlike a hospital, where the short stay of a typical patient makes relationship-building difficult, a long-term care setting allows nurses to get to know their patients and their patients’ families.

“That helps with managing their care, it gives me insight,” says Misener, who has been working at Northwood.

Demand for long-term care

A nurse entering long-term care can look forward to a secure career. An aging population—the over 85 age group is the fastest-growing demographic in Canada—means more people are suffering a decline in their ability to take care of themselves and manage their affairs, and an increase in the number of people with dementia.

At the same time, the family structure has changed, with parents moving away from their children who, in turn, are not being immediately confronted with the aging process. Instead of caring for elderly parents at home, children are instead looking for an alternative, in which long-term care come in.

That trend is expected to continue for at least the next 20 years and this demand for long-term care, coupled with a well-publicized staffing shortage hitting healthcare in general, means that a nurse graduating in 2008 can expect an interesting, varied, and rewarding career in the long-term care setting.

A learning environment

Long-term care gives new grads “room to grow,” according to Cherie Gilbert, assistant professor at Dalhousie University’s School of Nursing. Even if they are not ready for the needs to geriatric patients, many of whom live with complex co-morbidities, the different levels of care at a typical institution allow a nurse to progress as he or she feels comfortable. “It’s a great learning environment,” says Gilbert. “You are developing relationships with the residents and learning how to manage chronic diseases while supporting resident and family choices.”

While the complex needs of some patients can be demanding, a long-term care nurse has resources available of which the most important is the development of a multidisciplinary team in which the nurse is an integral member. Not all these specialists will be on site, but a consultancy arrangement allows a nurse to pick up a phone and call for specialty assistance.

Misener, who graduated with a diploma in nurse practitioner studies from Dalhousie last fall after several years as a practicing nurse, works closely with other nurses and in a team. “For example, I get a phone call from staff and they tell me that so-and-so has an eye infection, so I will go and see them and prescribe for that,” she says.

Part of the community

There’s no denying many institutions face a staff shortage, and that crunch can affect the daily life of a long-term care nurse. Misener says everyone pulls together at her institution, with the personal care workers making sure residents’ care is managed.

But despite the demands of the jobs, nurses find the long-term setting rewarding. After all, caring for the elderly is a vital social function, and nurses find they become a highly respected member of the community.

But what really separates long-term care from other types of nursing is the patient. “Somehow when a hospital gown comes off and the clothes come on, suddenly the patient becomes the neighbour down the street, someone’s grandpa or someone’s mother,” says Gilbert.

“A special ‘family’ environment exists in long-term care—a very large family consisting of nurses, physicians, nurse practitioners, personal care workers, social workers, dieticians, therapists, and other residents and families ... When you walk through the front door, you are walking into someone’s home and become part of the family-like environment.”

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