The Beginner's Guide to Working in a Nursing Home

Nursing homes are becoming the new normal.

By 2050, the U.S. 65+ population will double from what it was in 2012 to a staggering 83.7 million. And while many families would like to care for their aging relatives, they’re not always able to do so themselves. That’s where nursing homes come into play.

Looking forward, the aging population combined with the national nursing shortage will create an even greater demand for healthcare professionals. This means employment in a nursing home could very well be in your future.

You love caring for others, but are you really cut out for working in a nursing home? Is it that different from other nursing settings?

We spoke to seasoned nurses to see what they liked best about long-term care in a nursing home – and their answers may surprise you! Here’s what they have to say.

What is it like working in a nursing home?

Working in a nursing home is special in that you’ll be a member of the care team collectively taking care of your residents. And because these are long-term care residents, you’ll get to know them and their conditions much better than in other types of nursing positions. Everyone works together to provide the best care for the residents.

You’ll play an important role in an interdisciplinary team, including physical therapy, occupational therapy, speech therapy, social work, case management and more. Together you’ll work on forming beneficial care plans for your patients, explains Rebecca Lee, RN.

And if you’re worried that nursing homes aren’t active and lively enough for you, think again.

“A few of our residents were bat mitzvah’d in their 80s and 90s,” shares RN Josie Vega. “Some have dementia, but revert to teenage girls and sing along when an Elvis impersonator visits. When the pet therapy dog arrives, residents talk about the puppies they once had.”

Many residents are still very proud of the lives they lived, the families they raised and the things they accomplished personally and professionally. You get to honor their legacy and contributions to society when you’re at the bedside, she adds.

What skills are needed to work in a nursing home?

Nurses in nursing homes need a different skill set than nurses in a hospital or clinic. These specialized skills allow them to concentrate their care to the needs of their residents. Hospice, rehabilitation and therapy differentiate nursing home nurses from those in more traditional settings. And they also have more involvement in the case management of their residents.

“It’s important to deliver quality care with compassion, dignity and respect,” Vega says. “A resident’s inability to see, hear or talk makes them particularly vulnerable so it’s important to notice nonverbal communication.”

But what are the most important skills you’ll need to succeed in these positions? We used real-time job analysis software to examine nearly 300,000 nurse job postings from nursing homes over the past year.* The data helped us identify the top 10 skills needed in nursing home positions.

Here is what we found:

• Patient care
• Home health
• Treatment planning
• Case management
• Hospice
• Patient/family education
• Acute care
• Medical administration
• Advanced cardiac life support (ACLS)
• Patient evaluation

What are the advantages of working in a nursing home?

As with any occupation, there are various pros and cons that come with the job. Here’s what our nurses noted as some of the perks of being a nursing home nurse:

1. You’ll get to know your patients better

“Get ready to become attached to your residents and their families,” Vega says. “They become a part of who you are and there is a special bond formed in long-term care.”

Working in a nursing home offers the opportunity to foster relationships with long-term residents more so than would be possible in an outpatient or a more traditional nursing setting.

2. You’ll sharpen your pharmacology skills

As a registered nurse, you hand out a lot of medications in nursing homes. Your pharmacology skills will improve, according to Lee.

3. You’ll work as a team

Members of the care team—including social work, therapeutic recreation, music therapy, dietary and even housekeeping—all work together for the good of the patients. This kind of camaraderie is unique and makes stressful days more enjoyable.

“The nurses are just one part of the total care package. I like that,” Vega says.

4. You’ll experience variety

You see all types of diagnoses because nursing homes are basically a generalized internal medicine unit, says Lee. This type of diversity means you’ll rarely have a boring day on the job.

5. It’s less physically demanding

Though you will be on your feet much of the day, working in a nursing home is typically less physically demanding than other options for nursing careers, according to Lee.

What are the disadvantages of working in a nursing home?

There are two sides to every coin, With the various benefits also comes a few drawbacks to working in a nursing home. Here’s what the nurses have to say:

1. You'll get attached to patients

There is a downside to establishing close relationships with your residents. You’ll inevitably develop a favorite resident or two because it’s so easy to get attached, according to Vega. Whenever a resident’s health declines, it can be heartbreaking, she adds.

2. There is a stigma about nursing homes in general

“I dislike that nursing homes get such a bad rap. People have so many negative perceptions of life at a nursing home,” Vega says.

You may work in the most wonderful nursing home in the world, but there will still be some that see it otherwise. Overcoming these misconceptions is something that you’ll likely learn to deal with on a regular basis.

3. Your skills are more concentrated

“You don't gain as much acute medical knowledge because you're working in a low-intensity environment,” Lee says.

She points out that nurses in nursing homes don’t get to practice EKGs, responding to medical codes, starting IVs, drawing cultures and blood tests, calculating medication drips or starting A-lines. So if you’re looking for an environment to help you hone those skills, a nursing home may not be your top choice.

Now you know…

Working in a nursing home is not for everyone. It takes a special person to care for the most vulnerable patients in their final years. But with the aging population, elderly patients will need your care now more than ever.

If you think you have what it takes, learn more about how to launch a career working with the elderly. Check out our article: Everything You Need to Know About Becoming a Geriatric Nurse.

RELATED ARTICLES:

• Acute Care vs. Ambulatory Care: Which Nursing Environment is Right for You?
• Teamwork in Nursing: How to be a Key Contributor in Your Unit
• Best Day on the Job: 4 Nursing Stories that Prove it's All Worth it

*Source: BurningGlass.com (Analysis of 296,316 nursing home nurse job postings, Feb. 1, 2015 – Jan. 31, 2016)
AUTHOR'S NOTE: This article was originally published in February 2014. It has since been updated to include information relevant to 2016.