Long-Term Care Nurse Career Overview

NurseJournal Staff
Updated July 6, 2023
The demand for long-term care nurses has never been greater. Use this guide to learn more about LTC nursing, salary and job prospects.
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Long-term care nurses provide extended care to patients living with disabilities or suffering from progressive or chronic illnesses. These specialized registered nurses often work with the elderly and others who need assistance with daily living. A career in LTC nursing offers unprecedented professional growth opportunities. As the U.S. population ages and the need for primary healthcare expands among all demographic groups, the demand for long-term care nurses is expected to explode over the next decade.

What Does a Long-Term Care Nurse Do?

ADN or BSN required
certification optional

While the duties required of long-term care nurses depend on the type of healthcare facility and specific patient needs, these RNs spend much of their workday coordinating and assessing patient care. They partner with an entire team of professionals, including doctors, social workers, physical therapists, and case managers, to provide a comprehensive plan to deliver quality care for their patients.

Long-term care nurses perform routine procedures such as recording vital signs and administering medications while also providing specialized treatments for progressive and chronic conditions. These nurses also provide educational and emotional assistance to patients and family members.

Typical Duties

  • Develop, coordinate, and implement comprehensive patient care plans with medical and clinical staff
  • Administer medications, perform vital sign checks and medical procedures, and provide therapeutic treatments such as range-of-motion exercises and massage
  • Operate medical equipment, monitor and assess patient status, and record patient information in medical records
  • Assist patients with daily tasks such as bathing and dressing
  • Offer education, emotional support, and guidance for patients, families, and caregivers

Career Traits

  • Ability to build long-term relationships with patients and caregivers
  • Patience working in stressful conditions
  • Strong observation and assessment skills

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Where Do Long-Term Care Nurses Work?

Long-term care nurses find ample employment opportunities in a variety of work environments. While most often employed in skilled nursing and assisted living facilities, these nurses may also work in rehabilitation centers, hospices, and home health settings. The facilities listed below that serve the elderly, patients with disabilities, and those suffering with chronic or terminal conditions rank among the top employers of long-term care nurses.

Assisted living facilities

Residents of assisted living facilities live in home-like environments, often in fully equipped small apartments. They may not need 24-hour care but require help with daily activities, housekeeping, and medical care. Long-term care nurses in these settings provide a variety of duties, such as bathing, dressing, and administering medication, to help residents maintain some degree of independence.

Nursing homes

Skilled nursing facilities provide 24-hour nursing care for people who can no longer maintain their independence or be cared for at home. Nursing home residents, who are elderly or have chronic and complex medical needs, require a high level of LTC nursing care. Long-term care nurses in these settings administer medications, assist with hygiene and daily activities, and monitor and assess patient conditions in collaboration with other healthcare providers on the staff.

Memory care, Alzheimer’s, and dementia facilities

These settings only accept patients with memory and cognitive impairments due to senility, Alzheimer’s disease, or other forms of dementia. Long-term care nurses in these settings often acquire specialized certifications to provide behavioral support and administer therapies to stimulate cognitive functions. An important aspect of their job involves ensuring the safety of residents who may be prone to wandering, mobility issues, or bouts of aggression or anger.

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Why Become a Long-Term Care Nurse

LTC nursing offers considerable personal and professional rewards including competitive compensation and employment stability. However, nurses entering this field also face particular challenges stemming from stressful working conditions and the types of patient populations they serve.

Advantages to Becoming a Long-Term Care Nurse

  • check-circleExpanding employment and professional development prospects
  • check-circleOpportunity to develop long-term relationships with patients and their families
  • check-circleAcquisition of specialized skills to provide treatments and therapies for specific patient populations, e.g., the chronically-ill elderly, patients with Alzheimer’s

Disadvantages to Becoming a Long-Term Care Nurse

  • x-circlePressure to maintain and upgrade proficiencies in medication knowledge and other specialized treatments
  • x-circleInadequate support dealing with patients suffering from complex conditions, due to understaffing and high patient caseloads
  • x-circleOccupation stress working with terminally ill patients and their families, leading to psychological problems and high levels of burnout

How to Become a Long-Term Care Nurse

Long-term care nurses must become licensed as registered nurses before they can enter the field. Although specific requirements vary by state, all nurses follow a similar educational path leading to an RN license.

Earn a Bachelor’s Degree in Nursing (BSN) or Associate Degree in Nursing (ADN)

Long-term care nurses, like all RNs, must earn at least an ADN degree, while many employers prefer to hire BSN-holders. Nursing school prerequisites typically include anatomy, physiology, biology, and psychology.

Pass the NCLEX-RN Exam to Receive RN License

Passing the NCLEX-RN exam is the final step before acquiring a nursing license. State regulatory boards use the NCLEX to determine if candidates qualify for nursing licensure.

Gain Experience in Long-Term or Gerontology Care

Completing clinical hours or working in a nursing home or assisted living facility with elderly or chronically-ill patients provides valuable hands-on experience for LTC nursing.

Consider Earning Specialty Certification

While there are no specific certifications for LTC nursing, nurses can enhance their career prospects by earning board certifications in specialty areas like gerontology, pain management, wound care, and chronic disease management.

How Much Do Long-Term Care Nurses Make?

As the U.S. population ages and the need for long-term care skyrockets, nurses entering this field will find ample employment opportunities and a promising salary outlook. While the U.S. Bureau of Labor Statistics projects a 9% increase in the overall employment of registered nurses from 2020 to 2030, they also expect greater than average job growth in facilities that provide care for the elderly, long-term rehabilitation facilities specializing in stroke and head injuries, and facilities that treat patients with Alzheimer’s disease.

According to Payscale, as of November 2021, RNs with long-term care skills earn an average annual salary of $63,120. LTC nurses looking to advance their career may consider earning a master’s degree in nursing (MSN) to become a nurse practitioner. A national survey conducted by the American Association of Nursing Practitioners reports that NPs who work in long-term care facilities make an average annual base salary of $110,000. NPs in gerontology, gerontology acute care, and gerontology primary care earn salaries well above $100,000 a year.

Frequently Asked Questions About Long-Term Care Nurses

What is the difference between long-term care and hospice nursing?

LTC nursing facilities provide care to patients with chronic conditions who may live for several years with specialized treatment plans and accommodations. Hospice facilities provide end-of-life care to terminally ill patients. Hospice care is usually available to patients diagnosed to live for six months or less and who have run out of treatment options.

What types of conditions do long-term care nurses treat?

Long-term care nurses treat a variety of patients, including those with complex medical needs as well as those who need a moderate level of assistance with daily living. They provide stroke and cardiac care and work with patients recovering from injuries or surgeries. Many long-term care nurses specialize in cognitive conditions such as Alzheimer’s disease and dementia or work exclusively with patients dealing with physical or mental disabilities.

What skills are important to succeed as a long-term care nurse?

In addition to maintaining their nursing skills through continuing education and professional development opportunities, the best long-term care nurses possess strong leadership and organizational skills and the ability to apply analytical and critical thinking skills to stressful clinical situations. Because of the collaborative nature of LTC nursing, these RNs must develop good communication and team-building skills.

What opportunities are there for advancement among long-term care nurses?

The fast growing market for long-term care has opened up many avenues for professional growth for nurses with specialized certifications and advanced degrees. Employers seek out nurses who hold in-demand certifications in fields like gerontology and pain management. In addition to clinical positions, long-term care nurses can also expect to move into administrative roles in skilled nursing and assisted living facilities.

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Page Last Reviewed December 6, 2021

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