Registed Nurses' Association of Ontario

7 Myths about long-term care nursing — busted

It's no secret there are challenges in Ontario's long-term care (LTC) sector. But despite some troubling headlines, LTC is filled with hardworking, compassionate, and dedicated nurses working hard to make a difference for LTC residents.

To help them provide the best care, LTC will need better funding models from government and more registered nursing staff. In order to achieve that, the sector must overcome some persistent negative misconceptions.

In a previous issue of Registered Nurse Journal, RNAO debunked some of these common myths by talking to nurses who work in LTC. Here's a sample of what we found:

Myth: I'll lose my skills if I get into LTC nursing

Of all the misperceptions that surround the field, this one is the most prevalent, according to RNs in LTC. But longtime Toronto-based LTC RN Saima Shaikh disagrees. "If anything, long-term care nursing requires superb leadership skills and outstanding assessment skills," she says. "The RN is there 24/7 and it's (their) judgment and... critical thinking that are called upon."

Nurses in LTC also develop excellent communication and interpersonal skills, she adds. "Families are informed advocates for family members. You have to be able to communicate, apply diplomacy and negotiate all of the time."

Myth: When I need casual work, I'll try LTC because it is so easy and slow-paced

Just like every field of nursing, LTC has its own unique, intense demands. "I've had staff come from a hospital setting, who, after two weeks, can't do it," says Shaikh. "The (resident) load is 30 residents to one nurse. You're supervising unregulated health-care workers. There's also 30 sets of families (of residents) to communicate with on a regular basis. Plus there's hefty case management, what with liaisons between specialists such as dietitians, massage therapists, doctors, the family and that's not counting the medication..."

Add to that needs of residents, and, well, point taken.

Myth: I'll just be spinning my wheels in LTC

Because of the nature of LTC staffing — one RN often oversees an entire floor — nurses have true opportunities to affect practice change and the culture of the environment, according to Shaikh. "An RN in long-term care is very much part of the leadership team. And you can change clinical outcomes for residents."

The bonus? Thanks to the "long" in LTC, you really get to witness the results of care in residents over the long run.

Myth: Residents go to LTC to die

This myth goes hand-in-hand with the stigma that LTC is depressing. "People do improve once they come into LTC," says RN Joni Wilson. "Often, they have not been getting the kind of care they need and when they do, the turnaround can be remarkable."

She believes LTC nursing also allows nurses to be advocates for a group of people who are vulnerable and often treated as unimportant in our society's culture. "They've lived long and they deserve the best quality care, the same as anyone in intensive care would."

Myth: I won't get to do any bedside caring in LTC

RNs say this just isn't true. While there is plenty of administrative work for the RNs in LTC, there are also many opportunities to provide hands-on care for residents. "You do not lose touch with your bedside nursing abilities," says Shaikh. She explains that RNs get to know residents over a very long time. "They share stories with you and you build relationships. You get close with their families. It's a more intimate type of nursing."


Myth: RNs are totally on their own in LTC nursing

Mary Bawden, RN and nursing professor at the University of Western Ontario in London, refutes the notion that RNs work in isolation. "You get a real sense of being a part of a team in LTC. You work with registered practical nurses and personal support workers, and develop incredibly strong working relationships."


Myth: LTC nursing is not fulfilling

LTC nurses say their sector enables RNs to develop long-lasting, enriching attachments to residents. "I think staff in LTC fall in love with their clients. They'll often go to their funerals," says Bawden.

RN Pamela Rowe says the smiles you receive and the relationships you build in LTC nursing are priceless. "It's both enriching and an honour to work in LTC. You can't underestimate the trusting relationships you form with each and every resident. What your heart puts into it, you receive back tenfold."


This post is based on an article originally published in the Sept./Oct. 2010 issue of RNJ written by Lesley Young. Visit to read the full article and to learn more about RNAO's policy priorities to improve the LTC sector.