How to Become a Long-Term Care Nurse

A long term care nurse greeting her patient
A long term care nurse greeting her patient

The U.S. Census Bureau reported during the 2020 Census that 55.8 million Americans - or 16% of the total population - were aged 65 or older. Seniors will represent 21% of the population by 2030 and there will be more seniors than children under 18 by 2034 based on Census projections

This population shift means millions of Americans will need comprehensive care later in life. Long-term care facilities provide around-the-clock services in more comfortable settings than hospitals or clinics. The National Center for Health Workforce Analysis estimates a 44% increase in overall demand for long-term care workers from 2020 to 2035.

Registered nurses specializing in long-term care employ valued clinical and interpersonal skills to provide dignity to seniors and optimize their quality of life. This nursing career path proves rewarding for those who want to build close relationships with their patients.


Job Responsibilities for Long-Term Care Nurses

Long-term care facilities help their residents achieve or return to as much independence as possible in basic daily activities. According to the National Center for Health Statistics, the average length of stay at an American assisted living facility is 485 days. The U.S. Senate Special Committee on Aging offered the following definition of long-term care:

“Long-term care encompasses a wide array of medical, social, personal, and supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition.”

Long-term care nurses develop and implement treatment plans for elderly and disabled adult patients. They coordinate care with patients’ families and physicians and provide around-the-clock assistance to ensure a high quality of life. On a day-to-day basis, a long-term care nurse may be responsible for:

  • Assessing patient health and well-being
  • Administering medications and other treatments
  • Educating patients and their families on medical conditions

Nurses with Bachelor of Science in Nursing (BSN) degrees may oversee facility staff. Vocational nurses, practical nurses and certified nursing assistants carry out basic tasks from bathing patients to preparing medications. Long-term care nurses use their RN training to foster teamwork among care team members.

An important element of a long-term care nurse’s work is communicating with family members and caretakers. Nurses establish expectations for the length of stays, service costs and patient needs. They also explain diagnosed conditions and prepare loved ones for difficult choices like palliative or hospice care.


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Long-Term Care Nursing Environments

The Centers for Disease Control and Prevention (CDC) estimated 65,600 long-term care providers served approximately 8.3 million patients in 2016. The phrase “long-term care” encompasses multiple types of facilities and employers. A majority of long-term care nurses care for patients in the following five provider types:

  • Residential care communities
  • Nursing homes
  • Home health agencies
  • Adult day services centers
  • Hospices

Long-term care facilities are operated by government agencies, nonprofits and for-profit businesses. The majority of adult day services centers are operated by nonprofits, while for-profits run majorities in the other four categories. CDC data indicate that registered nurses fill the following percentages of long-term care roles:

  • 53% of home health agency employees
  • 48% of hospice employees
  • 20.6% of adult day services center employees
  • 11.9% of nursing home employees
  • 6.1% of residential care community employees

The nature of long-term care means that services are often provided within accommodations more similar to apartments or homes than hospital rooms. Long-term care nurses may also work with patients in common spaces and outdoor areas. These surroundings support informal conversations and gradual improvements in patient conditions.


Education and Licensing for Long-Term Care Nurses

The skills needed for long-term care nursing are best acquired in a bachelor’s degree program. Associate degrees may be the minimum education for certain roles but more employers are seeking BSN holders. The National Nursing Workforce Survey found that 39.3% of nurses held bachelor’s degrees at initial licensing in 2018 compared to 36% in 2013.

Traditional bachelor’s degrees require four years of classroom study including general education requirements. Second-career nurses with bachelor’s degrees in other fields can expedite their education in Accelerated BSN (ABSN) programs. ABSN students focus on clinical skills and practical experiences as they complete degrees in less than two years.

Nursing school graduates can work as registered nurses once they’ve completed state licensing requirements. Each state’s licensing body establishes different pathways to initial nurse licensing. For example, Virginia’s Board of Nursing requires the following from first-time registered nursing license applicants: 

  • Official university transcript showing a completed degree with at least 500 hours of direct clinical care
  • Completed Criminal Background Check
  • Proof of a completed and passed National Council Licensure Examination for Registered Nurses (NCLEX-RN)

Once licensed, registered nurses can pursue certifications in support of their areas of professional interest. A common certification for long-term care nurses is the Basic Life Support Certification from the American Red Cross. Another option is the American Nurses Credentialing Center’s Gerontological Nursing Certification.


Job Outlook for Long-Term Care Nurses

The ABSN pathway to a nursing career helps long-term care facilities and career-changing nurses. Seventy-seven percent of facilities surveyed by the American Health Care Association and National Center for Assisted Living reported moderate to severe nursing shortages in 2023. Strong demand for long-term care nurses means above-average compensation and a favorable job market for new graduates.

Lightcast Labor Insights reported a median salary of $87,900 for registered nurses with bachelor’s degrees in 2023. The same report found a median salary of $84,000 for nurses who held associate degrees. This 4.6% difference in salary may grow as employers seek BSN-trained nurses for areas like long-term care.

There was a 33% increase in long-term care nursing roles from 2022 to 2023, according to Lightcast Labor Insights data. Acute-care nursing roles in long-term care facilities increased by 97% over the same period. Aspiring nurses can ready themselves for this promising job market with a degree from Marymount University.


Learning to Care for Patients at Marymount University

Marymount University’s ABSN prepares students with non-nursing bachelor’s degrees for new careers. This innovative program combines entirely online courses with clinical placements close to where students live. ABSN candidates practice clinical skills and meet their colleagues during an on-campus residency.

The ABSN curriculum provides the skills necessary for NCLEX passage and RN licensure. ABSN candidates complete their coursework over 16 months of full-time study. Experienced practitioners teach essential nursing skills during courses such as:

  • Health Assessment
  • Mental Health Promotion and Illness Management
  • Research and Evidence-Based Practice

U.S. News & World Report ranked Marymount University among its top 300 universities in the United States. The university also placed in the top 250 nursing schools across the country. ABSN graduates can tout their completion of a nationally recognized program when entering a competitive job market.

If you want to become an RN, contact one of our student advisors to discuss which pathway is right for you.


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