Nursing Education: Beyond Textbooks and Training - Key Skills for Long-Term Care Nurses Not Taught in School

Long-term care nursing requires skills that often go beyond the scope of traditional nursing education. These skills often involve managing a diverse range of emotional and psychological needs associated with aging.

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Nursing Education: Beyond Textbooks and Training - Key Skills for Long-Term Care Nurses Not Taught in School
6 Min Read December 29th, 2023 Updated:February 9th, 2024

While nursing programs equip future nurses with fundamental knowledge and techniques for patient care, there are critical skills essential for long-term care nursing that extend beyond classroom teaching. These include navigating diverse patients' unique personalities and needs, which are vital for career growth and effective patient management in the long-term care sector.

There is significant pressure on existing nursing staff, and the need is increasing. The health care industry is witnessing a substantial increase in the need for nurses across various specialties, a trend expected to intensify in the years ahead. The United States, with over 4.3 million registered nurses, faces a nearly 10% vacancy rate in hospital nursing positions, indicating a shortage of over 200,000 nurses. 

This shortfall extends beyond hospitals to outpatient clinics, home care agencies, and long-term care facilities, which collectively require millions more nurses by 2030. Factors like an aging population, prevalent chronic diseases, and a high rate of nurse retirements contribute to this rising demand.

Nursing and Long-Term Care

The demand for nurses in long-term care, encompassing facilities and home settings, is booming at an alarming rate. As of 2023, the United States alone faces a shortfall of nearly 500,000 nurses in just this area, encompassing 320,000 in nursing homes94,000 in assisted living facilities, and 82,000 in home health agencies. 

This stark gap reflects a confluence of factors:

  • An aging population requiring more care
  • Rising chronic illness rates
  • An impending wave of nurse retirements

The consequences are evident; understaffing stretches caregivers thin, jeopardizing the quality of care and the well-being of nurses. 

Staffing shortages paint a stark picture. Understaffed facilities mean stretched caregivers juggling an ever-growing number of residents with varying needs. From administering medications to assisting with daily activities, nurses bear the brunt of this imbalance, often sacrificing breaks and facing constant time constraints. This translates to stress, fatigue, and, ultimately, a potential decline in the quality of care provided.

The nature of long-term care itself presents unique challenges. Residents often grapple with chronic illnesses, cognitive decline, and physical limitations, demanding a high level of specialized care and emotional support. Nurses act as surrogate families, confidantes, and patient advocates, navigating complex emotions and challenging behaviors with patience and empathy. The emotional toll of witnessing the decline and managing difficult situations can be considerable, adding another layer to the pressure cooker they navigate daily.

Nurses today must find ways to be more productive without burning out. As a nurse already working in long-term care, you'll find that there are critical skills necessary for your role that you may not have learned in nursing school. These skills may be helpful as you continue to develop and excel in your long-term care career.

Staffing shortages paint a stark picture. Understaffed facilities mean stretched caregivers juggling an ever-growing number of residents with varying needs. From administering medications to assisting with daily activities, nurses bear the brunt of this imbalance, often sacrificing breaks and facing constant time constraints. This translates to stress, fatigue, and, ultimately, a potential decline in the quality of care provided. 


A growing number of nurses are opting to enroll in direct-entry MSN programs, which helps them gain a deeper understanding of the field but puts an additional strain on their time and mental resources.

Effective Time Management and Prioritization Skills

In the fast-paced environment of long-term care, nurses manage a diverse range of responsibilities, from overseeing multiple patients to meticulously tracking medications and coordinating care with a team of health professionals. 

Mastering the art of time management and prioritization becomes indispensable. Maintaining a detailed to-do list allows you to track your tasks efficiently. It's also important to hone the skill of delegation, entrusting appropriate tasks to colleagues where feasible. Staying meticulously organized is critical — whether through digital tools or traditional methods — to ensure you can navigate your day without overlooking any vital aspects of patient care. 

This level of organization and prioritization not only safeguards your patients' well-being but also enables you to deliver the highest quality of care without succumbing to the pressures of a demanding workload."

Enhancing Intrapersonal Skills for Challenging Situations

Encountering patients who present challenging behaviors is an inevitable part of the job when dealing with long-term care. While nursing education lays the groundwork for developing a compassionate bedside manner, the true refinement of your intrapersonal skills occurs through hands-on experience with real patients. These skills are vital in navigating complex situations, such as calming a distressed or uncooperative patient and de-escalating tensions with angry patients

It's essential to build your emotional intelligence — the ability to understand and manage your own emotions while empathizing with those of your patients. By adopting a patient approach, actively listening, and genuinely empathizing, you can forge a connection with even the most challenging patients. Respecting their emotions and perspectives while maintaining a composed and professional demeanor is essential. 

This approach not only de-escalates potential conflicts but also fosters a sense of trust and security, ensuring that patients feel genuinely heard and cared for. As you advance in your career, these enhanced intrapersonal skills become invaluable assets, enabling you to provide exceptional care even under the most demanding circumstances.

Embracing Technological Advancements in Nursing

The nursing field is continually transformed by technological innovations, ranging from advanced Electronic Health Records (EHR) systems to the burgeoning field of telemedicine. As a nurse in long-term care, staying abreast of these changes is not just beneficial — it's essential. 

Adapting to and mastering these new tools and methods is crucial for providing efficient and effective patient care. It's important to actively engage in continuous learning to keep up with these advancements. Seek out educational opportunities, such as workshops, webinars, and online courses that focus on healthcare technology. Participate in training sessions offered by your workplace and explore self-study resources to deepen your understanding of new software and equipment. 

This ongoing commitment to technological proficiency enhances your skill set. It ensures you are well-equipped to leverage these tools for improved patient outcomes and streamlined care processes.

Building Resilience and Healthy Coping Skills

The demanding nature of nursing in long-term care settings makes it imperative for nurses to cultivate resilience and establish effective coping mechanisms. Facing challenging situations and emotional pressures is part of the job, and managing these aspects is key to maintaining your well-being. To build resilience, prioritize self-care routines, including adequate rest, balanced nutrition, and regular exercise. 

Cultivate a support network of colleagues, friends, and family to share experiences and seek guidance. Engage in activities outside of work that rejuvenate your spirit and provide relaxation, such as hobbies, exercise, or mindfulness practices. 

Maintaining a positive mindset and practicing stress-reduction techniques like deep breathing or meditation can also help manage stressful situations more effectively. Developing these coping skills and resilience will benefit your personal well-being and enhance your professional performance, enabling you to provide compassionate, high-quality care to your patients.

Establishing a Robust Professional Support Network

For nurses working in long-term care, cultivating a robust support network is essential for both personal well-being and career advancement. The job demands can be mitigated through connections with peers, mentors, and other healthcare professionals who offer invaluable guidance and support. Actively seek opportunities to build these relationships by participating in professional networking events, joining nursing associations, or engaging in online communities. 

Establishing regular meetups or mentorship sessions with experienced colleagues can provide you with practical advice, emotional support, and diverse perspectives. Moreover, actively participating in workshops, conferences, and training sessions can broaden your network while enhancing your skills and knowledge. A strong support network provides a sounding board for challenges. It fosters a sense of belonging and collective growth within the nursing community.

Mastering Essential Skills Beyond Nursing School for Long-Term Care

Nursing school lays the groundwork, but real mastery comes from practical experience and ongoing professional development. As the demand for long-term care services grows, nurses face an increasing number of patients and complex care scenarios. This necessitates a strong foundation in nursing skills and the ability to adapt to evolving care practices, patient needs, and team dynamics. 

Continuous learning and self-improvement are critical, as is the ability to work collaboratively with a larger staff to provide the highest quality of care. Embrace every opportunity to learn from experienced colleagues, participate in advanced training, and reflect on your daily experiences to enhance your abilities. By doing so, you'll not only enrich your professional skill set but also contribute significantly to the evolving landscape of long-term care, where compassionate, skilled nursing professionals are more crucial than ever.

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About the Author

Mallory Knee is a freelance writer for multiple online publications where she can showcase her affinity for all things beauty and fashion. She particularly enjoys writing for communities of passionate women who come together for a shared interest and empower one another in the process. In her free time, you can find Mallory trying a fun new dinner recipe, practicing calligraphy, or hanging out with her family.

LTC News Contributor Mallory Knee

Mallory Knee

Contributor since September 25th, 2020

Editor's Note

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