Written by Lucy Peters,
Nurses who work in long-term care (LTC) have been working longer shifts. A McKnights Long-Term Care News article by Alicia Lasek highlights the data, noting that according to Vivian Health, the average full shift consisted of 10.5 hours in 2024. Long hours, often due to mounting concerns like staff shortages, are just one workforce pressure that has the potential to contribute to greater issues among healthcare professionals, such as excess stress that can snowball into burnout. For those that specialize in long-term care, a unique set of challenges brings to light the importance of self-care as well as greater intervention via workplace solutions.
The many challenges of LTC
Working in a long-term care facility can present a variety of benefits to workers, particularly for those who have a passion for providing quality care. In residential facilities like nursing homes, nurses are able to connect with residents while gaining a deeper insight into individualized care needs. This can often make the job even more fulfilling for some professionals, especially when compared with positions that focus on short-term or emergency care. While long-term care positions can be rewarding, they often present a characterized set of unique challenges.
Reputable facilities strive to provide the very best for patients. Day care, residential facilities, and end-of-life care are just a few types of LTC that work to successfully care for individuals with varying needs. However, even in the best facilities, there are challenges. Low pay, an aging population that drives demand for LTC services, and staffing shortages are just a few key concerns. In the United States specifically, staffing shortages in nursing homes are just one example of a major workforce issue that puts more pressure on current workers. One article from the Association of Health Care Journalists by Liz Seegert dissects the concern by citing an analysis, which showcases the issue of staffing shortages throughout U.S. nursing homes. According to this analysis, a shocking 12,000 LTC and “skilled rehabilitation facilities” failed to provide high quality care, with a lack of staff serving as just one prevalent issue. Seegert further mentions that better staffing is actually a significant benefit for patients, with sufficient staffing linked to having a positive impact on patient outcomes – a factor that underlines a gap that is well worth addressing.
Staffing shortages in the general care industry are not limited to the United States, further emphasizing a need for skilled workers that extends around the globe. While it differs from American LTC, the adult social care industry in the UK is just one example of where staff shortages echo similar concerns. For context, the adult social care industry in England boasts 111,000 vacancies alone. The significant need for care workers stems from a variety of issues that are unique to the area, such as changes in immigration policies in 2024. Workforce conditions are another contributing factor in the UK adult social care sector that almost mirrors the concerns seen in US LTC facilties, with low pay an issue especially for those who are just entering the industry.
The specific LTC setting can factor into the unique challenges that a healthcare professional may face while on the clock. While some individuals will require intermittent help with tasks like bathing, others may have more complex needs that require extensive care routines. Individuals who work in a residential facility may find themselves more easily burned out due to repetitive routines. On the other hand, those who specialize in end-of-life care may experience complex feelings like grief on a routine basis. Regardless of the setting, healthcare professionals who specialize in LTC have the potential to encounter a variety of physical and mental health concerns.
An August 2025 article from McKnights Long-Term Care News by John Roszkowski highlights that policies that aim to address mental health are a pressing need for nursing home caregivers, based on a study conducted by researchers from China and Malaysia. According to the article, the study featured in Geriatric Nursing and involved a review of 26 studies that came from 13 countries, which highlights the worldwide need and impact that such policies could have. The studies focused primarily on nursing home caregivers, with the review ultimately unveiling that caregivers’ mental health reflected concerns that included those such as anxiety, depression, and “perceived stress.” The article explores this further, citing the study authors who wrote that the perceived stress of caregivers is “closely linked to workplace demands and expectations.” Workplace related factors that affected mental health concerns were identified as frequent night shifts, staff shortages, low wages, conditions of the workplace, and chronic burnout, to highlight a few.
Discovering individualized solutions
Compassion is essential for healthcare workers across all sectors, though along with excess stress and burnout, compassion fatigue is another risk that many face. In LTC settings, this may be due to the fact that nurses often have to juggle a variety of challenges. A 2021 article from the American Nurse Journal by Marlene M. Steinheiser, PhD, RN, CRNI highlights the risk of compassion fatigue as it relates to nurses in skilled nursing facilities (SNF). “For example, they may care for residents with multiple co-morbidities and cognitive and emotional issues, as well as residents who’ve lost function and independence,” Steinheiser writes.
It’s not uncommon for healthcare professionals to place their own personal needs on the backburner in order to prioritize those of their patients. Steinheiser’s article proposes that a combination of both self-care in addition to workplace support in the form of an “organizational resiliency program” can make a difference. To bring further yet stark context to the matter, a Nurse Journal article on nurses and self-care by Daniel Bal highlights that 70% of nurses were of the opinion that they put the care of their patients above their own. While suggestions to benefit self-care often include a healthy diet, regular physical activity, time spent away from screens, and taking part in enjoyable hobbies or activities, the dedication to a solid work-life balance can help build a sustainable approach.
Long-term care professionals may find self-care to be particularly challenging due ot the connections that are often built with their patients, and may even feel guilty when they do put their own needs first. For example, a nurse may feel guilty for taking time off when a patient enjoys or may expect the care of a specific individual. However, it’s important to remember that healthcare professionals with healthy work-life boundaries and who routinely dedicate time to self-care activities will be better equipped and rested to perform at work. Bal’s article echoes the words of pediatric oncology nurse Kendall Conn, who emphasizes the importance of flexibility. For LTC nurses who often find themselves with long shifts, the definition of self-care may vary widely depending on the day. For instance, one day may allow ample time for a nature walk after work, while other days may lean towards a simple routine, like light yoga or taking part in a hobby to unwind.
The critical need for a supportive workplace
Beyond personal measures, a supportive workplace is crucial in minimizing the impact of workforce pressures for nurses in long-term care. One January 2025 report from the McKinsey Health Institute explores the role that employers can have. While it doesn’t focus on workplaces in the healthcare industry, the report suggests that a workplace can experience heightened productivity when employers focus on and invest in employee health, which can further translate to benefits such as an increase in economic value. “Organizations that prioritize health often see marked improvements in productivity, reduced absenteeism, lower healthcare costs, and heightened employee engagement and retention,” the report states, going on to cite additional benefits including bettered resilience among the workforce.
The American Nurses Foundation has pioneered a unique program that aims to support the wellbeing of nurses, and has already been brought to four different healthcare organizations in the United States. Called The Nurse Well-Being: Building Peer and Leadership Support Program, the initiative aims to address nurse recovery from stress reactions through the access of resources, support, and tools, accoridng to the American Nurses Foundation webpage that discusses the program. The American Nurses Foundation also highlights the words of Kristy Todd, MSN, RN, ONC and Clinical Advisor at Indiana University Health in Bloomington, who notes that the program “equips us to effectively help each other in directly meaningful ways.”
While long-term care facilities across the board have significant room for improvement, there are a few ways that healthcare professionals can advocate and lead by example until there are more structured programs in place. The promotion of open communication among workers can be a great way that leaders in the workplace can create a supportive atmosphere. Communication among healthcare workers can also help identify current issues and shared concerns among nurses that may have never come to light otherwise. Through positive communication that encourages employees to voice their concerns and potential solutions or other ideas, healthcare workers in long-term care facilities can band together and work towards a greater good.
Healthcare workers in long term care facilities across the board face an assortment of unique challenges due to the characteristics of the workplace. With concerns that range from burnout to emotional stress and worker shortages, healthcare professionals within the sector can take charge of their personal wellbeing while propelling change for the greater good by banding together through positive communication.
Author bio
Lucy Peters is a freelance writer who enjoys contributing to a range of publications, both in print and online. She spent almost a decade working in the care sector with vulnerable people before taking a step back to start a family and now focuses on her first love of writing.
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