4 Major Challenges of Working In a Nursing Home

Working in a Long Term Care facility, such as a nursing home has many challenges.

The least of which to worry about is getting up early or working weekends.

Once you get into the groove of things, your schedule becomes a part of you. I don’t even flinch at the thought of working on a Saturday anymore.

Infact, unless I have something specific already planned, I’d rather be at work.

That’s not sad, it’s smart.

Take advantage of the opportunities when they arise.

The challenges that I am referring to are obstacles that cannot be avoided. It isn’t right by any means, but these challenges are found in all Long-term care homes.

Welcome to your new job as a PSW! You’ve successfully completed your strenuous year long course consisting of both a theory and practicum workload.

Old Nursing Home

You know this. You’re ready for this.

Your first day of orientation in a LTC home has gone well. Yet, you’re not sure if you’re totally ready to do this on your own. Maybe another day of orientation will help you out.

Maybe a 3rd. After that, you’re on your own.

3 days is all you are going to get. Is it enough? I don’t think so.

One of the challenges is getting to know your residents and their routines in order to perform your job with ease. Working alongside a PSW who has known these people for a fair amount of time would be extremely beneficial to the newbie in town.

But it doesn’t work this way.

A lot of the time you are left figuring out the inner workings of your LTC home on your own.


This is more difficult than it sounds. The rules and regulations for LTC homes, which can be found here are long and strict.

Most of which are common sense.

For example, washing your hands before and after personal care.

Others also fall under the category of common sense but aren’t always followed through with such.

A common occurrence that I’ve seen one too many times is using a lift machine with your resident ALONE. Sometimes it’s easier to do it by yourself than to wait for a busy co-worker to help you. Yes, you probably know what you’re doing and would never intentionally put your resident in harms way.

However, this is NEVER to be done.


When I see this happen, I report it. Your job is not worth the risk. Ever.

A PSWs job is easy because a PSW only ever has 4-5 residents to take care of.

That was a lie. A big big lie.

The ratio of PSWs to residents is something along the lines of 1 to 10, sometimes more. A regular day may consist of 3 PSWs, not more. If the floor is extremely heavy you may get 4.

But that’s it.

During the evening it’s usually reduced to 2 PSWs per unit. During the night down to 1. 1 PSW to a unit consisting of close to 30 residents.

So what happens if someone calls in sick to work? Is that PSW replaced to balance the work load?


Most of the time someone will come in for only 4 hours, leaving 2 PSWs to handle the rest of the day on their own. Othertimes someone is brought in from an agency.

This isn’t a bad thing, any help is extremely appreciated.

But when someone comes from an agency which doesn’t know the nursing home facility or your residents, the workload for them becomes extremely difficult in turn making work harder for you. 


Every day you walk into work is going to be different, guaranteed. The routine will more or less be the same, but something  could have easily happened the night before, or even 3 minutes prior to you starting that could have changed everything.

A resident may have become ill or even passed away. A fire drill could occur at the most inconvenient time – yes, this happens and it extremely annoying – you maybe have to attend a meeting, etc.

A PSWs work life is extremely draining both physically and mentally. Click here to Tweet this.

You will face challenges everyday in this line of work. Not all of which will be daunting, most are in fact fun and the challenge is a part of the drive to want to do a good job.

Sometimes you will have days where if you here one more call bell you’ll want to pull your hair out.

That’s normal.

Working as a team with your co-workers will make your life that much easier. Talk it out. Follow the rules. Relax.

You can do this.

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Avlin is passionate about helping aspirants become better personal support workers. He is an entrepreneur and runs a clinic in Toronto.

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