NURSING SHORTAGE IN LTC?

Hape2baRN · Jul 8, 2001

I use to work in LTC. I loved working with the elderly. Sometimes the staff were the only family they had. I was the DON over a 245 bed facility including 40 Medicare beds. The staffing situation was awful and no light at the end of the tunnel. Nursing home corporations and management wanted a full building and like many of you have argued with the management about not adequate staffing to take care of the patients. The State was to implement staffing requirements to make sure facilities had adequate staffing but did not follow through with their plan because all the facilities would have been out of compliance and fined because all the facilities were understaffed. Nursing homes get a bad rap. I agree there are a few bad apples in the bunch but by far most of the people work in the facilities love working with the elderly and are not there for the money. There are just not enough people to take care of the patients.

I loved working in the nursing home and I really miss it. I will no longer work in a nursing home due to the liability, no support from State, corporation and upper management, no staff, and burn out.

Catsrule16, RN · Jul 8, 2001

We have minimum staffing requirements but still can't seem to meet them. On ALL shifts, the state requires 1 nurse for up to 50 residents. On 7-3, 1 CNA for every 9 residents, on 3-11, 1 CNA for every 15, and on 11-7, 1 CNA to every 22. Acuity levels do not play a role in determining these numbers. Last facility I worked in had 15 feeders on one unit. I was an RAI co-ordinator. Many times, I was asked to work the floor as a CNA or fill in for the charge position. A few times the administrator padded the schedule by putting on paper that I worked as a CNA when I didn't. Didn't find out about this till after I left. Went to a 250+ bed facility recently. Was shown a list of 150 new people hired in 2 months that were no longer there.

Have the values or work ethics of the newer Nurses and CNAs changed that much that they are afraid of a little hard work or are they finding easier ways to make money? Working in long term care facilities is definitly hard work. There is little glory and recognition from the outside. Just have to know in your heart you are doing a great job.

Bobl427 · Jul 9, 2001

I work in a small 74 bed facility in Western MA. Our facility is the best in our area (in my not so humble opinion) therefore we have the least staffing problems. Despite this, we still rack up a huge pool bill for nursing assistants. We rarely use an agency nurse but lately, there has been an increased need for management staff to fill nursing shifts.

Does anyone else find it offensive that in our society we pay garbage collectors more than we pay certified nursing assistants? Although it is true that one should not enter the nursing profession for the money, I find it disgusting that we put so little value on the work of caregivers. Maybe if the parents of our politicians were in the financial position that gave them no choice but to seek nursing home care, we would see some attention paid to reimbursement rates for nusing home care.

night owl · Jul 10, 2001

I'm not really sure, but don't these politicians get free health care as part of the benefits of being a politician? I mean would you be President of the USA for only $200,000 a year? Former President Reagan with his alzheimers disease...Do you think Nancy is paying out of her pocket for all of his care? How about Vice Pres. Dick Cheney and all of his heart attacks...Do you think his HMO is paying for all of his hospital stays in CICU???Heck no. We are his HMO! If these people were like you and I, (praying that we don't get sick because our HMO's usually pay for some of the healthcare costs, and the rest comes out of our pockets,) they would be working harder to change the healthcare system so that when they do get sick or too old to care for themselves they would see to it that staffing would be there for them when the time comes. Since they get it all for free, and in the privacy of their own multimillion dollar homes, why should they work to change these laws pertaining to adequate staffing. The more staffing hired to work at healthcare facilities across the USA, the less money these politicians get toward their own healthcare. I could be totally wrong, but I'm willing to bet it has alot to do with it. It all boils down to the o'mighty dollar and GREED, GREED AND MORE GREED. I couldn't meet my maker being that greedy and yet these politicians sleep at night knowing that they will be taken care of. I couldn't sleep knowing that the old folks of this WONDERFUL country who helped build this country are out there in LTC facilities sitting in soiled undergarments for hours on end with raw bottoms, lying in one position for hours on end with pressure ulcers as big as my fists, not getting fed their meal, all because there aren't enough people to care for them, and could really care less about seeing that these facilities are properly staffed with however many it takes to give them the care that they so deserve in their last few years of their lives. They worry more about whether or not their garbage will be picked up on time. INCREDIBLE...ABSOLUTELY INCREDIBLE!!! I could just cry thinking about their greed, and our old folks unnecessary pain and suffering due to inadequate staffing of LTC facilities. :o !!! It's a crime and all of these greed mongers need to be locked up for the rest of their lives and made to sit in soiled briefs, made to get pressure sores and purposely starved. The good Lord has plans for these people... Believe me:D yesssssssssss!!!

darby · Jul 10, 2001

hi. i like your outspoken opinion, me too ,the south is the pits, noone does anything,why,the racism and the dollars,believe me i think the only answer is to walk out let the admin brights.....ha.solve their own problems,the poor are getting poor..and the rich are getting it all,while we work for nothing,i hired three so called lawyers to try to get 214.00 from one facility,they shorted the pay and then the black admin tried to hustle me,it didnt work,to say the least we pay welfare,food cards,and they laugh when they eat,obesity and stupidity is what has the south,the money,greed will never stop unless the nurses refuse to work,no matter what it takes organization,i love the unions the other states have helped our poor,underpaid,overworked profession,lets stick together and let the overweight, nursing home owners drown in their own ltc world.it has taken me 30 years to say like they did in nova scotia thread,pay me or i will go down the street and get someone that will.............. think about it,nightowl you are 150% right. i will support anybody that speaks their mind,darby.

ktwlpn, LPN · Jul 20, 2001

Well-I had a beautiful day off today.Bright sunshine,comfortably warm,low humidity...Really rested,relaxed and did the things I enjoy-reading,cooking,gardening.All to prepare for the coming weekend...12 hours Sat and a double on Sunday....I will do anything I possibly can on my weekends on duty to try to prevent my co-workers from coming in on there weekend off-because I don't intend on giving up my time with my family.What are your policies regarding overtime and working on units other then your regularly assigned "home away from home" Some of my co-workers want to work over on the unit they have been on for their first 8 hrs-our problem is that we have several staff members whom have dictated to our administration where they will and will not work...Others feel that if you are coming in on your time off you should be able to work where you wish..Do you have a policy regarding this and do you work with staff whom refuse to work on certain units?

catlady, BSN, RN · Jul 21, 2001

I think if you're volunteering to come in on your day off, your preference for where you'd like to work should certainly be given some consideration. I wouldn't turn the building upside down to accomodate the request, though.

Now if someone's going to dictate where they're going to work on their scheduled days, they need to find another job.

As for the original question, yes, the nursing shortage has hit LTC. Our building is staffed adequately on paper, but there are almost always callouts that bring the numbers down. Then the other people in the building (DNS, ADNS, me--I'm a unit manager) are used to pad the numbers. I've had to work the floor a few times when they couldn't find a replacement nurse on days. Of course, nobody's picking up my work (supervising and MDS) when I'm pushing the med cart. Weekends are always tough--usually held together with string and baling wire. Except when I'm on-call, though, or when I find out I'm stuck doing the floor, I try not to think about staffing. It's someone else's job. That's the only way I was willing to take another management job. I quit the last one over the stress of staffing issues.