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Nursing staffing



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Oct 18, 2009 08:09 PM

Nursing staffing


Our nursing home has 42 residents. My ADON and myself are always available to help the nurses. We just ask them to let us know when they need help. Many times we offer. The staffing is 2 day nurses, 2 evening nurses, and one night nurse plus a sufficient supply of aides. They always complain that they don't have enough time to do their jobs. I think they are lucky to have the staffing they do. I took over the DON position one year ago. I know some of the older nurses are not willing to be involved in a "team environment". The old DON has been working as a staff nurse. I don't have these issues with the aides. They are great. We are working on "team building"and things to help improve their moral. I don't micro manage and encourage and initiate their ideas. Any ideas? How's your staff if you are a home similar to our size. Thanks for your input.

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28 Comments
No. 1
from CynicallyVexed
Old Oct 18, 2009, 09:46 PM

Default Re: Nursing staffing
Only 42 residents? wow.. where's this place at? LOL!!!! they shouldn't be complaining especially if you have plenty of aides and the nurses have their equipment.
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No. 2
from jmtndl
Old Oct 19, 2009, 01:30 AM

Default Re: Nursing staffing
I always wonder why management cannot hear the staff when the staff is saying "you are giving us too much to do and not enough help to accomplish the task". Have you actually worked the floor? How many of the patients are total care? What is "enough aides"? My Management team are always doing "team building" things too. What makes management think the floor staff aren't working as a team? Do you not realize that that is what you have to do to get all the work done and the patients cared for?And what are the "team building" programs you have...bulletin boards with race cars with a caption saying "There is no "I" in "TEAM"? Spend less time on your agenda and listen to the staff. Try to do something they feel will improve the situation...not the same old managementbabble.
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No. 3
from classicdame
Old Oct 19, 2009, 06:57 AM

Default Re: Nursing staffing
have you asked the staff for ideas? 42 residents seems like an awful lot for two people and then only ONE at night? Who witnesses meds? Who responds to emergencies while the other manages the floor? Sounds like a disaster waiting to happen.
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No. 4
from SuesquatchRN
Old Oct 19, 2009, 07:58 AM

Default Re: Nursing staffing
Originally Posted by classicdame View Post
have you asked the staff for ideas? 42 residents seems like an awful lot for two people and then only ONE at night? Who witnesses meds? Who responds to emergencies while the other manages the floor? Sounds like a disaster waiting to happen.

That's the usual staffing.

May I ask how many aides there are?
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No. 5
from AnnemRN
Old Oct 19, 2009, 08:26 AM

Default Re: Nursing staffing
I will bet the med pass and treatments are a nightmare if each nurse has 21 patients. The patients probably have multiple meds. The aides can only help so much and can't help with nursing functions.
Would it be possible for you and the ADON to take a certain number of patients for a week so, you can feel firsthand what your nurses are talking about? I'll bet they would have a great deal of respect for both of you for getting in the trenches.
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No. 6
from spunky1281
Old Oct 19, 2009, 03:19 PM

Default Re: Nursing staffing
Wait a second. It shouldn't be how many staff are on that is the issue. It is what are the cares like. If there are 42 residents and they are all pretty much independent with only needing the assist of throwing their legs back in bed, yeah, they shouldn't be complaining. However, if all or most of these residents are completely dependent with PAL and Lift transfers, then I wouldn't be blaming them. Management never seems to get this. Everyone seems to think these residents sleep all night, which isn't the case. These people are woken every 2 hours, are up most of the night and then end up sleeping all day. What are your cares like and are the staffing appropriate for those cares?
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No. 7
from lovelylpn
Old Oct 19, 2009, 03:46 PM

Default Re: Nursing staffing
I think the staffing sounds great if the number of CNA's is, indeed, adequate. I had 28 residents on day and evening, and about 60 on nights when I worked in long-term care. In terms of the team-building, like others have said, ask your staff what they need and what causes them the most trouble. Shadow one or two for several hours or an entire shift to see where the hold-ups are and what can be done to alleviate them.
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No. 8
from AnnemRN
Old Oct 19, 2009, 04:32 PM

Default Re: Nursing staffing
I don't see how staffing can be great for that many patients. It amounts to approximately 23 minutes per 8 hour shift for each of the 21 patients. The nurses must have to move very fast.
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No. 9
from AnnemRN
Old Oct 19, 2009, 04:54 PM

Default Re: Nursing staffing
The Dept. of Health and Human Services has a preferred minimum staffing level recommendation for nursing homes. It says each resident should received a total of 1 hour and 45 minutes of care from a licensed nurse. An LVN/LPN can provide 1 hour with the RN providing 45 minutes. My understanding is if there is no LVN/LPN available then the RN should be able to provide the entire 1 hour and 45 minutes.
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