What can we do to improve working conditions in Nursing homes? - page 2

NOTHIING......until the exact ratio of CNA's and licensed nurses to residents are mandated in the State and Federal Regulations.... Read More

  1. by   Destinystar
    What I have been refering to is the staffing ratio in LTC which is different than in acute care. A licensed nurse in LTC could easily have 30 residents to take care of and CNA's to supervise. I agree if nurses would get together and demand a change it could be of a great benefit to all.
    Quote from CeCiRN
    Nurses throughout the USA should do exactly what 2000 California nurses did in September, 2000. Get together and go straight to the governor of your states and DEMAND that a nurse/patient ratio law be passed like they did in California. Gray Davis listened and now thanks to him and those 2000 California nurses who let their voices be heard, California has a nurse/patient ratio law on the books. From what I hear, an RN cannot be assigned more than 6 patients per shift and I hear that nurses from all over are scrambling to California for employment. The secret to all of this is: NURSES SPEAK UP BACK YOUR PEERS UP INSTEAD OF STABBING THEM IN THE BACK!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
  2. by   jyoung1950
    Quote from Destinystar
    The staffing ratios are only the minimum amount of nursing hours that the State and Federal Regulations require. But if you accept an assignment and something bad happens to a patient YOU COULD BE HELD ACCOUNTABLE. Even if the staffing ratio was below the minimum amount mandated by the regulations. This is especially true if you were the Nursing Supervisor or Charge Nurse on duty. It is prudent for a nurse to size up a situation before s/he clocks in &/or takes report. If it appears that you cannot safely take care of the residents then with a witness call the administrator and the Director of nurses and report the situation immediatly. If they fail to respond (i.e. get the staff that you need by coming in themselves or calling a nursing registry) then refuse to accept the assignment. You can also call the nursing registry & if no response you can call MD's & tell them you cant safely take care of the residents and transfer them to a place that can. You can also call the board of registered nursing and report the DON for failing to provide adequate staffing. You can report the Administrator as well. Remember we are all PATIENT ADVOCATES not facility advocates. The patients are helpless the owner, Administrator, DON are not. The patients did not choose to be in the situation they are in the administrator, etc. does. You are better off not accepting an assignement and risk getting fired then you are to foolishly accept one and possibly loosing your license. If you blow the whistle you should in most states be able to sue the facility for retaliation. It is up to US to show how much we care by taking Drastic measures to send a message that if THEY wont do something about putting the frail elderly in dangerouse situations WE (the long term staff) will.
    Can CNA's utilize this process also? Or is just restricted to nurses?

    I used to work at a nursing home (now at a hospital). A couple of our units have 62 residents each and many nights they were staffed with only 3-4 aids.

    On my assignment I always had 13 women to care for by myself. That's why I decided to go to the hospital - got burned out at the nursing home.
  3. by   Destinystar
    sure cna's can utilize the process and i would encourage all of them to do so. there are so many more of you than there are licensed nurse in ltc. in california cna's belong to unions and have improved working conditions for themselves as a result of doing so.:hatparty:
    Quote from jyoung1950
    can cna's utilize this process also? or is just restricted to nurses?

    i used to work at a nursing home (now at a hospital). a couple of our units have 62 residents each and many nights they were staffed with only 3-4 aids.

    on my assignment i always had 13 women to care for by myself. that's why i decided to go to the hospital - got burned out at the nursing home.
  4. by   LPN4Life
    I work in a nursing home ran by the state, we have a union that worked out a contract of mandation.
    It has been pretty hard on the aides lately because of vacations and being summer, more call-ins, but none of them have quit. They are getting frustrated but are hanging in there.
    We aren't paid for it, we get comp time built up.
    We rarely work short, its a nice concept and it is working.
  5. by   Nurse GOODNIGHT
    Wow, so true! As John Adams said, if we do not hang together we most assuredly will hang seperately. I have learned so much from these boards and get that LTC is not a place to work. How can you deal with all the psychosocial , spiritual, emotional needs of your pt with 30+. I understand passing meds, etc. but what about doing all possible for the pt and that can only come through mandated pt/nurse ratio it appears. After doing clinicals in a nursing home, I find it so sad and that we as a nation need to do something. After asking the nurse to just warm a pt's food and getting a smart reply and stare, I know we need to do something for our countries older Americans as we (God willing) will be there someday ourselves and they have given so much to us.
  6. by   Destinystar
    i wrote to our governor in california today (arnold) and asked him to specify a nurse to patient ratio per shift for snf. i mentioned to arnold that the life he saves may be his own.
    Quote from nurse goodnight
    wow, so true! as john adams said, if we do not hang together we most assuredly will hang seperately. i have learned so much from these boards and get that ltc is not a place to work. how can you deal with all the psychosocial , spiritual, emotional needs of your pt with 30+. i understand passing meds, etc. but what about doing all possible for the pt and that can only come through mandated pt/nurse ratio it appears. after doing clinicals in a nursing home, i find it so sad and that we as a nation need to do something. after asking the nurse to just warm a pt's food and getting a smart reply and stare, i know we need to do something for our countries older americans as we (god willing) will be there someday ourselves and they have given so much to us.
  7. by   CapeCodMermaid
    Quote from Nurse GOODNIGHT
    Wow, so true! As John Adams said, if we do not hang together we most assuredly will hang seperately. I have learned so much from these boards and get that LTC is not a place to work. How can you deal with all the psychosocial , spiritual, emotional needs of your pt with 30+. I understand passing meds, etc. but what about doing all possible for the pt and that can only come through mandated pt/nurse ratio it appears. After doing clinicals in a nursing home, I find it so sad and that we as a nation need to do something. After asking the nurse to just warm a pt's food and getting a smart reply and stare, I know we need to do something for our countries older Americans as we (God willing) will be there someday ourselves and they have given so much to us.
    I think it was Benjamin Franklin who said we must hang together....if y'all could tell me where I could find more staff, I'd love to have them. Last night out of 5 nurses in the building, one was staff...4 were agency. Tonight one of the CNA's copped an attitude on me because a CNA called out last night at 10:30pm for an 11 o'clock shift...yikes..I was sleeping at home, so please tell me how that was my fault
  8. by   hipab4hands
    We as nurses will never get the correct working ratios while others are turning up with "free time". Check out the comments from the nursing unions about this, they have quite a lot to say in that area. Free time - NO!
    Regards, Mister Chris.[/QUOTE]
    My employer tried to by pass our contract, by making us wave the Premium pay agreement in the contract. So if you want to work additional hours, the only way to do that is to wave getting double time. Stupid me did it several times.
    I finally caught on to what they were doing, and now refuse to sign the waiver.

    My motto now- No premimum pay means that I'm no longer available to work extra hours.
  9. by   pj_marie
    Quote from Betty_SPN_KS
    How will this work if the only thing they can come up with is mandatory overtime to make up for not enough nurses and CNAs being willing to work in those places? That will only cause more people to want to quit. The government can't create more nurses or CNAs. If they can, tell me how. They can offer financial aid for education, but that doesn't mean everyone is going to see it through a program or stick it out with a job either.

    More money for these places? Where shall it come from? We all have our own ideas, but what are we willing to do without?

    Any more ideas?
    In our facility it is not a lack of CNAs willing to work there, it is the scheduling of these CNAs that causes problem. On day shift there is always 8-11 CNAs with 2-3 Restorative CNAs and a shower aide. However on 2nd shift, we are lucky to have 6 CNAs scheduled, let alone come in. Our capacity is 95 residents. Right now, census is "low" which means we have 12 empty beds... 9 in the front, 3 in the back yet the whole count is what they base scheduling on. So, we are short in the back and they have too many in the front. This makes no sense to me and only hurts those residents that have the shortage of CNAs to take care of them. I think there should be more specifics as to the number of CNAs to residents. But, hey I don't know anything, I just work there.

    PJ *Proud CNA*
  10. by   Destinystar
    the staffing pattern you described makes no sense to me. i think they should shift the load so that everyone has the same amount of work to do.
    Quote from pj_marie
    in our facility it is not a lack of cnas willing to work there, it is the scheduling of these cnas that causes problem. on day shift there is always 8-11 cnas with 2-3 restorative cnas and a shower aide. however on 2nd shift, we are lucky to have 6 cnas scheduled, let alone come in. our capacity is 95 residents. right now, census is "low" which means we have 12 empty beds... 9 in the front, 3 in the back yet the whole count is what they base scheduling on. so, we are short in the back and they have too many in the front. this makes no sense to me and only hurts those residents that have the shortage of cnas to take care of them. i think there should be more specifics as to the number of cnas to residents. but, hey i don't know anything, i just work there.

    pj *proud cna*
  11. by   CoffeeRTC
    How about just a simple thanks. Sounds funny, but it works...I've come in and covered shifts when asked politely and thanked for doing it. I know its just a small part of the problem......
    Another one for my facility...benifits for a family are 650 a month + 50 in union dues...They are also trying to limit OT for the CNAs (even tho we are understaffed on some shifts) No trading if it means another person will get OT...this has been encouraging call offs and mandation..doesn't sound reasonable...Im not sure how some of the women do it. With the pay it doesnt seem worth working so hard.
  12. by   purple_angel24521
    [font=Comic Sans MS]I have been a CNA/med-tech since 1994, and have worked at several different NH's, and things are the same today as they were back then, We are ALL unpaid, over worked, under staffed, and burnt out !!! They (the admin) will take any kind of resident that comes through the door. All they care about is the $$$$. They don't work the floor, so they have NO IDEA how these residents are, and they wonder why the cna's are quiting, and calling out, and why they're so many incident reports, and cna's on light duty(at least at my NH) I think if the higher up's would work a shift or two, then maybe they would/could see what it's REALLY. Sorry about venting.... but THAT felt GREAT !!! Don't get me wrong , I LOVE what I do, I just don't like working in the conditions that we are forced to. Have you ever noticed, that when STATE is in , there is PLENTY of staff?? amazing, This was my 1st post, sorry it had to be a negative one, but it's the truth, Y'll have a great evening!

    [font=Comic Sans MS]purple_angel24521
  13. by   TexasPoodleMix
    I was wondering, just how "common" are "attacks" in LTC? Meaning residents getting aggressive and violent.

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