What can we do to improve working conditions in Nursing homes? - page 5

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   jblvn
    Quote from ocankhe
    S
    Simple, increase reimbursement from medicaid. The increased income to the facility can be directed towards salaries. Then all levels of caregivers salaries can be increased....Oh I forgot, the increased revenue would be shifted to profits for the facility instead of to the caregivers. After all we need to increase the profit otherwise we couldn't stay in business. Thus you can be thankful you still have that underpaid and unappreciated job.

    Just thought you would like to know President Bush is planning to cut medicare by 24 billion dollors to SNF in the next 10 years. I just read on nursing news.
    Last edit by jblvn on Feb 10, '05
  2. by   germain
    WHY do we have FOR PROFIT Nursing homes. Please excuse me for being a horrible communist, but some things should not be for profit.

    UNIONIZE NURSES AIDES. Better pay/ better benifits/ better staffing=skilled staff that STAY. SEIU (Service Employees International Union) has a drive to unionze caregivers. Its the fastest growing union in the country, and the LTC aides they have sucessfully unionized are better paid and have better staffing ratios. You should work and suppor the unionization of your aides.

    REPLACE AIDES WITH RN'S? Please. THere are good aides, really there are, but they are smart and don't work for you because they can make more money for less work elsewhere. You don't need to go to nursing school to take good care of people.
  3. by   FutureNrse
    Quote from Hellllllo Nurse
    I have wrtitten to my elected officials several times concerning nurse's working conditions and pt safety. All I've ever gotten in reply is form letters.
    Then write again...and again...and again...
    Seriously, it takes perseverence. Organize a letter writing campaign. You can write a form letter of your own, outlining the major problems that you want to address, then give it to anyone else who agrees with you (like all the folks on this site), and they can use it as it is, or change it a little to personalize it, add thier own ideas, thoughts, experiences. Do a little research online to get the mailing addresses of anyone and everyone with even the tiniest bit of political clout in your area, assemblymen, gongressmen, mayor, governor, heck PRESIDENT too!
    Then you have everyone make numerous copies of thier letter and send one to every politician on the list. Then have them do it every week. And keep recruiting, spread the word.
    I learned this method from a college professor that I still remember fondly. She was a very prim and proper looking woman who preached activism and civil disobedience. She was something else
    And boy could she get things done!
  4. by   OC_An Khe
    The terrible working conditions in some hospitals and SNF's are a result fo staff putting up with them. When all members of the care giving professions say enough is enough that is when it will end. The shortage will also dissappear.
    Don't accept a position, or stay in a position, where the patient ratio is poor, or where frequent mandation od OT is prevalent, where its difficult or impossible to get a vacation. Don't stay for the sake of the patient as in the long run you are harming the patient. When people refuse to work under the conditions prevalent in some facilities today and those facilities can't hire the people they need, they will either close or change their ways. Until then SOS.
  5. by   CapeCodMermaid
    Quote from germain
    WHY do we have FOR PROFIT Nursing homes. Please excuse me for being a horrible communist, but some things should not be for profit.

    UNIONIZE NURSES AIDES. Better pay/ better benifits/ better staffing=skilled staff that STAY. SEIU (Service Employees International Union) has a drive to unionze caregivers. Its the fastest growing union in the country, and the LTC aides they have sucessfully unionized are better paid and have better staffing ratios. You should work and suppor the unionization of your aides.

    REPLACE AIDES WITH RN'S? Please. THere are good aides, really there are, but they are smart and don't work for you because they can make more money for less work elsewhere. You don't need to go to nursing school to take good care of people.
    Another person seems to have bought the union line...the union won't stop callouts, which, at my facility, is the reason staffing is short. The union can't manufacture CNA's to replace those who have called out. Part of the problem is the aides themselves and their horrible work attitude. The union won't fix that and, in the long run, will most likely make it worse. They promise things they will never be able to deliver.
  6. by   James Huffman
    Quote from germain
    WHY do we have FOR PROFIT Nursing homes. Please excuse me for being a horrible communist, but some things should not be for profit.
    Hey, I won't call you a horrible communist. A pinko, maybe. :chuckle

    I have found no evidence that for profit facilities are any worse than non-profits. "Non-profit" only means that profits don't accrue to individual shareholders, and that is no guarantee of some type of angelic goodness. I worked -- very briefly -- a nursing facility which was non-profit and horrible. The people were well-meaning, but the ratios were terrible, and the place very badly run.

    But all of this begs the question: why should we NOT have for profit nursing homes? Our food system is for profit. (Grocery stores, etc.) Most medical practices are for profit. Most child care facilities are for profit. Why should nursing homes somehow be different? The problem is not from the profit motivation.

    Jim Huffman, RN
  7. by   rstewart
    I can only confirm what many of you have already said.
    Obviously, clear, appropriate staffing legislation would be helpful. What is needed for adequate care has been calculated for the industry but only in the form of recommendations rather than requirements. If the experience in California is any indication, health care providers will fight implementation of mandated patient nurse ratios tooth and nail..........and try to reverse them once implemented. So there is a very real disconnect here. For many years providers pretended that they didn't know staffing's impact on patient outcomes. They no longer have that excuse, however they continue to oppose legislated minimum staffing standards.

    Then there is the CNA problem. Mandating staffing ratios is a helpful first step but budgeting for them is equally important. As we all know, CNA work is back breaking, many times thankless, is required 24/7 etc.----in short, in many respects undesirable. Yet in my state, nursing homes do not pay CNAs nearly what they might earn in other jobs requiring similar education and experience. So basically LTC gets what's left at the bottom of the employment pool and in insufficient numbers at that. Several posters have mentioned the negative effects of call-ins on morale and patient care. Call-ins occur because: 1) You can not attract enough people with a good work ethic due to low pay and 2) Facilities are reluctant to terminate employees who call in frequently because deep down they know they will have trouble replacing them due to low pay. The proverbial vicious cycle. The only way to break that cycle is significant reimbursement increases targeted for CNA pay. But as one poster correctly pointed out reimbursement is scheduled for decreases. So again there is a major disconnect between what must occur to improve care and what is actually occuring.

    What if we had put those multiple $80 billion dollar payments used in the Iraq war into senior health care and LTC? With adequate controls for fraud and waste I think you would see vast improvement. It's clearly a question of priorities, and taking care of our most vulnerable citizens is not a high priority in this country.
  8. by   Simplepleasures
    Quote from CapeCodMermaid
    Another person seems to have bought the union line...the union won't stop callouts, which, at my facility, is the reason staffing is short. The union can't manufacture CNA's to replace those who have called out. Part of the problem is the aides themselves and their horrible work attitude. The union won't fix that and, in the long run, will most likely make it worse. They promise things they will never be able to deliver.
    California Nurses Association helped get state mandated nurse patient ratios, could a strong union do the same in LTC? Not if we keep falling for this anti union propaganda.
  9. by   banditrn
    Quote from CapeCodMermaid
    Another person seems to have bought the union line...the union won't stop callouts, which, at my facility, is the reason staffing is short. The union can't manufacture CNA's to replace those who have called out. Part of the problem is the aides themselves and their horrible work attitude. The union won't fix that and, in the long run, will most likely make it worse. They promise things they will never be able to deliver.
    I agree with you, Capecod - but we need some kind of 'something' to give the nurses a voice. Constantly 'walking' isn't the answer, either.

    The Corporate, for profit, nursing home may sound good to the general public, but I've gotten a real nasty taste in my mouth over them - not just at the one I recently left, but at things my son has told me about the one he worked many years for - and left.

    The facility I work at now is better, but they've just started accepting skilled residents - and they're taking one's that none of the nurses there have ever had experience with - and they aren't doing any kind of inservices - just kind of putting them in a room and saying 'here they are'.

    One of the nurses there told me that at a recent nurses meeting, our new DON stated that her goal was to have 50 residents per nurse - and this will include the skilled residents.

    One of the reasons I went to this facility is that the staffing was much better than the last - but I'm NOT doing 50 residents.

    A good DON is a must, but if they don't have the backing of administration, there isn't much they can do to prevent some of the horror stories that are to come.
  10. by   withasmilelpn
    Quote from banditrn
    One of the nurses there told me that at a recent nurses meeting, our new DON stated that her goal was to have 50 residents per nurse - and this will include the skilled residents.
    I'll do it! But first I have some stipulations that facility will have to meet. The family members of the residents first have to agree to sign a waiver that their loved one will in no circumstances ever ring a call bell (for it will not be answered), they must sign a DNR, DNH (for we will be unlikely to get to them in time to do any good) and they waive any liability to the nursing staff should actual harm occur (because it will.) Also I would expect to be paid enough to forget I have a conscience... Never mind, they couldn't do that anyway! Guess I'm not working there!
  11. by   banditrn
    Quote from withasmilelpn
    I'll do it! But first I have some stipulations that facility will have to meet. The family members of the residents first have to agree to sign a waiver that their loved one will in no circumstances ever ring a call bell (for it will not be answered), they must sign a DNR, DNH (for we will be unlikely to get to them in time to do any good) and they waive any liability to the nursing staff should actual harm occur (because it will.) Also I would expect to be paid enough to forget I have a conscience... Never mind, they couldn't do that anyway! Guess I'm not working there!
    Do you wonder what the Long Term Care situation is going to look like in 5 or 10 years?
  12. by   Simplepleasures
    Quote from banditrn
    Do you wonder what the Long Term Care situation is going to look like in 5 or 10 years?
    Yes I see it now, we are all in a world of hurt if this despicable trend is allowed to perpetuate.
  13. by   Boston64
    Quote from Destinystar
    NOTHIING......until the exact ratio of CNA's and licensed nurses to residents are mandated in the State and Federal Regulations.
    Hi! This was the first question I saw and I felt furious and sad because I am a seasoned RN and I want to teach CNA's, but because I do not have a BSN, I have found it a fruitless search.

    With the high rate of baby boomer's reaching the age where they will need care, the demand for well trained CNA's as well as RN's is going to reach a crisis!

    I have decided, at the ripe old age of 64 to enrole in a BSN program so that I can pass on the gift of an excellent training that I was given 42 years ago. I may be too old to work at the bedside, but I still have a lot to offer.

    There are so many of us well trained nurses out there who could be of use for teaching purposes, if the requirements for teaching were not so great.

    Anybody else out there who thinks and feels the same way?






close