Aaaaarrrrrrggggggh!!

NC Girl BSN · Dec 29, 2007

Same thing in our facility. Over the holidays we had 3 for 56 patients. But they managed to pull it off. On 3-11 shift they don't have to give showers. Day shift does all that. Most of the people stayed in bed. Some got up if their families came. Some left for the day. I can't believe more families don' t take their loved ones home during the holidays. But to answer your question. Is it legal? I guess so, they get away with it all the time.

Plagueis · Dec 29, 2007

There have been plenty of times as a CNA that I've worked 16 hr shifts (days and evenings) and have known that it would be me and another girl for the whole 16 hours for around 55 patients (Alzheimer's at that and behaviors). Usually the two of us would come in at 5am and get started (the legal time we were allowed to get ppl up)... making a 16 hour day a 17 hr day with three meals and hardly one break. We got everything accomplished but we were worn out!

I cannot imagine having only 2 CNAs for 55 Alzheimer's residents. I usually have around 10 to 13 residents, and that is a handful! I cannot believe that it's okay for facilities to have such poor staffing, and that it doesn't violate any law. I know that understaffing is common in the LTC industry, but I wonder if families, and not just the LTC staff, are aware of how bad it is. Are they aware that their CNA is not only responsible for their grandparent, but up to 20 other residents? I would think that families would be outraged and protest to the state about the horrible staffing that many nursing homes have if they really knew, but this apparently isn't happening.

TheCommuter, BSN, RN · Dec 31, 2007

I know that understaffing is common in the LTC industry, but I wonder if families, and not just the LTC staff, are aware of how bad it is. Are they aware that their CNA is not only responsible for their grandparent, but up to 20 other residents? I would think that families would be outraged and protest to the state about the horrible staffing that many nursing homes have if they really knew, but this apparently isn't happening.

The management at my facility has forbidden nurses and aides to discuss actual staffing numbers with visitors, residents, and family members. However, I always tell the truth about our staffing ratios for that particular day if I am asked.

The spouse of a skilled rehab patient recently asked me, "How many patients do you have today?" I responded I had 36 patients. This was during 3-11pm shift.

She said, "Oh my gosh! Why does this place do that?"

I was speaking to another family member on the phone, who happened to be a nurse in the ER. She was accustomed to having 6 to 8 patients where she worked. She asked me about her father's morning blood glucose reading, and I replied, "I've got 15 other patients, so I really don't remember your father's blood sugar off the top of my head, but I'll go look it up." This ER nurse complained to the ADON and stated, "How do the nurses get things done on a skilled unit with 16 patients?" The ADON explained that our care was less acute, so each nurse was allowed more patients.

I always tell the truth about our staffing numbers to whomever requests this info.

ktwlpn, LPN · Dec 31, 2007

The management at my facility has forbidden nurses and aides to discuss actual staffing numbers with visitors, residents, and family members.

In this state that info must be clearly posted every shift right where anyone can see it...Also the state counts ALL licensed staff on duty-they are NOT looking at just the number of cna's per patient.They do not take into account the fact that cna's and nurse's have very different responsibilites in LTC...It's a bunch of crap-on a quiet day I may have time to do some direct patient care but that can not be counted on because anything can happen (and usually does)

CapeCodMermaid, RN · Jan 1, 2008

My ADON, the scheduler, and I spent a combined total of about 20 hours just working on the holiday schedules. We had all the slots filled. Guess what...people called out. Did the CNA's complain to their co worker who had called out again or to the management team? ...right ...they complained and gave attitude to the managers. I suggested they direct their anger and frustration where it might to do some good....at the people who had called out.

And in Massachusetts we have to post the daily schedule in a public place.

Nascar nurse, ASN, RN · Jan 1, 2008

We are also required to post daily staffing patterns w/ current census. This is required to be divided out for licensed and non-licensed staff. Only direct caregivers are to be listed - not nursing admin. staff. Must be posted for the world to see!

I was weekend manager, spent most of Sat/Sun getting staffing ready for ny eve and ny day. Had 3 CNA and one nurse call off just for day shift today (this was after I thought I had everything set to go!) AAAARRRRGGGGH!

Simplepleasures · Jan 3, 2008

Yes it is sad that the residents have to suffer because of poor scheduling. It is also sad that the staff has to burn themselves out because management is too busy looking the other way. Wonder what daughter/son would say about "dear old mom" not getting enough care because of short staffing? And if they did complain to someone other than management (state) would it be addressed?

No, most likely not, state is well aware of chronic short staffing, they have no authority to mandate decent nurse/patient ratios.MO.

Also, it is very unprofessional to call out on a holday, I wonder if hospitals have the holiday call out problem too? Maybe a sign of poor caliber worker so prevalent in LTC, any warm body will do.....

TheCommuter, BSN, RN · Jan 4, 2008

Also, it is very unprofessional to call out on a holday, I wonder if hospitals have the holiday call out problem too? Maybe a sign of poor caliber worker so prevalent in LTC, any warm body will do.....

I have never called out on a holiday. However, my facility does not provide any incentives for working on holidays, such as "holiday pay" or bonuses. When I work holidays, I am paid at the straight-time, regular hourly rate as if it is just another day. I do not even receive time-and-a-half on holidays.

While it is detrimental to call out on holidays, I would say that my workplace does not provide enough incentives to get people into work on these days.

CapeCodMermaid, RN · Jan 4, 2008

Our employees get holiday pay which is a huge incentive...on the major holidays they make double time and a half....work for 8, get paid for 20. Here's the catch...if you call out the day before or the day after the holiday, you don't get paid for the holiday whether or not you work it.

IowaKaren · Jan 7, 2008

We used to have incentive for Holiday pay but that is now gone since my facility has gone to PTO pay. The RN's have had PTO for quite some time but LPN's and CMA/CNA's were unionized and got the 1.5 x pay for holiday with stipulation of working scheduled day before and after to receive the pay, then we RN's had the same incentive for holiday pay. Now that the CNA's/CMA's (LPN's will be starting PTO this year when new union contract is due) are using PTO, all the incentive is gone. The holidays are difficult to staff as it is but call outs make it crazy. It seems there should be more incentive to work the holidays but without the bonus, the residents suffer and the ones that do come in are pushed so hard by resident/families and the customer service motto. Just makes no sense not to have incentive to come in over the holidays. The upper management (not necessarily nursing management) just don't have a clue since they have all holidays off anyway.

TheCommuter, BSN, RN · Jan 7, 2008

We used to have incentive for Holiday pay but that is now gone since my facility has gone to PTO pay.

My workplace has abolished holiday pay and vacation pay altogether, and has gone to PTO pay. If you want to be paid to work on a holiday, you must dip into your accumulated PTO time. If you want a paid vacation, you must dip into your PTO time. That way, your PTO hours never accumulate, which is precisely what management wants.

lil' girl, LPN · Jan 8, 2008

mmm...... we get paid time and a half for "working" the holiday, but if we are "off" on the said holiday and want to get paid for it then we too have to use at PTO day. However we accumulate hours pretty fast: less than six months 2.54 hrs per pay day, six months to 5 years 6.77 hrs per pay day (per 80 hours I should say) so that works out to 22 days a year. Not bad, but with help being so short you need everyone of em!

I see a pattern here, guess that is why it IS so HARD to get help at LTC.

Thanks for all the great responses!

lil'girl