Bad Facility Or Am I Crazy?

[OpinionatedCNA, CNA]

Okay to start off, I like being employed but every day I'm there feels like I'm walking on eggshells because there's not enough CNAs to go around and some resident always ends up getting shafted and not recieving proper care. Like today I felt bad because I couldn't perform enough incontinence care on my residents and the first time I had the chance to check on him he had soaked through his diaper to the sheets. I don't know what I can do if I'm already constantly busy and still can't finish, I already work pretty fast now that I'm used to the job.

Also lately there have been red flags that I don't know if they've always been there or if I just noticed now I've gotten settled into my first job as a CNA but one of our nurses quit because he said he didn't want to lose his license working here, and I've worked with him and he's a pretty good nurse not perfect but reliable and he wants what's best for the residents. I've talked to some of the other nurses working now and they all said they are planning on leaving asap, most are LPN's staying until they finish their RN schooling and then they're gone.

A few weeks ago our DON changed the staffing on the floor which I hoped would help but I don't think it is. She is supposibly trying to add more nurses to the floor and they are supposed to help CNAs with getting people up and 2+ assist people, so there won't need to be as much CNAs, but the only thing that has happened is that there is less CNAs and NO additional nurses. So the nurses are understaffed because they were always understaffed even before this change and now the CNAs are understaffed too.

I just don't want to get caught up in the crossfire of being fired or having my license taken away because I literally can't care for all these residents and being accused of neglect. I just am kind of unsure because looking at what people say online, the number of residests I have doesn't seem to be too much. I had around 8 residents before the "staffing change" and today I would have had 12 if there were no open beds and I can just barely take care of 8 residents, not 12 at all!

To elaborate today there was for 40ish residents dayshift, 2 nurses and 4 CNAs. Before the staff change there was 5-6 CNAs and the same number of nurses. This is a skilled care/rehab floor so we have anywhere between total care residents and just small care, but almost all of the residents are dependant and need help with transferring and going to the bathroom. Also there are a few random dementia patients on our floor (instead of being in the dementia unit the facility has) who really need constant supervision or they will wander and fall.

Anyway I guess I will stick around for a few more weeks at the least because today was the first I've seen of the new staff change and maybe it's not always this much of a disaster but if it is I'm out of here. I'm just scared that if I quit working here I'm going to go to another LTC facility and it's going to be just as bad or worse. Especially I hear online about CNAs having 20+ patients on day shift which can't be possible! Right?

I would appreciate anyone's opinions because I need some, this is my first job as a CNA and is this the norm or is my facility just going down the *******?

[Hygiene Queen]

It's been awhile since you posted. How are you doing now?

Your staff-to-resident ratios sound decent and were similar to when I was an aide, however, 12 residents was pushing it and 8-10 was the norm. Your ratios sound decent.

Things can also depend on how your fellow CNA's help each other out. I worked with a great team who would help out with other aide's teams and then we would return the favor. We just worked very well together and made sure the residents got what they needed. You sound like you care very much and maybe if your coworkers care as much as you, you can find a way to make things work for the best, by really working together.

Not all nursing homes are created equal. I have seen shoddy "care" and grossly large resident assignments. It's crappy you're getting 12, but I have seen larger and it's criminal. You may not find better staffing elsewhere. I stayed at my nursing home 11 years because no place had better staffing, teamwork or care... even if we ended up with a load of 12 from time-to-time.

However, beware. I have found that once TPTB increase the load and see that their staff manages to do more with less, the trend often continues. Never happened at my happy little nursing home, but I've seen it elsewhere. If that appears to be the trend, then by all means, see what else is out there.

Take care.

[Missingyou, CNA]

I completely agree with "hygiene queen"!

Your ratios sound reasonable but, it all depends if you have a good team of CNA's!! If you can all work together, then 10-12 is manageable.

It's NOT reasonable for the facility to count on the nurses to assist the CNA's with 2 assists etc. If that's the plan, I can tell you without even knowing your facility that it won't work. The nurses have their own work to do. While some will help when they can, it's not something we as CNAs or the facility should depend on. This is probably the reason that one nurse you mentioned (and probably the others) plan to quit asap. It is just too much responsibility on the nurses. (I'm a CNA btw).