Nursing Home Safe Staffing

Rustyhammer · Jul 23, 2001

Sooo...

what exactly does New York consider "safe staffing"?

and is this for nursing homes? Hospitals? what?

I'm interested in what New Yorks standards are.

-jt · Jul 23, 2001

see the title?

Nursing Home Safe Staffing

Nursing Home Safe Staffing Bill Passes in NY!

"State Nurses Association Hails Assembly Passage

of Nursing Home Staffing Bill

".......These levels are consistent with recommendations by the Nursing Home Community Coalition........"

for the text of the Bill's Staffing standards, based on the Nursing Home Community Coalitions recommendations, see: http://leginfo.state.ny.us:82/menugetf.cgi

Type in S2185

The NY staffing bill addressing safe staffing in hospitals is a different bill & is also presently under consideration in the legislature.

Mijourney · Jul 23, 2001

Hi -jt. This NY bill is but one step addressing the issue of severe staffing shortages in LTC. In my opinion, LTC needs to be reformed. First, there needs to be a change in attitudes toward seniors. It's not a surprise, but a disgrace the way our seniors in the states are frequently treated. It's sad but our current LTC system in the U.S. shows what we think about our seniors.

catlady, BSN, RN · Jul 23, 2001

mtjourney, do you actually *work* in LTC? Those of us in long-term care might beg to differ with your assessment. We work long and hard trying to improve the quality of life for our residents, and for our troubles, we get the state on our backs 24/7--not that they actually care about the residents, but we'd better have all the i's dotted and t's crossed or there's you-know-what to pay. If we identify a problem and correct it, we're cited for having the problem in the first place. The regulatory demands are incredible, and very few of them do anything to help the residents. The government operates from the assumption that we're all out to abuse the residents, and everything evolves from that assumption.

I'd say more but I have to leave for work now and abuse a few seniors. I think our "current LTC system in the U.S. shows what we think about our" *nurses*!!!

Mijourney · Jul 23, 2001

Originally posted by catlady
mtjourney, do you actually *work* in LTC? Those of us in long-term care might beg to differ with your assessment. We work long and hard trying to improve the quality of life for our residents, and for our troubles, we get the state on our backs 24/7--not that they actually care about the residents, but we'd better have all the i's dotted and t's crossed or there's you-know-what to pay. If we identify a problem and correct it, we're cited for having the problem in the first place. The regulatory demands are incredible, and very few of them do anything to help the residents. The government operates from the assumption that we're all out to abuse the residents, and everything evolves from that assumption.

I'd say more but I have to leave for work now and abuse a few seniors. I think our "current LTC system in the U.S. shows what we think about our" *nurses*!!!

Hi catlady. I don't believe I directed my generalized comments towards any professional or personal caregivers. But, since you brought it up, I must say that I've had enough experiences volunteering with helping family members and others confined to LTC facilities to safely say that in my neck of the woods, LTC facilities are looked upon as a last resort for our seniors to reside in. Many seniors including those in my family prefer the comfort of their own home. As a home health nurse, I work with the family to the greatest extent possible to keep their loved ones out of LTC. Why? Because the funding has never been there for the many caring nurses such as yourself, techs, and nursing assistants to do a truly consistent good job.

Catlady, you must admit and you do imply in your post that LTC has not received its due in terms of funding and positive support from private industry and government. This has resulted, at least in my neck of the woods, in the hiring of unqualified staff. I know a hand full of distant acquaintances where I live that have been hired and fired from many of the nursing homes in the area. Why? Because, they get minimum pay for the job they are expected to do, are overworked, undertrained, and are overburdened with rules and regs as you indicated. Where does the money for LTC go? To top heavy paper pushing corporate staff.

I'm sorry that you felt it necessary to take offense at my post. My post was not intended to offend, but the touchiness that many of us exhibit, including yours truly, is indicative of the sad shape that the health care system is in. Even in home health we are in a crisis. Instead of taking offense with my post, I encourage those like you who deeply care about what you do to do what you can to stand up for you and your patients in LTC. Whether you like it or not, LTC does have an image problem in the public's view.

catlady, BSN, RN · Jul 24, 2001

I wasn't offended at you personally. It's just a common, generalized assumption that nursing homes are pits, and that we're a bunch of sadists who get our jollies abusing old people. I recognize that there are some places you wouldn't put your dog, but most of us really *are* trying very hard. One of my CNAs was punched today because she tried to help toilet a resident. Another new resident, who is alert and oriented, does nothing but yell profanities into the hall if his light isn't answered within ten seconds. In the past week, I've had family members screaming vile personal insults at myself and my DNS because we don't want to restrain their loved one and they want her tied to a chair. Then they called the state on us. Now these same family members are urging other resident families to call the state if we don't agree with their demands. I certainly respect the input of the family members, but we *are* the trained staff, and they did put their family there for us to provide care. Nobody went to the robot school of nursing. We should be able to use our judgment.

There is so much paperwork that the government requires that most of the licensed staff, myself included (I am a unit manager), has very little time for direct patient care. I do MDS/PPS and it's a nightmare, as anyone who's done it can tell you. And instead of trying to help us, or collaborate with us, or educate us, the government--both state and federal--has set itself up as our adversary. They're going to protect the public from the big bad nursing homes by squashing the workers like bugs. I for one would welcome a survey, if it meant the state was going to use its resources to help us become a better facility. But it never means that. It always means they're going to come in and pick our nits and throw their weight around and prove to the public that they're the only thing standing between Grandma and elder abuse.

No, there aren't enough CNAs, and sometimes we have to tolerate CNAs we'd prefer not to have around. But it isn't exactly a field that attracts the best and the brightest, is it? For that matter, licensed nursing is getting to be the same way. Nobody who's really sharp would consider this career field any more.

It amazes me that the same public who has money for vacations and clothes and SUVs is the same public who expects health care to be free, and is surprised when it gets what it pays for.

maryb · Jul 24, 2001

To get back to improving ratios, if the "counting" occurs as it has in my experience, then the ratios are worthless.

It has been my experience that nurses who do ONLY MDS or Medicare (absolutely no direct patient care) get counted when the state comes in and checks on staffing. So, facility A gets credit for having 6 RNs on day shift (the nurse manager is counted also) when in fact there is ONE RN performing patient care.

But, the web sites that distribute information about nursing homes say 6.

In my opinion, these ratios should apply only to those staff members providing direct patient care.

grandmanurse1 · Aug 3, 2001

I am a unit manager in a long term care facility. I consider myself an excellent nurse. I have never tried working anywhere else, because I LOVE MY JOB and I LOVE MY RESIDENTS. Many times we are faced with working with less than optimal staffing (usually because we can't find the staff to work) and always too much paperwork. And yes, we do have the threat of the state survey team looking over our shoulders...but I can honestly say that anytime we have been cited, we deserved it (or else we IDR the cite and won). They made us do a plan of correction and stick to it. Sometimes they make corporate sit up and pay attention to what we need. I also live in Florida (the lawsuit capital of the country) who has recently passed new legislation to cap lawsuits and to provide for increased staffing. Things are bad...but they are improving...

P_RN, ADN, RN · Aug 4, 2001

Whoa....halt...haven't we JUST finished a similar thread?

https://allnurses.com/forums/showthread.php?s=&threadid=2007&highlight=nursing+home

I think we're killing the messenger here. NY faced up to staffing levels in LTC. That is a good thing. Lot's of places haven't touched that issue yet.

-jt · Aug 4, 2001

Only because the New York State Nurses Association insisted on it!

-jt · Aug 4, 2001

I dont know how its done in other states, but if you look at the text of the safe LTC staffing bill from NY (that nurses & the NYSNA wrote), you'll see that it deliniates the who & how many for each category of nurse & healthcare worker. The nursing supervisors, director of nursing, assistant directors of nursing are listed separately with staffing rules that will apply to them too - apart from the direct-care staffing. So they can not be counted as the RNs providing care when the question comes up "so-how-many-on-staff-tonight?"