We are having a few staffing issues, so I thought I would ask how CNA staffing is done elsewhere. Each floor/unit in my facility is different ... almost seems that when I go to another area I could be in a different LTC facility.
Who decides which residents are assigned to each CNA?
Does the CNA have residents in the same room, nearby rooms or anywhere on the floor?
Does a CNA have the same residents every day?
Do the CNAs rotate assignments?
When another floor is short staffed, who floats to the other floor/unit? Does someone volunteer? Is there a float list? Does everyone have to float? Can a CNA refuse to float? Does the floater get extra pay?
Does each CNA have a clean and soiled laundry cart?
Sep 5, '06
I worked as an aide and I like the way this particular LTC functioned. The assignments starts with the daily schedule posted. Under the wing was the nurse, than the CNA's by numbers. Each of those numbers represents a list at the wing, and the schedule breaks, and other assignments like call light duty during meal time.
Let me give you an example of this 3-11 schedule.
1st floor would consist of two units, 64 residents (32 to one unit), 2 nurses and 6 aides. On the daily schedule we would have Wing one: #1...CNA....#2..........#3......... wing two:#4......#5......#6..........
So when they clock in they would see what # their name is on which represents the list assignment.
First break # 1 and #4 , 15 minutes later # 2 and #5 go on break, 15 minutes later # 3 and # 6 go on break. by the time it's #3 and #6 it's already a 30 minute break they should be relieved by #1 and #4.
Looking at the list assignments, we may have 2 rooms and both resident assigned. The reason we have the rest in different rooms is because it's better to have two different aides go into the room verses one it gives a second set of eyes to a neat room.
So, when we're short staff 1 CNA, it would be 2 and 2, and a float (5 CNA's)
Two of the strongest CNA that can connect and work as a team work together. We have a float list which consist of 5 residents from one side (wing 1) and 5 residents on wing 2 (same floor) We ususally give the resident who are considered more needy or time consumers to the float list. Sounds like a horrible list but it's not because you have to think about the other two who have about 27 residents to worry about. By giving the float list the time consuming resident enables the two other staff members to focus on the unit and the remaining residents.
If we're short staff with two call outs which leaves 4 CNA's to 64 residents which does happen....we staff 2 and 2, again the two CNA's that can work together. And there is no list they decide amongst themselve who they do, it works provided with encouragement that they work as a team. And if they're knowned as individuals who don't work together then it's one CNA per hallway which is 16 residents.
As for who creates these assignments, we create them by room #'s and bed(a or b). Empty bed? lucky for that aide, new admission it's already on the list. We're able to do it like that because the census is always full with a waiting list. But one thing about working short is that nobody is allowed to sit and chart until ALL CNA's are done providing HS care because everybody's list is different, one may have an easier and the other may have it hard. If for whatever reason a list becomes difficult or overwhelming, then adjustment is made by the charge nurse with the CNA's input because only they know by heart of what is reasonable, just like a nurse would know what unit is difficult to work as a nurse....
My recent job as a nursing supervisor, I tried to add this but it couldn't be done, staff CNA's were under paid, so we were under staff to begin with. Agency Staffing hired on a daily basis, census was never full. It was constant adjustments.
As for rotating staff members, we usually keep our full time employee's on a certain list but probably once a week or maybe even twice we rotate the list, and for the most part keep them in a certain unit.
Last edit by mandykal on Sep 12, '06