How Long-Term Care Facilities Can Reduce Staff Burnout

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by Susan Sears RN BSN Susan Sears RN BSN, BSN, RN

Specializes in Rehabilitation Nurse, LTC Manager, Freelancer. Has 17 years experience.

Long-Term Care staff have been overworked, undervalued, and burnt out since long before COVID-19 hit. Staff burnout causes staff turnover and affects a Long-Term Care (LTC) facility's finance, operations, and quality of care provided to residents. Learn ways to prevent staff burnout in your facility.

Retaining Staff in Long-Term Care

How Long-Term Care Facilities Can Reduce Staff Burnout

Nurses and Direct care workers (DCW), such as certified nursing assistants (CNA) or nursing assistance (NA), provide most care in a long-term care facility. They regularly assist the patients with medication administration, wound care, toileting, bathing, dressing, feeding, and grooming. Next to the residents, they are the heart of the LTC facility. Nursing and Direct Care workers are the areas of most concern with staff burnout. 

According to one study from 2008, nursing staff turnover ranges from 45% to 100%, costing the LTC industry nearly 4.1 billion dollars per year. This was pre-pandemic; now, the turnover rates are even more challenging as healthcare workers leave for similar or increased paying jobs in lower-stress environments.

As an LTC manager, I understand the difficulties of employee burnout and the problem in the retention of skilled nursing employees. Utilizing workforce software can aid in tracking reasons people leave your LTC facility and the daily operations and assist you in improving staff retention by analyzing the real-time data that a LTC workforce software provides.

How Can Employers Reduce Staff Burnout?

There are several ways to reduce staff burnout; some suggestions are: 

Reducing Job-related Stressors through Hiring and Training

  1. Orientations – An individual that receives adequate training during orientation will tend not to struggle as much as someone who is inadequately trained during orientation. So, providing questions to see if the new employee has been given adequate training before working alone can be answered by both the new employee and the mentor. Time should be added to orientation to train the new staff member adequately.
  2. Continued education – Providing ongoing education in areas such as workplace violence or equality can equip employees to handle situations that can lead to staff burnout. Time spent in training staff can be tracked through a LTC workforce software. 
  3.  Age – Research shows that a person's expectations and personal priorities change with age, and older nurses and DCWs show greater job satisfaction and commitment. Therefore, keeping staff as they age or hiring older staff can reduce turnover. 

A workforce software program will track ages, preferences in shifts, continuing education hours, and hours worked. The software makes it easy to know just who you have working for your facility and where they are at in their training received.

Improved Staff Satisfaction Through Wages

  1.  Competitive Wages - Wages among higher-paid employees such as physical therapists, occupational therapists, or nurses do not tend to be why the employee leaves an LTC facility. Still, with DCW, it directly correlates with their decision to seek competitive wages in a reduced stress environment such as retail.
  2.  Providing a competitive wage provides satisfaction and a positive intrinsic satisfaction within LTC staff, directly correlating with improved care provided to residents.
  3. Competitive wages should Include sick pay and paid holiday incentives; these programs can easily be managed in workforce software.
  4.  Offering retirement plans increases satisfaction and longevity as employees work to improve the plan's value.
  5.   Self-scheduling – Many DCW employees are single parents and are attempting to juggle life/work responsibilities; allowing the ability to schedule around family needs provides a work/life balance. Self-scheduling is a key in LTC workforce scheduling software. Being able to self-schedule and manage schedules with a smartphone increases employee satisfaction.

Utilizing your workforce software can reduce time spent on scheduling and payroll. It easily keeps track of each employee's hours worked. It also shows real-time data revealing if you are going into overtime with particular employees. 

Reducing Staff Frustration

  1.  Reward systems – Providing clear role expectations and giving recognition to employees who regularly do a great job or go above and beyond regular duties.
  2. Difficult patients – Having a no-tolerance policy on patients that are abusive toward staff can reduce frustration and help an employee feel respected in their role as a caregiver. 
  3. Employee assistance programs - provide programs for exercise, health screening, or smoking cessation. Exercise and wellness promote a healthy lifestyle and reduce frustration for an employee. 
  4. Opportunities for advancement – This reduces staff frustration by allowing for goals for the employee to attain that will provide promotion in position.
  5. Staffing appropriately can be completed by utilizing workforce software to account for actual staff needed in each role. With adequate staffing, frustration is decreased, and caregivers can provide the necessary attention to each LTC resident.

Staff that is frustrated in their roles, whether through lack of respect, poor health, or lack of purpose, tend to provide a lower quality of care to their patients due to their frustration. By offering ways to increase a sense of purpose, frustration is decreased.

A workforce software is a great way to track the changes needed to reduce staff burnout and retain staff in a LTC facility. It gives you real-time data on why the team members call in or quit. It also provides an easy, accurate way to track hiring, training, payroll, and other essential needs to make your LTC facility successful.


References

Eleanor Feldman Barbara, P. (2014, July 10). Preventing burnout in long-term care. Retrieved from McKnights Long-Term Care News

Farida K. Ejaz, PhD, Linda S. Noelker, PhD, Heather L. Menne, PhD, Joshua G. Bagaka's, PhD, . (2008, July 1). The Impact of Stress and Support on Direct Care Workers' Job Satisfaction. Retrieved from The Gerontologist

Frederic H. Decker, PhD, Lauren D. Harris-Kojetin, PhD, Anita Bercovitz, PhD,. (2009, June 9). Intrinsic Job Satisfaction, Overall Satisfaction, and Intention to Leave the Job Among Nursing Assistants in Nursing Homes. Retrieved from The Gerontologist

Snap Schedule Employee Software. (2020, November 20). How Automating Employee Scheduling Can Increase Employee Satisfaction. Retrieved from Snap Schedule Employee Software

Susan Sears RN, BSN, CRRN has served as a nurse for over 15 years. Many of which were spent in the LTC setting.

3 Articles   11 Posts

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4 Comment(s)

No Stars In My Eyes

Specializes in Med nurse in med-surg., float, HH, and PDN. Has 43 years experience. 2,820 Posts

If "Adequate Staffing" is judged with current methods, it isn't adequate. I may be old-fashioned, but going back to Team Nursing would a plus. We had a Desk Clerk, the Charge Nurse, a Med nurse (or two depending on the size of the floor and # patients per hall), and two techs (per hall) who share a patient assignment and do the personal care for a reasonable number and mix of patients. 

I remember when Team Nursing was being trounced as being less effective than Primary Nursing. If you would read the book (and I am truly sorry not to be able to tell you the title and author) that first presented Primary Nursing as being far superior ... it actually was, EXCEPT then facilities started tweaking this and that, and before you knew it, it wasn't true primary nursing.

Overloading nurses is dangerous; multi-tasking can be dangerous and stressful. 

Long-Term Care, to me, has been like factory-line work, or ware-housing. Hurry up, you have to get all this done in X # minutes, and before you know it, times up! I don't think it can be all blamed on time management. 

To me, what is being left out, and shame on facilities for this, is the human factor, of both caregivers and patients. Once the world of Medicine became a BIG BUSINESS, it lost the human factor.

 

kbrn2002, ADN, RN

Specializes in Geriatrics, Dialysis. Has 20 years experience. 3,572 Posts

Well this was certainly written by somebody with zero bedside experience in LTC.  How exactly would selling probably very expensive "workflow software" magically reduce staff turnover? 

Some of the suggestions are quite laughable actually.  For instance, the idea of offering continuing education as an incentive to reduce turnover? Pretty much everyplace already has required annual learning which eats into the employees time, time they'd much rather spend doing something else. Offering even more on the clock training, taking time away from completing work that there's already not enough time in the day to finish won't do anything to reduce staff turnover. 

Oh, and hire older workers? Sheesh, is that suggestion really meant seriously? 

How about employers use the money they would be spending on this workflow software and invest it in the staff instead? The obvious solution to reducing staff turnover is simply providing a job people don't feel the need to leave. This is done by offering pay commensurate with the job responsibilities and work load and providing adequate staffing.  No workflow software is going to accomplish that. 

Susan Sears RN BSN, BSN, RN

Specializes in Rehabilitation Nurse, LTC Manager, Freelancer. Has 17 years experience. 3 Articles; 11 Posts

On 5/6/2022 at 8:05 PM, No Stars In My Eyes said:

If "Adequate Staffing" is judged with current methods, it isn't adequate. I may be old-fashioned, but going back to Team Nursing would a plus. We had a Desk Clerk, the Charge Nurse, a Med nurse (or two depending on the size of the floor and # patients per hall), and two techs (per hall) who share a patient assignment and do the personal care for a reasonable number and mix of patients. 

I remember when Team Nursing was being trounced as being less effective than Primary Nursing. If you would read the book (and I am truly sorry not to be able to tell you the title and author) that first presented Primary Nursing as being far superior ... it actually was, EXCEPT then facilities started tweaking this and that, and before you knew it, it wasn't true primary nursing.

Overloading nurses is dangerous; multi-tasking can be dangerous and stressful. 

Long-Term Care, to me, has been like factory-line work, or ware-housing. Hurry up, you have to get all this done in X # minutes, and before you know it, times up! I don't think it can be all blamed on time management. 

To me, what is being left out, and shame on facilities for this, is the human factor, of both caregivers and patients. Once the world of Medicine became a BIG BUSINESS, it lost the human factor.

I totally agree with the team approach - In fact the current facility I work at is restarting a team approach where each team will consist of an RN, LPN, and two Nurse techs or CNAs. I have to admit I am excited about this revolutionary new "Team approach" being utilized. The old is returning - something that should have never left. 

 

Susan Sears RN BSN, BSN, RN

Specializes in Rehabilitation Nurse, LTC Manager, Freelancer. Has 17 years experience. 3 Articles; 11 Posts

On 5/12/2022 at 11:22 AM, kbrn2002 said:

Well this was certainly written by somebody with zero bedside experience in LTC.  How exactly would selling probably very expensive "workflow software" magically reduce staff turnover? 

Some of the suggestions are quite laughable actually.  For instance, the idea of offering continuing education as an incentive to reduce turnover? Pretty much everyplace already has required annual learning which eats into the employees time, time they'd much rather spend doing something else. Offering even more on the clock training, taking time away from completing work that there's already not enough time in the day to finish won't do anything to reduce staff turnover. 

Oh, and hire older workers? Sheesh, is that suggestion really meant seriously? 

How about employers use the money they would be spending on this workflow software and invest it in the staff instead? The obvious solution to reducing staff turnover is simply providing a job people don't feel the need to leave. This is done by offering pay commensurate with the job responsibilities and work load and providing adequate staffing.  No workflow software is going to accomplish that. 

I am not sure about no bedside experience if this qualifies as no bedside experience...8 plus years on the floor in sub-acute care and LTC as a floor nurse. Then another five-plus managing the unit. I feel I have a pretty good idea of how both worked. Utilizing workforce software to assist in the management role made it easier for me to recognize gaps and fill them, track orientations, and ensure my employees were adequately trained. Yes, that meant continued education. Though, isn't that something that nurses are always doing, learning? In my case easing the back office made me have time to go to the floor and assist my nurses; it also stopped things like someone slathering Silvadene cream and allowed me to train on the moment - yes, that continuing education thing again. There were many ideas you did not notice or note, like competitive wages and self-scheduling, or were they not appealing either? As for the older nurses, well, I guess I qualify as that, and in my case, the idea of jumping ship is no longer appealing. So I am working as a "floor nurse or bedside nurse for the long haul. Interestingly enough, as I continue working as a nurse and learning, data shows that older nurses don't change jobs as often as younger nurses.