Agency Use? How Much & Staffing Solutions

Specialties LTC Directors

Published

Hi All,

I know Per Diem Staffing Agency use is sometimes a necessary evil. I'm looking to start a thread on the utilization and solutions.

If you could chime in, I think this could help out other like Minded DONs.

1.) What City/State are you based out of?

2.) # Beds in your Facility

3.) Number of shifts per week covered by Agency

a.) Before staffing solution

b.) After Staffing Solution

4.) Unique staffing solution that has helped reduced the usage of Agency (example, new grad orientation, internal float pool, scheduling system, etc..)

Specializes in Gerontology, Med surg, Home Health.

I'm not going to answer your questions one by one, but around here, no one uses agency. Facilities fill the holes in the schedule with managers and 'anyone in the building who has a license is expected to work at least 2 shifts a week on the cart'. It's an impossible situation. No staff so management has to take over. The managers don't get their jobs done so corporate complains. The MDS nurse can't do her MDSs on time because she's on a cart for 16 of her 40 hours. It's ridiculous. At one facility I was recently at, they thought they'd solve part of the staffing crisis by getting rid of the nurse manager positions and putting them on carts.

Specializes in LTC, Hospice, Case Management.

As CCM said. Around here, the term agency nurse is taboo - it's just not going to happen. I'll be working Saturday 2-10 to cover a hole in the schedule. Of course this is after working my own 40+ hour position and as a salaried DON, I get the pleasure of working it for free.

We just started using agency to supplement our CNA staffing. We are a small facility with 50 beds. Some days it is up to 3 agency CNAs we are using. Our pay rate is horrible and the benefits stink. It is hard to attract staff. It won't change either. The CNAs are unionized. The staff that has been there for a while get nice $$, but in the contract the starting rate is what it is.

So, with new management, they have weeded out some of the CNAs leaving a huge gap, hence the use of agency staff. We are about two months in and I see the company shutting this down real soon. We've currently hirred 6 new CNAs... I think 3 might make it pas tthe one month mark.

Solution....that is the million dollar question! I've been suggestion recruiting new CNAs or restarting a CNA training program. CNAs with zero experience don't demand high pay rates. If we can train them and retain them for over a year, that would be a huge step.

As far as nurses....we have a large amount of part timers and some LPNs that love OT, so we've been lucky. RNs are a bit tighter, but out managers rarely have to work the cart and if so, it is just the unit manager.

I work for agency and they send me to nursing homes.

One time I was on a floor with two agency CNAs because nobody on the regular staff wanted to change their usual assignment.

Well, it was all fun and games until one of the patients started projectile vomiting frank blood (it had nothing to do with the care she'd received from us, it was an underlying morbidity).

Last I heard, they don't staff a floor with just agency anymore.

Best of luck!

On 10/26/2017 at 6:55 AM, CapeCodMermaid said:

I'm not going to answer your questions one by one, but around here, no one uses agency. Facilities fill the holes in the schedule with managers and 'anyone in the building who has a license is expected to work at least 2 shifts a week on the cart'. It's an impossible situation. No staff so management has to take over. The managers don't get their jobs done so corporate complains. The MDS nurse can't do her MDSs on time because she's on a cart for 16 of her 40 hours. It's ridiculous. At one facility I was recently at, they thought they'd solve part of the staffing crisis by getting rid of the nurse manager positions and putting them on carts.

Holy crap that's horrible! We blow our budget EVERY month because we use agency, but until I can hire more staff it's a necessary evil.

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