Minimum Staffing Laws

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Specializes in LTC, Cardiac Step-Down.

I need opinions on a practice currently being employed at the nursing home I work at.

I work the evening shift (2p-10p). Many times, night shift will not show up until midnight or later due to most of them working evening shift at another nursing home owned by the same company, then coming to this different nursing home for the night shift the same night.

This leaves the nursing home grossly understaffed for about two hours. Apparently, by Oklahoma laws, my particular nursing home must have 5 patient care people in the facility during the night shift. Most nights, this isn't happening at 10p when it's time for me to be off. What the nurses have said is that some of us evening shift people HAVE to stay until night shift gets there since it would be illegal for them to not have enough staff.

Do I have to stay in this instance? Can they take my certification if I don't?

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Specializes in LTC.

It depends on state law, but I know that in my state mandatory overtime is legal and used. If you are reported to the state I'm sure they could pull your certificate, but I'm not sure they would and I'm not sure that the facility would report you. You can however lose your job.

Are these people coming late being written up as tardy? I would bring this up in a meeting simply put. "I've noticed that PM shift is expected to stay a lot of times into the noc shift. This is really hard on us. We all have families and have other things going on such as school and second jobs. What is the policy on call-ins and tardyness and why does it not seem that it's being implemented."

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In most states they will consider it abandament or neglect and two yes you could lose you cna. but than how could a facility like that get away with that thro? i suggest you do you're darnest to cover your butt. fine out the state laws. isn't it osha or hippa?

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I would def. find out what your state laws are, however, I am not sure how to do this. How large (pts) is your building? I work in a large LTC Corporation with several sister companies. If we work at one, we are expected to let find our own coverage at the other building until we get there. If not you will be tardy and could result in termination. If reported for negect, say by another employee or family member if they overheard talk, you could lose your certification. I pull doubles all the time and I try to hurry to get paid for the hours. I would find out what the max. amount of pts u can take care of. I work on a skilled unit and we avg 18 pts and max 25 pts. Hope this helps

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Specializes in LTC, Cardiac Step-Down.

No, these individuals are not counted as tardy. Those with the authority to discipline these people believe that a little lateness can be understood, because they get off at 10p just like me and then have to travel. That's not a big deal to me - I stay till 10:30 anyway to make up for my lunch - but somehow these people are taking 2 hours to drive the 15 miles down the freeway to my facility. THAT makes me feel like I'm being taking advantage of - apparently it's thought that I am the person that they're supposed to get to cover them :angryfire

The thing is, I can see where the DON's hands are tied because if she gets rid of these people and/or counts them as tardy because of all this, she won't have anyone at all to work night shift, and then where would we be? All but a couple of the night shift workers come from this other facility. This is why a blind eye is turned toward all this. Questionable management aside, these are good CNAs, very hard working (obviously to pull doubles regularly, ouch!) and we frankly need them. I just need them at 10:30, not 0000.

Another thing that occurred to me about all this is that adequate staffing is NOT my responsibility as an aide. Therefore, if the facility is not adequately staffed at night, how can I, as an aide, possibly be liable?

To answer previous questions:

Checked the OSHA website putting in every keyword I can think of, but still came up with nothing. I was thinking, since this facility is regulated by the "state", maybe I could find something there on possible consequences of my not staying over to make the legal minimum. Trouble is, I don't know the actual entity that does the regulation. All anyone ever refers to it as is "state".

I don't think HIPPA would help me - that's mainly concerned with privacy and such, not staffing or actual regulation of personnel, as I understand it.

My facility is ~75 beds.

I want to stay employed at this facility because a lot of the aides are such good role models for me (in everything but punctuality....) and I love my residents. But these 10-hour days kill me and I do feel seriously taken advantage of.

Thanks for the input so far guys, I really appreciate it!

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I have worked at facilities that have the exact same issue. As a noc nurse, I wouldn't let evening CNAs leave without the noc ones came in. In most places it

turned out that there was an 'understanding' between the noc cnas and the noc nurses. Nobody ever got written up.

In your situation it sounds like you are bearing the weight of this problem. Why are you the one being left behind? What about the other aides? there should be something similar to a pull book where if you stay behind today, tomorrow someone else stays. Make sure this is done with the DON (or unit manager) and the staffing coordinator so that no one can start backing out.

Also, like a poster above said, bring up this issue in the meetings. It should not be acceptable for noc staff to show up at 2400 esp. without a heads up!

Ofcourse, you could volunteer to stay over each noc till 2400 for a bonus..$25/day sound good??

Another idea is to have one Cna that is willing to have their shift from 1600-2400 and that solves the issue completely.

These are just some of the solutions I have used as a noc nurse dealing with this particular issue. I hope you find an agreeable solution.

Good Luck

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Specializes in LTC.
Another thing that occurred to me about all this is that adequate staffing is NOT my responsibility as an aide. Therefore, if the facility is not adequately staffed at night, how can I, as an aide, possibly be liable?

Unfortunately until you hand over your assignment to the oncoming aide, you are responsible for those residents. So up and leaving th residents without an aide to care for them would be considered neglect. If they will continue being flexible for the night shift start insisting that overtime be rotated among the aides.

I don't think your DONs hands are tied with these CNAs, it sounds like she may just not want to go through the hassel of hiring new night shifters as that's the hardest shift to hire for. Also take into account that just because a person works doubles all the time doesn't insure that they are good. I've worked with several excellent aides that work a lot of doubles, but I've also worked with those that are so exhausted from their previous job that they can't stay awake through the night. With those aides it's better to work short than have an extra snoring body added to the facility.

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Specializes in ER.

The supervisor's solution could be to stagger the shift change times of the two facilities, with an hour's difference they could make the commute.

Your solution is to put in writing that you have agreed to work from x to x time as per the written schedule, and cannot stay later. When the time comes be nice and stay the extra 30 minutes but then you are outta there. They may fire you, but with the written communication between you and your boss, and no fixin' done on their part, I believe your certification will be safe as houses.

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Specializes in LTC, Cardiac Step-Down.

It's not only me getting left behind - it's kind of an unofficial rule among us evening workers that we pull our share of this late stuff. But none of us like it and are trying to figure out a way to avoid it.

Your suggestions have all been fantastic! Based on them, here's my current plan of action:

1. Schedule a meeting with DON and ADON about this.

2. Draw attention to the problem, and suggest the solutions I've gotten here, namely staggering shifts at the two facilities, having a couple CNAs work 1600 to 2400, and bonuses for those that stay until night shift comes in.

3. Provide written notice that I will not be able to stay late any more.

Thanks so much for the good advice :)

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