New Director of Clinical Services struggling with staffing issues

systoly · Feb 12, 2009

I have questions. Who takes the call ins? Are you salaried or are you getting paid for overtime? Do you have responsibilities only or did the position come with authority? Bottom line: This is a crisis caused by others - why would you contemplate quitting a position you love?

caliotter3 · Feb 12, 2009

I've never worked in a facility where the DON or ADON came in to cover. We just had to work short. You really need to get proactive in finding someone who is willing to cover for call-ins or get an agency involved. It sounds like you won't be able to do this for very long without damaging your own health. There has got to be somebody out there who could use some shifts. Approach your present staff. Ask them if they have any friends who are available. In most places I've worked, staff was procured through the networking of the staff that was already there. Good luck with this.

achot chavi · Feb 12, 2009

While I'm not sure why you would agree to management after only 10 months, I am sure you know what you are doing. With all my call ins I have never had to cover a shift or shifts as you have, You are doing something wrong and I would fix it immediately - How can you be expected to do your job if you are busy doing other peoples jobs.

I would also ask why are there so many call ins.

We have an incentive program to prevent call ins. If we really cant fill the shift, we split it and the outgoing nurse stays a bit and the following shifts nurse comes in a few hours early.

I would ask to hire another nurse so you are not stuck doing this.

Remember if your job doesn;t get done- it could be serious repercussions, noone will care if it is because you were busy filling in someone else's shoes.

Good Luck!!!

Trauma Columnist · Feb 12, 2009

You need some prn staff. With the economy so bad, I would bet there are several nurses that would like a prn position in your area. You can't possibly work third shift AND first shift.

CoffeeRTC, BSN, RN · Feb 13, 2009

Welcome to the world of LTC!

Does your place have a recruitment and retention type of committe? Might be something to look into. Try to track and trend the call offs and you will see a pattern. Keep staff accountable for call offs too.

For the longest time corporate wouldn't let us call agency. Yes...not at all. Now we need them for nurses, but still can't call for the CNAs...yeah...alot of folks get angry with mandatory OT. Do you have a mandatory OT policy in place?

Do you have to cover the call offs yourself? That spells burn out fast. If you are salaried or not...I'd be taking comp time for the time you have to come in...are you working as a LPN or CNA for the call offs.....if you keep doing this, you will be the one that always gets stuck. Yes...okay a few times, but then they will expect you do to it.

I suggest the incentives for picking up extra shifts, working OT and good attendance. That and getting a prn or per diem list together...Find out what you are able to do or what your facility/ company is willing to do..

ChristinaDCS · Feb 14, 2009

I think when I posted this thread, I was definitely to the brink of complete exhaustion. The main problem was that on my third shift I had one staff member out last week with death in her family and one person who had been out for over a month with health issues. I had originally hired a temporary CNA to cover for the person who has been out with health issues, but she decided to abandon the job (and the residents for that matter). So, in essence I was down three staff members in one week. Fortunately, both of these staff members will be back within the next week, and the other staff are pitching in a little more to cover the shifts until we are fully staffed again.

Unfortunately, we are a small 35 resident assisted living facility and we are required to have two nursing staff members in the building at all times. With the small facility, comes the inherit small staff pool. I am currently working on hiring some more PRN staff. The PRN staff that I have has been bumped up to part-time or full-time due to staffing needs or they have another job that we have to work around. Unfortunately, I cannot just leave the facility with no staffing available. The staff that I have on other shifts can be pretty selfish when it comes to their own shifts...

Either way, the issue is resolved now... Thank you all for your advice.

On the subject of agency staffing, I am not allowed to use it. Corporate company believes agency staffing to be like cancer to a business.

Mr Ian · Feb 17, 2009

On the subject of agency staffing, I am not allowed to use it. Corporate company believes agency staffing to be like cancer to a business.

...and staff burn out is like a AAA.

schroeders_piano, RN · Feb 17, 2009

I know assisted living is a little different than skilled care. I was DON of a skilled care facility and also the MDS/Careplan Coordinator. I had some trouble with covering shifts for call ins and then I lost a nurse as well. I simply sat down with my licensed staff and had a talk with them. I would work 3rd shift on Saturday night and then the other shifts I needed cover I had the nursing staff get it covered amongst themselves. Sometimes a nurse worked 16 hours, sometimes they did 12's to cover the shifts, and sometimes they divided the shift up into small segments. They actually were happier working it out amongst themselves instead of me mandating overtime. I already was working everyday of the week with the many hats I was wearing as DON and when I made my staff aware of that, they were happy to help. Maybe your staff will be the same way?

barefootlady, ADN, RN · Feb 17, 2009

I am glad you are seeing an end to this situation soon, but you certainly need that PRN staff asap. As we all know, there is always another staffing problem waiting to rear its head. Good luck.

P.S. Agency nurses are cancer to corporate ideas because they demand and get higher wages, do not have to return if treated badly, and speak up when certain situations are present at a facility. Just my opinion.