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Nonskilled home care issues.....

by sjbmrn sjbmrn (New) New

I am currently the nursing director for a nonskilled home care agency. We have several issues that I would love some input on.

1. How do I keep our employees from running amuck. There is zero loyalty, call offs are out of control, they pick and chose shifts, take off constantly, are completely unreliable and dependable, throw us under the bus on a daily basis. I realize the pay is low but I need to figure out how to build loyalty. We offer no benefits at this time, I am researching clinical ladders/lattices right now. I am an RN with only skilled home care experience behind me so I am at a loss.

2. How do other nonskilled agencies handle call outs when you cannot find someone to fill the shift? Some we leave go with out care but we have 2 24/7 cases that cannot be left unattended. Yesterday I had to go out when the caregiver overslept.

Do you just have to go out to cover when you are on call?

3. How do other agencies handle being on call. I am on this weekend and it has been ok, but it keeps me home close to the computer. I really feel like I cannot go to far from home incase I need to run out to cover something. I just started taking a lot of call this week since our HR staff supervisor and scheduler walked out.

4. Are there any other message boards available where there is a community of home care management, I would love to bounce ideas off others and get a feel for how we can change the course of our company.

Thanks! I really want to make this company a place CNAs and NAs want to work but I spend so much time herding cats that I cannot spend on minute on making improvments....


Has 1 years experience.

Here is an idea , pay better than the competition and you will retain the most reliable, dependable workers

Alex Egan, LPN, EMT-B

Specializes in Home Health (PDN), Camp Nursing. Has 9 years experience.

Yea you want to pay a rate commensurate with other local agency's. But higher pay doesn't equal better performance. Truthfully I have spent years in peds PDN and am laid quite well as are my coworkers and We have the same issues. Lots of callouts, no call no shows, and blinding stupidity. We never take 24 hour cases where there is no good plan for the family to provide backup care. As for call it rotates, but at the end of the day it has been my branch director on call for months at a time, however our on call will not generally work callouts themselves. If no replacement can be found the case goes without. If your loosing management staff at such a fast rate you really have to figure out why, before you can do anything else.

Alisonisayoshi, LVN

Specializes in LTC.

So it's both about pay and about incentive to work. Build incentives. When hiring/recruiting advertise yourself as willing to work around nursing school schedules, child care schedules, and the like. Loyal employees tend to be those that are grateful to their employer for the extra help they are being given. Someone may take a lower paying job, if that job is working to help them get through school, easily be able to get to a child dentist appointment ect.

Make your employees you have feel appreciated. Perhaps keeping the pay the same but offering small bonuses here and there built in for picking up shifts, having no call outs or lates for 90 days (seems like this should just be expected, but sometimes for someone new to the job market this may help enforce responsibility). Recognition in the form of a caregiver of the month. Maybe with a small reward attached, like a gas card or a starbucks card. People like to feel good about the work they are doing, but they also like to feel like YOU see it. If they feel like nobody cares, they stop caring too, especially when the work is hard.

Lastly, visit your local welfare to work office, you might find a lot of willing workers through them, especially if they have people on plans to transition into healthcare fields, and they are required to fill the hours they agree to with you. So it's a win/win. You pay low, so they retain benefits, but to keep those benefits they have fulfill their hours with you.

Sorry for any errors, typing from my phone.


Has 1 years experience.

99% of employees will jump ship for higher pay. You goal is to attract and keep the best. I once worked for a place that wanted me to drive 1.5 hours each way for a 3 hour gig only paying $9 hr. How many times do you think I made the drive ? lol She got mad at me not showing up. If the pay was $12 I will go. 99% of employees are loyal to their bank account