Restorative program in small facility

[rnto?]

How do you DONs at small facilities manage your restorative program? I am currently a new DON in a 55 bed facility which has two levels. The lower Level is my long term unit and has 25 beds. Upstairs is skilled with 30 beds. I am currently struggling with staffing patterns that were developed years ago. I have 2 CNAs on the LTC unit and a restorative aide who is supposed to help out on the floor until 11am then do restorative. However, he continuously struggles to complete his programs and document accurately, and the floor staff feels that he does not help them as much as he should in the am. He is not the strongest CNA. I also struggle to keep my staffing within budget. So my thought was if I could cross train the floor staff in the Restorative program I could run 3 floor staff by having the current restorative CNA take a section and expect each person to perform and document restorative in their section. Does anyone do something like this or have any better ideas? Thanks!!

[gerRN23]

In our facility we have one restorative aide who does strictly restorative. She comes in at 6:30am and leaves at 3:00pm and she is booked all day with programs. She has a schedule that she goes by. I can tell you from experience that we've tried having our nurse aides do the restorative and it usually doesn't work out as well. Our papers that we use for documentation usually end up lost, the nurse aides forget to document, or they just do not have the time. I would suggest that you have a particular person as your restorative aide and have them do that job only. If they want to help feed at meal times that is fine but helping out on the floor is taking away from time spent doing restorative exercises with resident's that need them. If it is in your budget I would suggest hiring 2 restorative aides. Have 1 on day shift and 1 for second shift. As far as the current restorative aide goes try changing his schedule to where he is only doing his restorative duties. Then follow up in a month or so and see how he is doing with only 1 task. Maybe he is feeling overwhelmed with having to help on the floor and do restorative at the same time. Hope that helps. If you have any other questions let me know. :)