Published Feb 1, 2022
I am a former DON, now regional nurse manager at a company that owns several LTCs in a few southern states. Like most other facilities, mine are having severe staffing issues. There have been no applicants to positions posted, even with a major sign on bonus. The company has a reputable reputation and provides competitive pay and benefits, but nothing is drawing nurses and CNAs in.
At first I thought maybe it was because so many left to do travel jobs, but even the travel agencies are having trouble filling their slots. Covid has been a driving factor in changing the nursing world along with the vaccine mandates and CMS restrictions. Patient/staff ratios have become more unsafe than they ever were. We are finding that agency staff are not doing a thorough job and the facilities that have contracts are seeing worsening QMs. No offense to the good agency nurses, but most are there for the money and low accountability.
So, my question is to those out there who have left the profession, or may be considering it. What could the company have done different to get you to stay and what could other companies do to entice you to work there?
I'm just an STNA. But if you don't mind, I'd like to add my reason. I'm 46 years old. I've been doing this on and off for 20 years. I'm also an Army Vet. I fully understand how the chain of command works. I respect my nurses fully and I've watched many walk out in the past year. The new generation does not have any respect. I'm leaving for many reasons. Short staffing is just one of those things. Dealing with mostly bariatric residents. Long gone are the days when Nursing homes were little old ladies. The vast majority are there due to problems caused by obesity. Many are non-complaint diabetics. I actually had a lady last week who weighed 320lbs. I was by myself AGAIN and needed to turn her. To put it in perspective, I weigh 130lbs. I asked her to turn on her side and since she has no issue working her phone, laptop or eating. I figured she could at least put in some effort. No. She held onto her bag of chips and refused to let go of it just to grab the siderail to assist me. Once I got her over, during which I felt the muscles in my shoulder ready to give way, I of course did the rest of my job...which includes pulling large chunks of rotten food from her folds. Then digging in really deep with a washcloth to remove the sour odor and the diarrhea which typically accompanies the meds. Meds which are given to counter-act the fact that the resident is non-compliant. And usually after I change the resident, they will push their call light to ask me to hand them something well within reach, taking up much needed time for my other 30 residents that I'm left to deal with one my own. Of course, this means the ones without families or a voice to complain are often left sitting in their own filth, in order to cater to the non-compliant complainers. And if that's not enough, having taken care of MANY MANY people with Covid, I can tell you that Covid isn't even what scares me. Hep, Shingles, MRSA, C-Diff, Active Herpes, Active AIDS on a violent resident who likes to throw his blood-tinged urinal, hitting, biting, scratching with feces under their fingernails as often they dig into their own briefs... etc...have LONG been part of our jobs. One of our aides died from Covid. The thing is, the aides are the CLOSEST to the residents in LTC. NOT the nurses. The residents do not wear masks and we're extremely close to them while feeding. Nobody cared before, as was evidenced by our pay, and nobody cares now. Add to that, the disrespect I see DAILY which is appalling! I watch brand new teenage untrained aides take photos, play on tiktok, cuss out the nurses etc... Whenever someone says I'll be taking the West Hall with upwards of 62 residents, with the two little TikTockers, what that really means...is I'm on my own. And of course they're hired at our pay rate, even though our pay rate is lousy. 13$ an hour, taxed into to nothing...the taxes of which PAY TO CARE FOR OUR NON-COMPLAINT RESIDENTS! I can understand funding 90 year old fragile grandma. I cannot understand funding those who REFUSE to follow their care plans. In a hospital, they'd be discharged. But nursing homes will take ANYONE for money. So we're essentially paying our own wages. On top of that, sustaining LIFE LONG and LIFE CHANGING injuries to our bodies. And when I tell my charge nurse, God Bless her...she REALLY TRIES to get the LAZY ones to do their job, but then she ACTUALLY GETS YELLED AT BY THE DON for making the lazy aide FEEL BAD?!?! I can't work with snowflakes. Cashiers are making more money now. As for your nurses, stand by them! The problem is, as an aide who does her job...I burnt out because even after my nurse tried to help me by getting the DON to do their jobs and get the lazy ones in line...the DON did nothing but yell at my nurse! So nothing was done! I followed my chain of command. The chain of command is non-existent to the new people coming in.
momofstudent, ADN, BSN
During Covid I was feeling that I should do something to help in light of the nursing shortage. Because I had been out of nursing for years I felt LTC would work. I found an agency and worked hard to fit in with absolutely no orientation. I had to learn the computer program myself. I found the regular staff to be touch and go. A bit of sleeping at night and manipulating things that forced day shift to do more work. Crisis staffing was ridiculous the last few months. I was sent to care with only one assistant on floors with helpless people. Of course I had to help the assistant turn patients and lift etc. My rotator cuff was torn in one move. Now, I am at home and in the process of applying for jobs that will be impossible to short staff.
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