What is going on inside your head? What are you thinking when you assign two CNAs for 50 residents? Whats the rationale for this? What makes you think this is even remotely acceptable? I know money is tight, the big to dos don't want to pay for regular staffing and you could probably care less about staffing on the off shifts. But its not effecting you so as long as it doesn't interfere with your bankers hours, its not an issue to you.
This morning at work we had an incident that probably wouldn't have occurred, caught early or might have even been preventable if we had the correct amount of staff working. I'm just imagining administration's response to it now, the nurse is going to be responsible for it, to sign off on it, write it on a flow sheet. Just add more to the nurse's plate. That seems to be your answer instead of scheduling the correct amount of staff.
This effects our residents. They are not getting the care they deserve this way. Please really think about it next time before you leave the evening or night shift short staffed.
Thanks,
Frustrated Nurse at her wits end.
- Sorry if I offended anyone. I'm just sick and tired of seeing my residents get rushed, quick care because the CNA has too many patients due to short staffing that people who can change it.. don't seem to give a damn about.
Specializes in LTC, ER, ICU, Psych, Med-surg...etc....
OMG! I can remember trying to staff. That was the worst, most anxiety producing part of my job. I always staffed with the "right numbers" and never just scheduled low, but there were times when there were call offs, and emergencies. I remember being on the phone for hours begging people to work. I remember coming in to work the floor myself, and mandating other charge and unit managers to help as well. I never asked anyone to do anything I wouldn't do myself. I remember offering extra time off, extra pay, Walmart gift cards, hotel rooms in bad weather, free meals, pizza or sub lunches...I remember still not being able to get people to work. It was not that I did not have the staff, but people want their time off and I understand that. Sometimes you do all you can do and there is nothing left. Sometimes money and "gifts" do not suffice, because people get tired. I had to "weed" out people who were frequent call in's because in a crunch they could not be counted on. Some people wanted to work and were so decicated to what they were doing and yes, needed the money. But there were others who didn't care and worked when it was convienent for them or if they had nothing better to do. I had those people who would plan to be off at the same time, and I felt as though they "screwed me and the residents". I tried to foster an environment that was pleasant, supportive and caring and tried to make my staff feel that they were appreciated and needed. Sometimes it worked, sometimes it didn't. I have cried, prayed, and obsessed over staffing. It was the hardest, most thankless job I ever did....
Nobody is getting what I'm trying to say here and I don't appreciate obnoxious comments.
They didn't fill the 3rd CNA, which is very necessary. They didn't even attempt to ask anyone to come in. They just scheduled 2 CNAs and that was that.
It is very frustrating. This isn't about mandating people to come in or forcing them to stay. Its about scheduling them IN THE FIRST PLACE.
Specializes in Gerontology, Med surg, Home Health.
Look in the mirror before you call other people obnoxious. There are no staffing rules...the regs (at least in Massachusetts) say you have to have 'adequate' staff. If they think 2 CNAs is an adequate number......
Do you know that they didn't try to place the 3rd CNA? Also, in my experience, the staffing coordinators take their instructions from the DON or at least someone in authority. I also know from experience, that with caller ID, staff purposefully will not answer their phones if work is calling, have said they will pickup shifts but then don't, etc.
Well when I was a CNA at a very nice "looking" facility, I and two of my good friends worked nights, each one of us was assigned one hall (there were 6 halls in total), and we each had 36-40 patients EVERY NIGHT. No mistake in scheduling, that is what it was. I don't care how you spin it one CNA for that many patients is not "adequate". And for those who think it is adequate or those who say well, that all we had to work with, well they need to get on the floor on those shifts, period.
Specializes in LTC, assisted living, med-surg, psych.
OP, what are your state's minimum staffing ratios? If you don't know this handy bit of information, it might be good to research it so you have some ammunition to fight with when you report inadequate staffing to your local ombudsman.....
I can't imagine any state being OK with 2 aides for 50 residents, even on night shift. Back in the early '90s when I was a CNA, my state's staffing was 1 aide for every 12 residents on days, 1:20 on eves, and 1:30 on nocs. A couple of years later, it was changed to 1:10, 1:18, and 1:25 respectively.
It took another decade before TPTB realized that acuity has been rising rapidly, that today's nursing home residents were the Med/Surg patients of the mid- and late 1990s. Staffing ratios were finally changed a couple of years ago to 1:7 days, 1:11 eves, and 1:18 nocs, which is more doable, but still inadequate IMO. (A few places will staff better than that, but they're few and far between.) So it's hard for me to believe a facility can purposely staff below state standards and keep its doors open......or that your state's minimum staffing ratios are as high as Oregon's were 15 years ago. Wow.
Not sure of the day shift ratio, but 3-11 has about 8-10, 11-7 has 17-19. Some assignments would vary between 1 or 2 residents because the assignments that have 1 or 2 less residents have residents that require more assistance.
Those numbers not official written word. But the unit functions at 6 CNAs on days, 5 CNAs on evenings, and 3 at night. Residents are safe, clean, dry, and happy, and there are some residents who wish to be up early before day shift comes in. When there are 2 CNAs, they can't get anyone up or start anyone's shower because changes/turn and positioning for 26-27 residents are too much to do.
I found this website and my state.. is one of the many that says there are no requirements. I could be wrong because this is from 6/08
Specializes in LTC, assisted living, med-surg, psych.
Yes, ours is definitely outdated.........but I was shocked to learn that so many states have absolutely NO minimum staffing ratios. WOW.
So in theory, that means a facility could staff only one aide and one nurse for nights, or one nurse and NO aide, just as long as there's somebody in the building who's qualified, awake, and able to respond to the residents' basic needs. That is downright frightening......and the implications for residents in these no-minimum-staffing facilities are staggering.
All of which goes to prove yet again that the frail elderly and disabled of this country are utterly devalued, and that we Baby Boomers and the generations following us are in deep Bandini if we should become ill and poor in our old age. {{{{{{{shudder}}}}}}}
Yes, ours is definitely outdated.........but I was shocked to learn that so many states have absolutely NO minimum staffing ratios. WOW.
So in theory, that means a facility could staff only one aide and one nurse for nights, or one nurse and NO aide, just as long as there's somebody in the building who's qualified, awake, and able to respond to the residents' basic needs. That is downright frightening......and the implications for residents in these no-minimum-staffing facilities are staggering.
All of which goes to prove yet again that the frail elderly and disabled of this country are utterly devalued, and that we Baby Boomers and the generations following us are in deep Bandini if we should become ill and poor in our old age. {{{{{{{shudder}}}}}}}
It is very frightening. I mean its not practical for 2 CNAs to care for the entire unit. In some facilities that might be the case, but in mine its not.
The nurse shouldn't count in the CNA staffing ratio. We can do care and I have no problem walking someone to the bathroom, or answering a call light, etc but we have other things, med pass, am fingersticks, charting, more and more charting etc.
This two CNAs idea is half-assing it so they can save money. Whats next? 1 CNA? 1 CNA for 50 residents.
CoffeeRTC, BSN, RN
3,734 Posts
Wouldn't that be nice. You can make em to fit.
Even with the union you cannot mandate them to stay.