Under staffing Cna

Editorial Team / Admin · Aug 26, 2015

You will find this in many, many, facilities. Unfortunately, in health care it's all about the money as health care has pretty much become a business. As such, only one state mandates ratios for nurses- CA. As far as I know, not a single state has a ratio for CNAs. The reason CA has a nurse ratio? The nursing union. While risky as many facilities will find a way to get rid of employees who mention the U word, a union is probably the best bet for improving working conditions and workload.

A word of advice: I would contact a moderator through the help desk to have your name removed from your post if you can no longer edit it. Most people like the anonymity of AN, and posting your name here, where you may be recognized, can put a target on your back.

kidsmom002 · Aug 27, 2015

I second the advice to remove your name from your post. No need to make yourself a target. In my experience those managing facilities with perpetual understaffing are not generally open to complaints about staffing from workers.

allnurses Guide · Aug 27, 2015

Our staffing plan requires that if the facility cannot staff sufficient nursing assistants for the census and acuity they may staff with a licensed nurse instead. The same for unit secretaries.

Nurses report in writing to the manager of supervisor when sufficient licensed, certified, or unlicensed staff to meet needs of all patients is not provided.

Usually there is enough staff.

wanttonurse7 · Aug 28, 2015

what is the CNA to patient ratio? i never heard of this... i live in California, also. my floor has 30 beds and 1 CNA. i just figured out today we have CNAs.

allnurses Guide · Aug 29, 2015

what is the CNA to patient ratio? i never heard of this... i live in California, also. my floor has 30 beds and 1 CNA. i just figured out today we have CNAs.

Clearly one CNA is not able to perform the usual tasks as they do on medical/surgical and telemetry units at my hospital.

(I retired, but still attend meetings and social events with my former coworkers.)

The first paragraph of Title 22 Section 70217 states:

" Hospitals shall provide staffing by licensed nurses, within the scope of their licensure in accordance with the following nurse-to-patient ratios...
... Staffing for care not requiring a licensed nurse is not included within these ratios and shall be determined pursuant to the patient classification system."
https://govt.westlaw.com/calregs/Document/I8612C410941F11E29091E6B951DDF6CE?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=%28sc.Default%29

Our patient classification system (PCS) requires one CNA for each ten patients.

Based on acuity and the patients lack of ability for self care direct care RNs may request one or more additional CNAs. If the charge nurse agrees the PCS requires the addition of a CNA or licensed nurse.

Generally the previous shift charge nurse puts in the request at least 2 1/2 hours before the start of the next shift.

If the request is made after the start of the shift an additional CNA may or may not be provided.

Title 22 Section 70217 also includes:

... In addition to the requirements of subsection (a), the hospital shall implement a patient classification system as defined in Section 70053.2 above for determining nursing care needs of individual patients that reflects the assessment, made by a registered nurse as specified at subsection 70215(a)(1), of patient requirements and provides for shift-by-shift staffing based on those requirements. The ratios specified in subsection (a) shall constitute the minimum number of registered nurses, licensed vocational nurses, and in the case of psychiatric units, psychiatric technicians, who shall be assigned to direct patient care.
Additional staff in excess of these prescribed ratios, including non-licensed staff, shall be assigned in accordance with the hospital's documented patient classification system for determining nursing care requirements, considering factors that include the severity of the illness, the need for specialized equipment and technology, the complexity of clinical judgment needed to design, implement, and evaluate the patient care plan, the ability for self-care, and the licensure of the personnel required for care. The system developed by the hospital shall include, but not be limited to, the following elements:
1) Individual patient care requirements.
(2) The patient care delivery system.
(3) Generally accepted standards of nursing practice, as well as elements reflective of the unique nature of the hospital's patient population.
© A written staffing plan shall be developed by the administrator of nursing service or a designee, based on patient care needs determined by the patient classification system.
The staffing plan shall be developed and implemented for each patient care unit and shall specify patient care requirements and the staffing levels for registered nurses and other licensed and unlicensed personnel. In no case shall the staffing level for licensed nurses fall below the requirements of subsection (a). The plan shall include the following:
(1) Staffing requirements as determined by the patient classification system for each unit, documented on a day-to-day, shift-by-shift basis.
(2) The actual staff and staff mix provided, documented on a day-to-day, shift-by-shift basis.
(3) The variance between required and actual staffing patterns, documented on a day-to-day, shift-by-shift basis.
https://govt.westlaw.com/calregs/Document/I8612C410941F11E29091E6B951DDF6CE?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=%28sc.Default%29

Vtachy1 · Aug 31, 2015

This is a widespread problem. What are they going to do? It is worrisome. The population is aging, and no one wants to be a CNA, and I totally understand why!!! I teach CNA classes through a college and every single day, I get at least 5-10 phone calls begging to send CNA's their way. They work them so hard, burn them out, stretch them too thin, and when you have any kind of a family or social life, it becomes nonexistent because you are working lots of weekends, holidays, hard hours. One CNA from our facility has 9 herniated discs in her back and this is a darn good facility, they have lifts galore tons of them!! Its just very very very hard (emotionally, physically, psychologically, and socially). And if they paid enough to support yourself it would help. CNA's are pure gold, but they can't figure out how to treat them right and pay them right.

allnurses Guide · Sep 4, 2015

I know CNAs who truly are respected for the care they provide and their ability ton work together and be proud of their valuable work.

New inexperienced CNAs at my former facility start at $14.00 an hour. With yearly increases most earn more. They have health insurance, paid vacation and sick leave, and other benefits. They are appreciated by patients, other nursing staff, and physicians.

The highest paid Certified Nursing Assistants work for Manchester Memorial Hospital at $70,000 annually and the lowest paid Certified Nursing Assistants work for Colonial Manor Nursing & Rehabilitation Center at $14,000 annually.
UCLA Certified Nursing Assistants earn $35,000 annually, or $17 per hour, which is 33% higher than the national average for all Certified Nursing Assistants at $25,000 annually and 54% lower than the national salary average for â€‹all working Americans.
UCLA Certified Nursing Assistant Salaries | CareerBliss

iluvivt, BSN, RN · Sep 4, 2015

Realize you are only one person and do what you can. Always take your breaks and let the nurses pick up the slack while you are on break. Do your best always and those nurse will have your back. You are appreciated by the nursing staff and are a valuable member of the team, Unfortunately without a union and a legal contract to back you up there is not much you can do but learn to cope and realize your strengths and limitations and accept them.

nurseswholovenursing · Sep 19, 2015

Being a CNA, Is the hardest job in all of nursing. You are all sorely underpaid, and undervalued. I learned many years ago, that any nurse that does not listen to their CNA's and follow up on any patient/resident concerns, is a fool. You all have saved many lives by your observations that you bring to the nurses attention. I could not function without you. I hope that you do know how much you are appreciated by many nurses, and know that you are a vital part of patient care. Thank you from the bottom of my heart for ALL you do!!

SlickSouthpaw · Sep 19, 2015

It certainly makes me nervous! My last work place had me working from anywhere between 13-20 patients depending on census. Unfortunately, HR/DoN/CNA staffing coordinator and admin were all in a circle jerk mode and there was little care about CNAs....but absolute shock when CNAs quit to go to better jobs.