Under staffing at LTC Facilities

[AzDeb]

I'm a fairly new CNA and I just have a question about LTC facilities. I see a lot of postings in threads where it is stated that there are a lot of shortcuts and things are done differently from what you learn in school because if you don't take shortcuts.....you won't get all your work done on your shift. Why are facilities not staffed better where the CNA/resident ratio is more manageable so you can spend more time with residents to support them and care for them both physically and emotionally.....in every capacity? I had my first CNA job at a LTCF and it was complete chaos! Each CNA had about 13 residents and had to RUSH from room to room. Some of these residents have no visitors, no family. They want companionship and emotional support and you literally don't have time for them. I had a resident who began crying, saying she didn't know why she should continue to live. I stayed with her and talked to her until she put a smile on her face. It put me behind but I felt it was part of my job to console her. The last thing I was about to do was say "sorry, but I have to answer other call lights". I became a CNA because I wanted to care for elderly in the same way I would care for my own loved ones. I worked two weeks and knew that I needed to find CNA work in a different capacity where I could give them the love and support they so deserved. I moved to home health care where I can work one on one. The experience was good and I would have stayed in LTC if staffing would have been adequate and I could have cared for each resident as I was taught in school. Does anyone have the answer as to why CNA's don't have a limit as to how many residents they care for per shift? I would think 6 to 8 would allow for better quality of care.

[Ev1987]

I assume because nowadays nearly everything runs on money. This has been an issue for many nurse aides in many facilities, sad to say.

[TheCommuter, BSN, RN]

Why are facilities not staffed better where the CNA/resident ratio is more manageable so you can spend more time with residents to support them and care for them both physically and emotionally.....in every capacity?

The answer is rather simple: ideal staffing is not profitable.

The love of money is the root of all evil, and too many corporate nursing home administrators have a deep love for money that compromises resident care.

[Sally Lou]

Wow, i just did some research. I thought all states had to have mandated coverage, only 8 states do.

http://nursingassistants.net/2008/01/26/staffing-ratios-each-state/

[rosey2007]

I agree with the op that 8 ratio works well but its all about the money. At the last facility I worked at, it got to the point that some of my residents only saw me when they had to go to the bathroom or were getting their meal tray.

[yousoldtheworld]

First, money. They are going to have the least amount as they can, and most places aren't going to schedule a bunch of extra aides in case someone calls off.

Second, it's hard to keep CNAs around, for lots of reasons. There's really high turnover, and hiring and training new aides is not instantaneous.

Third, for some reason, aides call off work more than any other job I've ever had. In the winter, we are averaging at least one and sometimes two call offs per shift, daily.

When we are fully staffed, we have 7 (on first and second shifts). If two call in, that brings us down to 5...leaving us with 16 total care kids a piece.

On third shift, we have 5 aides. If two call in, that leaves the people up front with 22-24 each, and the person in back with 37. Last week, we had three call in. The other aide and I had about 40 each...100 percent are incontinent and all but 5 or so need to be turned and repositioned.

So yeah. It sucks. And you have to just do what you can. But quitting because of staffing only makes things worse - that's one less aide they have who cares.

My favorite part is when the people who call off all the time complain when they're working and someone else calls off. I have missed one half day of work in the last two years, when I had to sent home for throwing up bile in the shower room. Don't you think it's just as hard as everyone else when YOU call in?

[Jen{NAR}]

Yeah, this is normal, I have worked for a facility where at least one person called in per shift daily. It's rather stressful and just takes it's toll on the aides and nurses that rarely call in ((I have only called in twice in the two year I have been working there)). It's crazy...and the thing is when people do call in normally we try to call someone in to cover the shift but no one wants to work...:: sighs :: Off to work I go ((and I hope that there are no call ins))

[AzDeb]

I sort of figured the main reason was money/profit. I do think there needs to be a limit set in each state. (Just my personal opinion)

And just to set the record straight before posts get out of hand, I didn't just leave the facility due to understaffing, there were several other reasons. Also, I wasn't just a "no show", I gave notice. My main question I had is why facilities can't staff more people each shift. Anyway, I'm sure there are plenty of great facilities out there that are well staffed, I just wasn't that fortunate with my first LTC job. I'm enjoying home health care and it is much more suitable for me. Thanks for the replies!

[fuzzywuzzy, CNA]

I've had assignments with 6 people that were way more grueling than some with 12. I hate the feeling of constantly being stressed out because of all the call lights and screaming residents, and the needy, time-consuming residents and then having to rush so you can change and hydrate the ones who *can't* ask for anything. I always think what if that was me? And no one gave me a drink or wiped my snotty nose or took off my sopping brief for hours because they were too busy with some whiny resident. Blech.

[interceptinglight, CNA]

Wow, i just did some research. I thought all states had to have mandated coverage, only 8 states do.

http://nursingassistants.net/2008/01/26/staffing-ratios-each-state/

Oh my god, I had no idea. Thank you for this !! How enlightening. I work for a 'not-for-profit' Jesus-Christ-centered LTC facility that is long-established and very well respected, it's in Idaho where there's no mandated coverage. I'm told that not-for-profit facilities have better conditions for residents and staff; however I can tell you first-hand that working here is still like herding and corralling people like cattle. Hustle them out of bed, hustle them into bed, hustle them down the hall to meals, hustle them back, hustle them in and out of showers. Always hustle. Give them a little one-on-one TLC ???? Forget it!! You'll have the nurses up your butt for not answering call lights in a timely manner. After a few months of this I could stand it no more -- fortunately a position opened up in the Special Care Unit for dementia residents and I started working there. We have 2 aides for 12 residents, night shift has one aide after 8:30 pm. The Unit residents get more personalized care because they require it and have financial resources to cover the expense. Otherwise....for a so-called Christ-centered facility, the bottom like is still money money money. They staff as few people as they can possibly get away with and pay us as little as they can as well. The Unit is better than working the resident halls....however, I still want out of this racket.

[yousoldtheworld]

I sort of figured the main reason was money/profit. I do think there needs to be a limit set in each state. (Just my personal opinion)

And just to set the record straight before posts get out of hand, I didn't just leave the facility due to understaffing, there were several other reasons.

Just so you know, my comment about quitting because of staffing wasn't directed at you. I was mainly referring to people I have worked with, who have quit because there are a lot of call offs and they're tired of working short. It doesn't make sense to me in the slightest. Outside of home health, they're going to have to deal with call ins wherever they go.