What can we do to improve working conditions in Nursing homes?

NursesRmofun, ASN, RN · Jun 6, 2004

NOTHIING......until the exact ratio of CNA's and licensed nurses to residents are mandated in the State and Federal Regulations.

I agree! Where do I sign up?? :) Really, I guess we have to start writing our congressmen.

Hellllllo Nurse, BSN, RN · Jun 6, 2004

I agree! Where do I sign up?? :) Really, I guess we have to start writing our congressmen.

I have wrtitten to my elected officials several times concerning nurse's working conditions and pt safety. All I've ever gotten in reply is form letters.

tattooednursie, LVN · Jun 6, 2004

That is so true. If you find an address to write to let me know.

Betty_SPN_KS, LPN · Jun 6, 2004

How will this work if the only thing they can come up with is mandatory overtime to make up for not enough nurses and CNAs being willing to work in those places? That will only cause more people to want to quit. The government can't create more nurses or CNAs. If they can, tell me how. They can offer financial aid for education, but that doesn't mean everyone is going to see it through a program or stick it out with a job either.

More money for these places? Where shall it come from? We all have our own ideas, but what are we willing to do without?

Any more ideas?

Blackcat99 · Jun 7, 2004

:) Wow Betty you have asked some very tough questions! I don't know the answers to your questions. The state requires so much paperwork in LTC's that it is overwhelming. In the "old days" it seemed that I had more time for my patients. Now it seems that I have no time for my patients because of the never ending paperwork. :crying2:

night owl · Jun 7, 2004

We can do without all the darn paperwork that's for sure! It's like you're stuck between a rock and a hard place. Our facilities need more medical staff to take care of our residents, yet they mandate these ridiculous ratios. OT doesn't cut it because the people who are willing to do the OT are getting burnt out fast, so the residents are still and will always suffer in getting the care they deserve. What will it take to wake up congress??? Something needs to be done and soon.

Destinystar · Jun 7, 2004

:crying2: The staffing ratios are only the minimum amount of nursing hours that the State and Federal Regulations require. But if you accept an assignment and something bad happens to a patient YOU COULD BE HELD ACCOUNTABLE. Even if the staffing ratio was below the minimum amount mandated by the regulations. This is especially true if you were the Nursing Supervisor or Charge Nurse on duty. It is prudent for a nurse to size up a situation before s/he clocks in &/or takes report. If it appears that you cannot safely take care of the residents then with a witness call the administrator and the Director of nurses and report the situation immediatly. If they fail to respond (i.e. get the staff that you need by coming in themselves or calling a nursing registry) then refuse to accept the assignment. You can also call the nursing registry & if no response you can call MD's & tell them you cant safely take care of the residents and transfer them to a place that can. You can also call the board of registered nursing and report the DON for failing to provide adequate staffing. You can report the Administrator as well. Remember we are all PATIENT ADVOCATES not facility advocates. The patients are helpless the owner, Administrator, DON are not. The patients did not choose to be in the situation they are in the administrator, etc. does. You are better off not accepting an assignement and risk getting fired then you are to foolishly accept one and possibly loosing your license. If you blow the whistle you should in most states be able to sue the facility for retaliation. It is up to US to show how much we care by taking Drastic measures to send a message that if THEY wont do something about putting the frail elderly in dangerouse situations WE (the long term staff) will.

Mister Chris, MSN, NP · Jul 14, 2004

Yes Yes Yes! You could also bear in mind that there are some nurses who choose to work many hours unpaid overtime on a regular basis. Not for hands-on care but for paperwork. They are the ones that are really upseting the situation. I am told that the admin. managers and some supervisors think that doing this "free-time" is great! We as nurses will never get the correct working ratios while others are turning up with "free time". Check out the comments from the nursing unions about this, they have quite a lot to say in that area. Free time - NO!

Regards, Mister Chris.

OC_An Khe · Jul 14, 2004

S

Simple, increase reimbursement from medicaid. The increased income to the facility can be directed towards salaries. Then all levels of caregivers salaries can be increased....Oh I forgot, the increased revenue would be shifted to profits for the facility instead of to the caregivers. After all we need to increase the profit otherwise we couldn't stay in business. Thus you can be thankful you still have that underpaid and unappreciated job.

Destinystar · Jul 14, 2004

I agree Mister Chris. If we donate our time we are minimizing ourself to volunteer workers. In California some of the LTC facilities by pass this by giving administrative nurses and supervisors a salary which is a set amount of money every month. They get paid this amount whether they work 40 hours a week or 80. And they abuse the heck out of these people. Like they will come in and work their regular shift then when someone calls in sick they are giving a directive to work a double shift and then to show up the next day at their regularly scheduled time and in reality only get paid like they worked 8 hours b/c they are on salary. If a staff member repeatedly works overtime they get reprimanded by the nursing supervisor and told that there must be something wrong with them if they cant get their work on time. So a lot of the nurses fear they will loose their job so they just clock out and continue doing the paperwork.

Yes Yes Yes! You could also bear in mind that there are some nurses who choose to work many hours unpaid overtime on a regular basis. Not for hands-on care but for paperwork. They are the ones that are really upseting the situation. I am told that the admin. managers and some supervisors think that doing this "free-time" is great! We as nurses will never get the correct working ratios while others are turning up with "free time". Check out the comments from the nursing unions about this, they have quite a lot to say in that area. Free time - NO!
Regards, Mister Chris.

Destinystar · Jul 14, 2004

You are right if the facilities are given more money they will probably just add it to their profits. Seems like it has to be mandated by State &/or federal regulations before anyone will adhere to it. :)

S
Simple, increase reimbursement from medicaid. The increased income to the facility can be directed towards salaries. Then all levels of caregivers salaries can be increased....Oh I forgot, the increased revenue would be shifted to profits for the facility instead of to the caregivers. After all we need to increase the profit otherwise we couldn't stay in business. Thus you can be thankful you still have that underpaid and unappreciated job.