What do you think about universal workers in LTC?

Specialties Geriatric


Specializes in Gerontology, nursing education.

Just curious. Have talked with some people in LTC who are enthusiastic about the idea of universal workers---meaning employees who could work dietary, nursing, housekeeping---whatever the needs are for the day. Others are skeptical. What are your opinions about and your experiences with universal workers?

Thanks for the input.

Specializes in Med/Surg, Ortho, ASC.

Never heard of the concept.

In terms of nursing being interchangeable with dietary and housekeeping....that will never happen.

could be possible for nurses aide to transition back and forth between dietary and housekeeping. be a little concerned about cross contamination and spread of infection though. wouldn't see it feasible to wear three hats all in one day on same shift...although...wait a minute...I do remember working as an aide and doing all three jobs, wasnt called a universal worker though, was called short staffed! i think it really depends on the level of skill the hall is that your working on. couldnt see it feasible for a nurse but possibly for an aide.

Specializes in Gerontology, Med surg, Home Health.

We have thought of cross training CNAs for the dietary department...we have people not getting enough hours as CNAs so it seems logical to have them work in dietary.

Specializes in LTC, assisted living, med-surg, psych.

Having seen it in action in assisted living, I'm not a fan. The concept itself isn't a bad one at all---one aide sees to all the needs of her "pod", or residential unit, including meds, laundry, homemaking, and ADLs---but in practice it's used to maximize profits at the expense of staffing. It's also an infection control disaster; I still cringe at the memory of seeing caregivers running back and forth between dining-room duty and personal care tasks, but it couldn't be helped, there simply weren't enough bodies on the floor to meet everyone's needs and still get the meals out on time.

As hard as it was in AL, I really can't imagine it working well in LTC where the residents' acuity is so much higher and the staffing is only slightly better than it is in ALFs. I know our CNAs hardly have time to do everything that's expected of them even now; it's hard enough to get them to do room tidies (I'm super-anal about "stuff" on the floor) and meet the minimal safety requirements, I'm sure they'd go out of their minds if I tried to get them to sweep and mop floors or do their residents' laundry!

It sounds to me like another attempt to cut staffing costs by making everyone do everything. If an aide want to work in dietary, they need to be hired in dietary and put their time in the kitchen, not take time away from their resident care. This is a ridiculous idea to have aides do even more. Anything to maximize profits for the administration.

Specializes in Gerontology, Med surg, Home Health.

wow...we're not trying to cut staffing. We're trying to make sure the people we have get the hours they need. We're not all evil you know.

Specializes in LTC.

I would hate that. If I wanted to work in the kitchen, laundry, or housekeeping, I would have applied for those positions in the first place.

Specializes in LTC, Hospice, Case Management.
wow...we're not trying to cut staffing. We're trying to make sure the people we have get the hours they need. We're not all evil you know.

CapeCod, I have read your thoughts for a long time now and really believe that YOU would have good intentions at heart here, but I would not trust the corporate powers. Surely someone, somewhere would come up with this fantastic idea only to ultimately save the company some $$ (and the powers that be get a little extra bonus $$ for meeting budget so nicely). These poor aides are already overworked. The last thing they need is to be running in and out of this kitchen and mopping a floor!

You see it as instead of CNA job they would do Hskp or dietary job. I think others mean it as they will do all 3 jobs within the same shift!

Specializes in LTC.

I agree I think maybe in an assisted living area butin LTC i think everyone is hired to do a specific job. Ok to cross train to get hours but do one job per shift. Plus the residents would get confused on who was doing what job and who should they ask for help.

Specializes in Gerontology, nursing education.

The concept of universal workers was presented to me by a non-nursing administrator in a LTC. This administrator thought it was a "peachy keen" idea because a worker could do a few hours helping in dietary, a few hours taking care of residents, a few hours working in housekeeping---all in the course of one 8 or 12 hour shift. To me, this seemed like a nightmare, especially in terms of infection control. I have serious concerns about one staff member helping residents get up in the morning then switching off to food preparation or serving food later in the same shift. Passing out prepackaged snacks---that's different. Serving hot food in a dining room----that's a whole 'nuther matter.

Now, the way that it's presented by posters such as CCM, it makes sense. I don't have a problem with someone being cross-trained to various departments, especially in a small LTC that might not have a huge pool of workers from which to choose. It would also be beneficial to workers who need extra hours but can't get them just in one department. But, as CCM said, the "universal worker" would then work only ONE department each shift and not get pulled from one area to another within the same shift. That's common sense and, utilized wisely, the universal worker concept could benefit interested workers and facilities, resulting in higher retention and better quality of care.

I can also see where the concept of universal workers might be useful in ALFs in which the residents would require minimal assistance with their ADL's. It also seems like it could work in ALFs that are divided into small pods.

Anyway, as presented by this administrator, the concept of universal workers in LTC sounded like yet another way to get by with short staffing various departments because someone could theoretically be "pulled" from one area to another. BTW, that administrator once told me about a "study" that showed how nursing personnel in LTC only spent something like 50% of their time productively. :angryfire Common sense is apparently rather uncommon, at least among some of the PTB.

Thanks for the responses!

Specializes in Gerontology, Med surg, Home Health.

I wonder if the people who did that study thought it was 'productive' when a CNA or nurse spent half an hour with a resident when they were alone and in the process of dieing.

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