What do you think about universal workers in LTC?

caliotter3 · Jul 5, 2009

I've done plumbing as well as floor mopping in the middle of the night even though I'm a nurse. Done out of necessity. Can't see this being done on a regular basis and working the way it would "on paper". I can see the problems with infection control and too much for one person to be responsible for. When I was a CNA, we were not able to get all of our residents fed with proper assistance. Add to that preparing the meal and cleaning the room and doing laundry too. Just too much.

noc4senuf · Jul 6, 2009

I have seen how this is done in a brand new facility that I toured a couple of months ago. They have "neighborhoods" of 10 beds each. The unit I toured was the TCU. It had 2 workers for the 10 beds. They did all personal cares, served the meals that were brought to their own kitchen, at breakfast did the actual frying of the eggs, etc; They had their own washer and dryer that they washed each resident's clothes (linens were send out). It seems to be working out quite well for them. I do not know the staffing on LTC areas.

The nurse does not have a desk on the neighborhood, it is away in a central area and she acts like a visiting nurse to keep the unit as homelike as possible.

Moogie · Jul 6, 2009

I have seen how this is done in a brand new facility that I toured a couple of months ago. They have "neighborhoods" of 10 beds each. The unit I toured was the TCU. It had 2 workers for the 10 beds. They did all personal cares, served the meals that were brought to their own kitchen, at breakfast did the actual frying of the eggs, etc; They had their own washer and dryer that they washed each resident's clothes (linens were send out). It seems to be working out quite well for them. I do not know the staffing on LTC areas.
The nurse does not have a desk on the neighborhood, it is away in a central area and she acts like a visiting nurse to keep the unit as homelike as possible.

I could see it working in a situation like you describe, in which the actual physical facility is set up to be more homelike and less like an institution. I can't see it in a more traditional facility that, well, looks and is set up like an institution.

TheCommuter, BSN, RN · Jul 6, 2009

My workplace does this with the CNAs.

The company will hire people off the street, get them certified as CNAs, then cross-train them in housekeeping, laundry, transportation, and dietary. The cross-trained people rotate every few weeks.

They'll spend a month on the floor working as a CNA, then be rotated into the kitchen for a month, then work as a housekeeper for another month, and so on. Since the cross-trained worker isn't working in all 4 departments in the same day, the risk of cross contamination is minimal.

It also reduces burnout, because the employee is not in the same area for months or years. So far, management has been able to retain staff by having universal workers.

Moogie · Jul 6, 2009

My workplace does this with the CNAs.
The company will hire people off the street, get them certified as CNAs, then cross-train them in housekeeping, laundry, transportation, and dietary. The cross-trained people rotate every few weeks.
They'll spend a month on the floor working as a CNA, then be rotated into the kitchen for a month, then work as a housekeeper for another month, and so on. Since the cross-trained worker isn't working in all 4 departments in the same day, the risk of cross contamination is minimal.
It also reduces burnout, because the employee is not in the same area for months or years. So far, management has been able to retain staff by having universal workers.

I think that sounds like an innovative approach to staffing, one that provides for excellent care and increased worker satisfaction.

The administrator with whom I spoke with about universal staffing, however, saw nothing wrong with rotating people through different departments in the course of one shift. :down:

Aviationurse · Jul 6, 2009

moogie, the LTC facility i last worked had CNA work on the floor doing patient care , pass breakfast, lunch, dinner in dining room, clean tables, pick up dirty silverware etc...during meal times, the bed bound residents who stay in room are under the care of the nurse...meaning we dont have cna during meal times...we are one staff/RN in floor while the cnas serve the food...restaurant style...from table to table like waitress taking orders and serving them food from table to table.

fuzzywuzzy, CNA · Jul 7, 2009

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.

whaaat? how can that be? lol.

bluegeegoo2, LPN · Jul 7, 2009

Originally Posted by Moogie

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.

whaaat? how can that be? lol.

They must have been referring to all of that time we spend running up and down the halls. What a waste of time! If only we could "beam" ourselves around the unit?

Moogie · Jul 8, 2009

I think that's exactly what this administrator meant.

Beam me up, Scotty, someone needs the bedpan in room 306.

universalcna · Nov 2, 2011

I work in a facility where the aides are universal workers. It is a nightmare. We are a small facility, less than 100 residents. We are called AL, but we have at least 1/4 of our residents who require skilled nursing care. Three aides are responsible for housekeeping, laundry, passing meals(going in and out of the kitchen), passing snacks, all resident care, and any other duties that come up that our nurses dont want to do (i.e.We even change colostomy bags).

Anyways, the aides generally feel worn out, we run constantly for the entire shift, but our administration seems to think we still have free time. It makes for a very tense working environment.

Universal workers end up being rushed and not doing as good of a job as they could because there is too much to be done and enough time to do it in. Also, I find it disgusting that we go into residents rooms where some are incontinent all over the floor and then we walk into the kitchen and through the dining room.

universalcna · Nov 2, 2011

I have seen how this is done in a brand new facility that I toured a couple of months ago. They have "neighborhoods" of 10 beds each. The unit I toured was the TCU. It had 2 workers for the 10 beds. They did all personal cares, served the meals that were brought to their own kitchen, at breakfast did the actual frying of the eggs, etc; They had their own washer and dryer that they washed each resident's clothes (linens were send out). It seems to be working out quite well for them. I do not know the staffing on LTC areas.
The nurse does not have a desk on the neighborhood, it is away in a central area and she acts like a visiting nurse to keep the unit as homelike as possible.

This may only work so well because each aide is only responsible for five residents??

DixieRedHead, ASN, RN · Nov 2, 2011

I think that when everybody is in charge of everything, nobody is in charge of anything.