Commentary on Long Term Care Part 2

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Facility staff are overworked and underpaid for what they do.  That is how the system is set up and will continue to be until something changes.  I’ve got ahead of myself. I was talking about staffing.  Some states do not require a particular number of staff to take care of the patients.  Some states require a minimum.

Back in time when I was working in LTC, Oklahoma required one to seven direct care staff to provide care to the residents on day shift.  This number counted the LPN giving the medications and providing treatments.  It also counted the activity director as providing direct care.  I always felt this was very deceptive.  The CNA’s on the floor where the ones who were bathing, feeding, dressing, walking, cleaning changing, taking to the bathroom and just doing whatever the person could not do for themselves.  The number of CNA’s decreased with each shift.  If you had four people on day shift providing care on one wing, that would go down to two on a wing and then for night shift it could go down even further.

For some reason, the thinking is there is not as much to do on the evening and night shifts. That  is not entirely true.  You still have to do the care, feed the patient, problem solve, ect.  I think you can see my point.

The facilities have people who call in sick, without thinking of the problems it will cause. You also have people who are so dedicated or need the money so badly, they come to work when they should have stayed home.  That in itself can cause problems.  Rampant virus illness is not pleasant for anyone, and it can go through a nursing facility quickly.  Care should be taken, family or staff if you are sick, stay home.

It is not easy finding staff to work when someone calls in.  Usually some overworked CNA, who needs more money will volunteer.  It is not uncommon for the caregivers to work more because of the low wages they receive.  When someone is tired, they can’t give their best, even though everything in them says they are.

States that do not have mandatory staffing use the premise that a facility must provide enough staff to care for the patients.  This is well and good, sort of.  You can have five on the floor caring for ten patients.  You would think all the care would be done, and everything would be wonderful.  It could be, only two of those people are really working.  They bust their behinds
getting all the work done while the other three take smoke breaks outside, hide, look busy doing something else, but not really accomplishing anything.  So there is the dilemma.

Unfortunately, I have been in facilities that consistently ran short of staff to provide care to the patients.  During the three days of survey, they would bring in staff from sister facilities to really make it look good.  The survey team knew what was going on but nothing could be done about it.  We would hear statements from patients such as “I am really glad you’re here, we have so
much more staff today than we usually do. Another might say, my call light is sure being answered quickly today.”  I always felt the difference I made in patient lives were the three days I was there doing a survey.  I think it is a very sad thing not to be able
to completely trust the care that is given to some of our geriatric population.

The general public has no idea how many restrictions are really placed on surveyors that go into a facility.  We all started the job thinking we were really going to make a difference in people’s lives. Those money hungry cooperation’s that provide poor care, because they are trying to get more of those sacred dollars are going to be shut down.

Nope, that is not the reality.  The federal government has a very large book of regulations for LTC and what you can and can’t do.  It is almost impossible to shut a home down.  It can be done, but it takes a great deal of time, effort and money that states do not have.

Then you have to consider the patients in these homes. Where are they going to go?  In some areas they may be moved fifty miles away before a facility can be found that will accept them.  If they have family that visits them, what happens if they don’t have the transportation or resources to get to where the patient is located.  Families can’t take care of mom and dad like
they use to because of being scattered across the country, or everyone is working trying to survive.  So where does that leave the patients?

The survey process itself is unannounced.  The facilities do not know exactly when the survey team will show up.  What they do
know is, a three month time frame it could happen in.  The tension can be felt in a home when it is getting close to survey time.  It has happened that a survey team will check into a motel and the facility will know the survey team is in town.

Surveyor’s are not suppose to talk about their schedules.  It could mean their job if it is proven they let a facility know when their survey is going to take place.  If a town has several facilities, you could go into a home to do a complaint and every facility in town will know you are there.

As soon as a team walks into a building, fresh drinking water starts being put out, and call lights put within reach of the
patient.  You can see the activity of preparing for surveyor’s beginning.  If it wasn’t so sad it would be comical.

About shirleymclain930

I am a retired RN, I am currently promoting my book, Dobyns Chronicles. My first book published in November 2010 called "The Tower", has been revised. My newest book is a Young Adult Fantasy called Princess Adele's Dragon. It was a fun book to write. I'm enjoying my retirement to the fullest. I like adventure and travel and making friends. I have 5 dogs and 1 cats. They are like having a house full of three years olds. They are a large part of my life and I can't imagine not having them. I spend most of my time sitting in front of my computer working on my latest book. The final edit is time-consuming. I prefer to write or monitor my social sites. On the personal side, I'm married to a wonderful man who spoils me and I love it. I am very much a country girl. I love living on our 5 acres on Pole Cat Creek watching the deer and other animals occasionally stick their​ heads out of the trees. It's a fun life.

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