We need staff… NOW – The world according to Dr. El

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Dr El

Last year, as the pandemic raged in New York City and sirens filled the air, a group of young travel nurses arrived to help tired long-term care teams. They took over nursing stations that had been depleted due to positive COVID tests and allowed healthy staff working in duplicate to rest. They gave us hope that after being ignored in the COVID-19 war zone, we were finally getting help.

There may not be sirens blaring outside today, but the need for more personnel is even more urgent now.

Current alarm bells are making the headlines about closing establishments or limiting admissions due to understaffing, lack of staff, McKnight’s Mood of the Market survey results show nursing directors and administrators would rather have more employees than more money, with an AHCA / NCAL survey indicating that only 1% of nursing homes have ‘a full staff, and the level of exhaustion is felt at all levels of the field.

Less noticeable alarms are the silent complaints of exhausted workers telling their co-workers that ‘it’s too much’, the incessant ringing of unanswered call rings and the flashing lights of family phone calls that are not returned.

The reality of the current staff shortage is probably even worse than the data suggests, due to increased resident acuity, more residents with severe mental health issues and level of burnout among workers who have experienced trauma from COVID-19.

Nursing homes need immediate ‘boots on the ground’ to alleviate the situation, followed by additional measures to ensure adequate staffing.

Increasing the number of workers costs money, but there are costs in not increasing the number of workers.

When teams are too busy to know their residents, changes in their clinical presentation are missed, so conditions that could have been treated in the nursing home require hospitalization instead.

Unanswered phone calls from family members hamper the flow of essential information (such as a history of a bad reaction to a medication) and increase the risk of care transitions (relatives are often the only ones accompanying a resident to a care facility). medical event to another). They also increase family frustration and the likelihood of lawsuits.

There are expenses for workers on stress-related disability, expensive agencies used to temporarily fill vacancies, and replacement costs for new hires who take on roles abandoned by exhausted alumni.

Closed facilities lead to jobless claims, add financial strain to the families of unemployed workers, and can impact the economy of communities that depended on that employer. Human costs are also significant, such as the disintegration of long-standing teams and the need for loved ones to travel long distances to visit a loved one in a remote nursing home.

The health care situation in the United States is more than frustrating, with consequences independent of behavior. A business that regularly understands its units can generate profits, but if the understaffing results in increased medical costs for its residents, Medicare, Medicaid, and private insurance pay the bill, with little or no ramifications for it. this company.

Sometimes some staff like me can avoid the cascading costs.

For example, I started seeing a frail nonagenarian for psychotherapy sessions. Her advanced directives indicated she was in full code. When I raised this issue with her, she told me firmly that in the event of a health crisis, she wanted staff to “let go. [her] Go. ”Her social worker, who would normally have handled this situation, resigned. A new social worker did not arrive for several weeks and was immediately inundated with more urgent tasks.

Soon after, the woman, who had virtually no social support, mentioned a nephew. I took out my smartphone, searched for it online, miraculously reached it during our session, told him of his end-of-life wishes and entered it as a contact in his file. A week later, she was hospitalized and returned to the facility weakened, but with her updated advance directives in place. This facilitated her eventual death and, had she been resuscitated but further disabled, it potentially saved the system several thousand dollars.

It shouldn’t take Google and divine intervention to meet the basic needs of residents. However, it takes a full team of workers. Every day without one costs us money and our humanity.

Eleanor Feldman Barbera, Ph.D., author of The savvy resident’s guide, is a Winner of the Award of Excellence in the Blog Content category of the APEX Awards for Publication Excellence program. She is also a Bronze medal for the best blog in the American Society of Business Publication Editors national competition and a Gold medal in the Blog-How To / Tips / Service category in their Midwest regional competition. To contact her for speaking engagements, visit her To EleanorFeldmanBarbera.com.

Opinions expressed in McKnight Long Term Care News guest submissions are those of the author and not necessarily those of McKnight Long Term Care News or its editors.


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