Are you a manager who feels like this or do you have staff relay to you that they feel like this.

If you are being honest then you and your staff may feel like this on any given day.

Do you ask yourself is this job worth it? Is this job causing me to lose sleep or worse have physical negative symptoms such as headaches, weight gain, weight loss, increased anxiety to name a few.

Do you feel that everyday you give your best with what is available at the moment to meet the goals but it just isn’t enough. Do you feel that your roles now have blurred lines of responsibilities and you are expected to do more of what was not in your job descriptions due to staffing shortages, or just due to the hiring of inexperienced staff.

Are you struggling to get your job completed in the allotted time? Are you an employee who is paid by a salary and expected to do what it takes but now that may be 55 plus hours that interfers with your family time. That salary may have been what you thought was great but you now see that coworkers who punch in without the responsibilty that you have are actually being compensated for what they do or don’t do.

This all leads to the question of what do we need to change in this culture to help us to continue to work in an industry that we love.

I should share that these are my thoughts and my ideas that I am expressing and not from any textbook or from any educational expert. It is rather based on my many years of experience as a Nurse who has worked at the center level as a staff nurse, as a DON, as a Nurse Consultant and as a regional manager. I have also worked utilizing my paralegal education as an expert witness for a law firm that represented nurses who were accused of negligent nursing care.

My Thoughts:

We need to acknowledge that life as we knew it in Long term care has changed.

We need to stop blaming the inefficiencies that are noted on Covid.

We need to get back to holding the staff accountable to do their job.

At the management level:

That includes expecting the Administrator and Director of Nurses to solve the problems in their buildings. In the old days you were expected to know the regulations inside and out. You were expected to strive to have positive outcomes and know what was occurring in your facilities. You had 24 /7 accountability. Your managers had 24/7 accountability. You didn’t give most of the management staff vacation at the same time. You had plan B for most unexpectant situations. You did not have a corporate structure that ran in and saved the day. Your team did what it takes to produce positive outcomes for the residents in your charge.

At the Staffing level:

It is not acceptable to not document care provided.

It is not acceptable to committ to working and then not show up.

It is not acceptable to show up for a shift late and expect the nurse who was on the prior shift to cover until you get there.

It is not acceptable to expect the nursing staff to complete assessments that should be done by other disciplines because they weren’t done and the Nurse knows how.

It is not acceptable to expect Nurses that have a job that is not direct care to now cover shifts and complete direct care roles because they have a nursing license.

I always say would you want a foot doctor delivering your child? I think the answer is obvious. Well why should a nurse who may have not been a staff nurse for several years now be expected to provide direct nursing care?

I am speaking of MDS and MMQ nurses who are now expected to pivot whenever a staff nurse is not available or calls out. They did not sign up for that and that same staff nurse can’t pivot and reciprocate. The MDS/MMQ nurse ends up not completing timely assessments that can have both a patient care and revenue negative outcome. It can lead to a delayed timing of developing a plan of care for the residents. It also can lead to lack of ability to monitor documentation to ensure that accurate coding is being done.

It is not acceptable to bully or make your coworker feel less than a nurse because they voice this concern of now after many years needing to pass meds for 20 plus residents and expect to do it well.

Some of you may be reacting and saying well yes this would all be good if it was 2016 and where am I coming from. I am coming from being a manager who now sees Nurses who are talented and experienced leaving the field of Long term Care Nursing. Listening to them expressing that more is never enough.

Let’s remember our “ Why” of what led us to Long Term Care nursing. It is time that we get back to disciplines completing their basic role expectations and then offering help to the team to get what’s needed done.

Let’s examine what is the root problem leading to most of this added stress.

It appears to be the staffing shortage in all the fields needed to meet the needs of the residents. It is not just Nursing. Social service and ancillary staff are also affected.

Unfortunately, there is the crucial nursing shortage. Agency nursing has been needed to bring staffing levels to the regulatory guidelines. This has come with added difficulties because they may not know the residents as well as the facility staff. Again, this is where facility staff can help. They can orient the agency staff. They can try to get consistent staff. They also can not contract with staff that does not complete the expectations of the facility. Here is where accountability comes into play again.

Staffing is going to continue to be a problem and as an industry we need to find a way to retain our staff and welcome new staff.

I encourage staff that work in this industry to promote kindness, fairness, and teamwork. I encourage you to breathe more, take timeouts when the stress level begins to rise. I encourage everyone at any level to compliment fellow employees whenever you notice one another doing the right thing or something special. That means if you are an aide and you see your manager doing something that you think is great tell them. If you are a manager and see another colleague doing something you think is great tell them in the moment. I encourage managers to tap into the strengths of your staff. You should know who is good at what and encourage them to share their wealth of knowledge with the rest of the team. We all want and need to be acknowledged for our efforts whether they are big or small. We want to know that we matter and made a difference because we came to work today. Please remember at the end of the day if we are stressed then the residents in our charge are stressed.

I recommend a couple of resources for anyone who works in Long Term Care noted below:

The inspirational Leader: Inspire Your Team to Believe in The Impossible By Thomas Gifford.

Mindfulness Made Easy Learn How to Be Present and Kind – to Yourself and Others. Ed Halliwell