This is the first in a series of articles we will be writing on topics related to nursing home staff turnover, keeping the aides happy and keeping the UNIONS out.
Let’s list some reasons why this work is unattractive, to CNA’s:
1) The obvious- very low pay
2) The work itself…physically brutal, demanding, hard, non stop…
3) Poor Management
* Good aides are not recognized via pay raises, special bonuses, a write up based on their GOOD traits ect.
* Bad aides are given too much slack and leeway, and they are often the ass kissers to management
* Managers/DON types don’t come out to the units often to see who is working hard and who is not
* New CNA’s are not given adequate training/orientation periods. Who mentors the new aides?
* Families: Some are very rude, abusive and have too many expectations. Management needs to be supportive of staff!
* Aides who abuse policies are allowed to continue employment. Call out queens, those who are late or leave early…
* The other side- being TOO strict with policies can lower morale and cause turnover (POINT SYSTEM anyone?)
* A DON who disrespects CNA’s- where there is high turnover there should be a BIG question as to the worthiness of the DON
* Charge nurses with BIG HEADS and little anything else- they ruin the atmosphere and morale
* Schedules- no creativity. It’s always every other weekend; every other holiday…CNA’s are given little leeway in this
* The work we do is often over supervised or under supervised- there is little middle ground (AKA trust)
* Assignments are not always fair, spread out evenly; aides get stuck working with the same residents and it can get OLD
4) Lack of autonomy
* CNA’s are given little voice in the work they are asked to perform. Their input is rarely asked for when decisions are being made about policies, procedures, ratios, new admissions and budgetary issues. How many CNA’s are invited to join safety committees and daily rounds? How many CNA’s are asked to give feedback when a care plan is being written? (and not just the ass kissers; aides from all 3 shifts)
* CNA’s are not trusted in the work they are asked to perform. Nurses, especially those with big heads and egos, are always out to make aides look bad or to “catch” them doing something wrong. Why not catch them doing things RIGHT and being positive about it?
* Ratios make this work difficult to manage. Resident demands vs. real needs are lost in the daily shuffle and it makes the shift very difficult to work. Expectations of overzealous families, catering nurses dictate which residents are priorities, vs. real and true medically needy residents.
These are things management can think about. What can be controlled and what can’t? How can these issues be addressed? Culture change is hard work. The mindset of so many who work in the nursing home, from the Administrator to the aide to the housekeeper to the dietary worker can and should change.