Nursing Homes and Staffing Level Study -- It is a Lose-Lose Work Environment

My clients are medical professionals working in emergency rooms, surgery centers, mini-clinics, rehabilitation homes, and hospitals. The majority however work in nursing homes. The clients are on the front lines of our modern medical war on cost cutting and corporate profit maximization.


A recent study confirms my conclusion that nursing home staffing levels are inadequate. Understaffing and high patient census creates enormous exposure and risks to the licensed professional. Low staffing levels result in care shortfalls. Inappropriate staff-to-patient ratios on weekends and holidays result in sicker patients, with significantly more complexmedical conditions.


During weekend and weekday evening shifts residents still require assistance to the bathroom, eating, and repositioning to avert bedsores. Nursing homes that intentionally maintain low medically trained staffing levels ignore these facts. Consequently, day work nurses are exposed to more demanding, sicker patients who are left alone in the evenings and weekends. This, in turn, exhausts all medical professionals generating further care gaps. Fluctuations in staffing levels, legitimate or not, also place significant burdens on family members who paying for 24-hour skilled nursing care, to dress, bath, care and feed family members. Longer illnesses, of greater depth and severity, tax the entire nursing home community.


The report reveals some nursing homes may go several days or a week without a single RN or LPN on staff to provide the skilled nursing care many residents require. Simple pain management methods and preventive care techniques are omitted. When nursing homes reduce LPN or RN staff schedules, residents' medical needs become exponentially worse. License professionals arrive at work confront ongoing and continual emergent patient medical needs that, if addressed preventively, would not be so great.

This work environment exposes the license professional to family member licensing complaints and investigations of missed medications, inappropriate care, neglected care, and possible malpractice. Pain medication demands and doctors that place PRN prescriptions on the charts lead to nursing home audits and allegations of overrides and charges of high level of narcotic dispensing based the same PRN prescriptions required for longer lasting illnesses.  As a mandatory reporter, the nursing homes that create the horrible work environment then blame and report the nurse to the state licensing board.

This toxic combination creates a work environment that is untenable but on going every day. Nursing home administrations that focus on money saving measures via reduced staffing levels create higher long-term medical costs. Patient/resident falls, bone breaks, contusions, bedsores, infections, pneumonia are all preventable if the staffing levels are proper. It is the RN or LPN that gets blamed first for the nursing home administration staffing level caused work issues. Please call to discuss your case.

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