The circle of life. It applies to everything around us. We all exist at different stages on this ride we call life. Our elderly family members and friends go on to their final resting places and are replaced by the new little ones in our lives. That is how is supposed to be.
Our staff is no different. They arrive as shiny new employees, some staying for years, some a few months. I am not telling you anything new when I mention that there have been and continue to be high turnover rates among nurse aides. Whether they are moving on to nursing school, choosing to retire — or in the worst-case scenario — just leaving your organization, it is an ongoing challenge.
This is a time of quick change for our industry. PDPM is here. Everyone is looking for ways to maintain revenue streams and make sure nurses are ready to meet the increased challenges they will have taking care of residents with multiple comorbidities.
And what about nurse aides? The current focus is on making sure nurses are ready for the challenge, and they need to be. But the challenges our industry faces are not limited to nurses and nurse managers. Nurse aides will need to cope with the increase in acuity as well. They will be working with residents who have less mobility, more equipment, and because of co-morbidities, higher risk for quick or subtle changes in condition. Your nurse aides are the nurses’ eyes and ears on the floor. They are the first line of defense when it comes to recognizing change in a resident. Their education needs to be up to snuff.
There are a lot of factors to consider when assessing how well qualified your nurse aide workforce is for dealing with the coming onslaught of industry changes. How do you find your nurse aides? Are you recruiting people that are already certified? Are you raising your own, instilling your mission and vision in them and teaching them the way you want them to provide care to your residents? Are you providing them with enough support throughout their tenure with your organization? What about mentorship programs where your senior nurse aides can help newbies adjust to their role? Do you provide them with a clear vision of what their career ladder looks like, should they choose to climb it?
Recruitment and retention, while very important, are just pieces of the nurse aide solution puzzle. Managing your entire nurse aide supply chain (including education) is the key in a long-term retention solution. If you already have a nurse aide training program, look at where you are getting your candidates. Local high schools are generally an untapped resource in nurse aide recruitment. Don’t forget that staff in your other departments may be interested in becoming nurse aides. You may have diamonds in the rough around you already! Find out who they might be.
Some facilities are moving to a philosophy that all employees need to be trained as nurse aides. That may or may not work for your organization or for all employees, but it’s something to think about. Some states are increasing the scope of what nurse aides can do beyond being medication aides. Even the scope of LPN practice is changing. Some states are requiring nurse aide certification as a requirement for nursing school.
This, of course, is all in response to the ever-evolving reimbursement climate. As time passes, these challenges will only grow in number – disrupting the way we currently do things. I know you have all heard “think outside the box.” Better than that is to think like there is no box at all.
As the LTC industry adjusts to PDPM, organizations should consider creating and managing their own nurse aide pipelines. By doing so, you will be able to fill staff vacancies before they happen, keeping in line with your goal of providing the highest quality of care, while maintaining financial stability. Plan for future shortages now and prevent forthcoming lapses in quality care.
Debi Damas, RN, is a clinical consultant with Straightaway Health Careers, a Relias sister company.