Jacqueline Vance, RN
Jacqueline Vance, RN

It’s back to school time. I picture in my head that silly commercial of the office store with the dad skipping merrily through the store throwing school supplies in his cart while his two kids plod, heads hung down, behind him.

Truthfully, for most of the world, figuring out childcare just got easier. We want to celebrate! But it isn’t so easy when you have to be at work before school starts, or after it ends AND you’re making the money a nursing assistant makes.

Let’s face it, these are some of the hardest working, lowest paid employees out there. (I know, we can’t change long-term care reimbursement overnight and this isn’t the platform to get a change, but …)

So for them, additional childcare is not only a challenge, it can be unaffordable. I recall years ago, one nursing assistant who repeatedly showed up at 7:20 a.m., despite being written up for serial lateness. We, of course, had to have a talk and she finally opened up and told me that she could not drop her children off at school until 7 a.m. She could not afford preschool daycare, which required a minimum of one hour’s pay per child, and her children were too young to leave on their own.

She explained that the soonest she could get to work was 7:15 or 7:20.  She did not want to work a different shift, as the school had a free after school program and could keep her children until 4 p.m. She was a really good nursing assistant with dreams of becoming a nurse. I didn’t want to lose her. Something told me that this was an issue affecting other employees, ones I didn’t see or hear about. And … I was right.

So, what to do? One of the principles of performance improvement is questioning why you do something the way you do it. So, yes, we have shifts and we need shifts covered, but there had to be a way to do that and help our employees meet their needs on a tight budget.

I decided to think outside of the proverbial box. I posted memos announcing a meeting on each shift for employees who had children and were interested in sharing childcare. I was amazed at the number of people who showed up at each shift meeting, and not just nursing assistants but also workers from environmental services, dietary staff, and some other nursing staff.

The result: Employees found others in their neighborhood whom they felt comfortable sharing child care with. Staggering shifts by 30 minutes (for example, an 11 p.m. to 7 a.m. employee worked 10:30 p.m. to 6:30 a.m. instead, meeting a 7 a.m. to 3 p.m. employee’s children at the facility and taking them from there or getting home in time to meet them; an 11 p.m. to 7 a.m. employee working 11:30 p.m. to 7:30 a.m. instead, being able to childcare share with a 3-11 p.m. worker.

Somehow it worked (bless my scheduling coordinator). All shifts were covered, childcare became affordable and people were happy.

So if we get creative, this can be the most wonderful time of the year for everyone — except probably the kids!

Just keeping it real,


The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.