Q: I have been at my building for five months as a new director of nursing. I am having trouble filling the schedule to cover all the needed resident care. My supervisors are working the cart, and the medication nurses are assisting the aides. Do you have any suggestions?

A: This is definitely the most asked question at the moment. It seems that the facilities that have had some success have made several specific moves. Meet with your staff, one-on-one and ask where the help is most needed.

Look at your medication pass time and the number and type of meds being passed. See if you can combine some of the med passes, as many facilities have meds every hour, which potentially can keep a floor nurse anchored to the cart for her entire shift. 

Meet with the medical director and other physicians to see what meds you can move, combine or discontinue.

Think about scheduling and hiring nurses for three- , four- , or six-hour shifts. Maybe there are some moms who can work only while their kids are in school — or after the kids go to bed. Or there’s a nurse getting her degree and only has a few hours here and there. Hire them! Give your overworked nurses some assistance!

Same with nurses aides. Perhaps hire some high school students to pass water and ice, deliver the mail, read the mail, make the beds or tidy up the rooms. They may love what they are doing and decide to become certified or even apply to nursing school. Bring them in during your busy times, or activities times. Many high school groups, such as the Future Nurses of America, may be perfect, or approach church youth groups and the Girl Scouts and Boy Scouts.

I know thinking out of the box can be hard to do and hard to be accepted by others, but it could be a way to help you. It bears stating that raising salaries, granting paid time off and offering incentives also helps!