Wednesday, August 4, 2010

Nursing Home Care and the CNA

I have spent a large part of my professional life taking care nursing home patients. I have worked on management teams, and studied systemic approaches to improve care.  What I learned is the following. The direct care giver (CNA) is the key to the sucess or failure of a nursing home facility. So when a recent newspaper article about nursing home horrors was published, it stirred some emotions... enough to bring me our of my social media slump.

An online response to this article from a nurses aide demonstrated how unappreciated she felt.  Clearly, this response was from an individual who has the toughest job in the world.  Just think about what she must do to get through the day.  In some cases, aides are the only connection the patient has to the world. The dedication of some of these individuals is truely remarkable. I often wondered why anyone would do such a thankless job when they could earn more in Walmart and have a better quality of life.  The majority of aides care about their patients as if they were family. They infact do what most family members cannot or will not do. They get it from all ends; patients, family and management.  Ironically, they are the least paid and most undervalued members of the nursing home staff. This is evidenced by the tendency is to cut aide staffing during economic stress rather than management positions. This make no practical sense at all.  One middle management position would equal many CNA fte's.
If an investor approached me and said lets build a new nursing home, I would start with the aide. Focus your resources to ensure they are trained properly and have the proper temperment. I would pay them well and make sure they are part of key decision-making in they facility. They are an extension of the family and as such they should be involved in important aspects of the patients life. I would let them know they are enriching the lives of fellow human beings and intern enriching their own.

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