Thursday, April 2, 2009

McDonald Hire

Time is short, your back is against the wall, you are down one assistant with pregnancy, one with emergency surgery, and one with pneumonia, what are you going to do?

You have tried everything but giving birth to a full grown nurse assistant. Administration tells you agency is not an option. You have to have staff on the floor. Who will care for the residents?

You open your office door, music from “Chariots of Fire” starts playing, a bright light appears over your desk, and the room fills with the fragrance of fresh cut roses … nay... you are dreaming! It is the same old office and the same old smell. Back to reality!

If there was a quick fix, I would package it, sale it and retire to an island without phones.

On your desk sits 4 resumes of candidates that you pushed aside, but now in the “real light” of day, you think they might not be so bad. Their references are good, they have moved around a lot, but they have no charges of abuse, they are not felons, they are certified and “WHAT” they can start right away!!

The past has taught you these types of candidates will be gone in a month or at tops, three. However, today a month is a very….long time. These are what I call “McDonald Hires”, no one wants a steady diet of McDonald’s food, but when you are real hungry that “Quarter Pounder” looks!

A facility of McDonald Hires would end in disaster just like a steady diet of McDonald’s food. The cholesterol would kill you. Staff that only stay for a month or two would be very unhealthy for the residents! Medication errors would occur, baths would be missed, dressings would not be changed, diets would not be adhered to, etc. Continuity of Care is essential for residents and that can not be attained if staff come and go through a revolving door.

With that said, in times of emergencies, emergency measures must be taken. However, an emergency situation is short lived. The McDonald Hires are only there to give you and the hard working staff a break. Take the break, but know it is short lived. Get strong and then get out there and do what you have to do to develop a pool of interim staff.

When I was a Director of Nursing (I had to walk two miles in the snow to get to work and it was uphill both ways) in the great state of Ohio, there were several nursing homes in a 6 mile radius of where I worked. I invited the DNS’s of these homes to meet with me and discuss developing a pool of interim staff that we could all call on to use during times of shortage. We had to agree to share the on call for this pool, to set the salary the same, to keep the benefits the same, to sign a non recruit and non compete, to serve first called and to have the same job descriptions and requirements.

It took us a while to work through things and a whole bunch of cooperation, but we did it and for the remainder of my time as the DNS (one and half years) in that facility we were able to successfully share a group of staff. We were able to keep the pool staff busy between the 5 facilities.

It really does take stepping outside the box to make things work sometimes.

Remember you can now train volunteers to feed residents, therefore, if you train a few of those to feed and those same volunteers can help escort residents to the dining room, they can serve trays, they can make beds, they can set up the shower room with wash clothes, towels and resident’s clothing and bring the resident to the certified nursing assistants to bathe the resident, etc., etc. These things can help in a pinch and it definitely frees up the nurse and the nursing assistants to do what is required of them. Do not forget to train these volunteers on HIPAA and have them sign off.

McDonald’s anyone?

Written by Peg Tobin