“If Governor McKee doesn’t change course and allow the safe staffing law to proceed, the quality of care will continue to get worse and residents will suffer.”
By Cheryl Chianese,
RN in UpRiseRI
Recently, Governor Daniel McKee issued an executive order delaying The Nursing Home Staffing and Quality Care Act. There couldn’t be worse timing to halt implementation of the nation’s strongest staffing law and it’s imperative he change course.
I offer this
perspective both as a former nursing home employee and also as a daughter who
watched my father suffer firsthand from inadequate nursing home staffing.
In the 1990s, I was employed as a staff RN/shift supervisor at what was then Elmhurst Extended Care, now known as Elmhurst Rehabilitation.The dignity and comfort of our residents was priority. This was reflected in the quality of our food, medical supplies and linens.
It was also reflected in our staffing; 30 nursing home residents could depend on 5-6 CNAs and two nurses. Registered nurses always filled supervisory positions. Standards of care have drastically changed, much to the heartbreak of so many families.
My father was first admitted to Elmhurst on November 3, 2019 for
temporary rehab after a hospital stay. But problems with his care became
quickly apparent and his condition rapidly deteriorated – despite the
dedication of his caregivers.
The first night he was admitted, my father locked himself in the
bathroom, which was related to his increased confusion. Due to lack of
staffing, it went unnoticed for hours. I then learned that he was sleeping
nightly in a chair near the nurses’ station which was a “resolution“ to that
event and decreased staffing. On several occasions, I observed him wearing
ripped socks and johnnies. I would bring in Gatorade, Ensure and snacks each
visit because of lack of supplies. On one occasion, I noticed he had flu
symptoms. I asked the staff to take his vitals but there was not a working
thermometer on the unit.
Once the pandemic hit, all in-person contact ceased. I was reduced to monitoring him through staff phone calls. As I could no longer bring in supplements and encourage eating and hydration, he became deconditioned and lost 13 pounds in less than 2 months. Then, I was contacted that he had COVID and was being moved to the COVID unit. Because of short staffing, nurses were forced to float to all units, including the dementia and covid units, which could have led to cross contamination of the virus.
On June 4, 2020, my dad passed away from COVID-19. I did not
have an opportunity to say goodbye.
Throughout his time there, I got to know my father’s caregivers.
I was aware of their frustration and despair. Many of them came from other
countries, made minimum wage and were not given proper support and resources.
It was common for only 3 CNAs and one LPN to be responsible for 29 residents.
Sometimes one nurse had to cover two units.
It is devastating to think that my father’s experience is
commonplace in today’s long term care system. Quality care has been compromised
for profits at the expense of patients.
In conclusion, If Governor McKee doesn’t change course and allow the safe staffing law to proceed, the quality of care will continue to get worse and residents will suffer. There will always be a need for skilled care for people like my dad who could no longer safely stay at home.
But if
competitive wages and safe staffing levels are not offered, nursing homes will
lose valuable employees. The future of our long term care system is determined
by the decisions our leaders make today. It’s time Governor McKee makes the
right choice.
For more on the Nursing Home Staffing and Quality Care Act, see:
After long battle, Nursing Home Staffing and Quality Care Act becomes law
Report: Inadequate staffing levels and low caregiver wages magnified nursing home crisis