To Keep Staff, Evaluate and Educate

Abstract

Susan Birk is a freelance writer in Chicago. CHICAGO — High turnover and staffing shortages are undeniable realities of long-term care, but providers can begin to tackle the issues by taking stock of what their organizations are doing right, according to a leader of a large retirement-services organization. Although staffing issues in long-term care can be daunting, “be patient and celebrate the small successes” instead of focusing on the problems, said Vickie Ragsdale, MSN, RN, director of education at Buckner Retirement Services in Fair Oaks, Tex. “It's really important to look at what does work,” said Ms. Ragsdale in an educational session at the annual meeting of the American Association of Homes and Services for the Aging. Noting that no single staffing strategy will meet the needs of all providers, Ms. Ragsdale offered the following suggestions, based on her experience at Buckner, to help administrators frame their own approaches to staffing issues: ▸ Evaluate the needs and strengths of the individual units and campuses within your organization in addition to looking at the organization's needs as a whole. Although demographic variables might make it impossible to apply the same retention strategies at all facilities, identify what is working at each and use what you can at other locations. “Look at the organization as a whole, but break it down from that point by campus, by team, and then by individual,” Ms. Ragsdale said. ▸ Facilitate regular communication. Despite busy schedules and physical distance, the nursing directors at Buckner's five campuses set aside an hour each month to share ideas and problem solve, with Ms. Ragsdale serving as facilitator and mentor. “Have everyone sit down and brainstorm. Have an agenda, direct the conversation, and bring up ways to help them figure things out for their team and for the residents,” she advised. ▸ Develop a person-centered career ladder. Buckner has developed its own year-long professional-development Webinar series for certified nursing assistants (CNAs). A mentor at each campus provides face-to-face, on-site support for staff. The four-level program covers such issues as stress management, motivation, conflict resolution, and clinical topics. The key is content that helps CNAs develop their personal skills as well as their patient-care knowledge, Ms. Ragsdale said. ▸ Consider new technologies and resources. Buckner has implemented paperless technology for all CNAs at its skilled-care campuses and has done an extensive no-lift, injury prevention program. “Budget sometimes stops you, but look at the end result,” Ms. Ragsdale said. “Sometimes the benefits are so helpful, you'll end up saving more money than what you spent up front.” ▸ Provide continuing education to nurses at no cost. Following completion of an 8-month program sponsored by the Texas Nurses Association, Buckner earned status as an approved provider of continuing nursing education in the state. As a result, the organization can provide continuing education to its nurses on site and at no cost. Although the time commitment involved in becoming an approved provider is considerable, the effort pays off, said Ms. Ragsdale. Nurses can earn their continuing education credits through Webinars provided by the organization. “It is a lot of footwork, but it is awesome to be able to say you provide that for your staff,” said Ms. Ragsdale. ▸ Provide educational opportunities for the night staff. Since 2008, Buckner has offered monthly Webinars at 2 a.m. for the night staff at all of its campuses, and this small effort has helped staff feel valued, said Ms. Ragsdale. “Be sure when looking at education that you do a needs assessment,” she advised. “We developed a one-page survey that we look at on hire and then annually, so [education] is not just according to regulations” but also reflects the staff's interests.