When the Covid-19 pandemic came to America, nursing homes became “ground zero” for the pandemic. Although less than half of 1 percent of the U.S. population resides in nursing homes, they account for nearly 40 percent of all Covid deaths. Nursing homes are supposed to help residents remain safe and healthy, but the opposite turned out to be the case: When it came to the coronavirus, residents in nursing homes were more vulnerable, not less.
There are many ideas floating around for how to fix nursing homes to make them safer for both long-term residents and short-stay patients going forward. Those suggestions include making facilities smaller, with more private rooms and bathrooms, to keep contagions more contained. Other ideas include partnering with hospitals and improving infection control.
But rebuilding nursing home facilities is an expensive and long-term solution to an immediate crisis. I’ve been studying long-term care settings for many years, and I think there’s a quicker and possibly even more effective approach we can take in the short term to ensure better care for our seniors in the post-Covid era: improve staffing.
It’s no secret that nursing home staff are paid relatively poorly for incredibly demanding work. Certified nurse aides who provide over 90 percent of direct resident care are often paid at or near minimum wage — the same wages as entry-level workers in retail establishments or fast-food chains. Nursing staff are also underpaid; registered nurses and licensed practical nurses who work in nursing homes are often paid below their counterparts who work in hospitals and other health care settings.
What’s more, nursing home staff often lack essential benefits, like health insurance and paid sick leave. That means nursing home workers are incentivized to come to work even when sick — how does that make sense when they are caring for medically vulnerable residents during a pandemic?
Nursing homes are also very hierarchical workplaces with lower-level staff having little autonomy and control in their jobs. Not surprisingly, being undervalued and unempowered makes it hard to recruit and retain individuals to work in nursing homes.
The result is that many facilities around the country often have dangerously low levels of staffing. Additionally, the average U.S. nursing home was recently found to have an annual staff turnover rate of 128 percent. This suggests an average facility’s staff completely changes over the course of a year, and many nursing homes have even higher turnover rates — as much as 300 percent — suggesting the staff changes every four months. If some part of good nursing home quality depends on the relationship between staff and residents, it’s hard to see how those relationships can develop when staff keep changing.
Working conditions have always been challenging in nursing homes, but this has been magnified during the pandemic. Over half a million staff have had confirmed Covid cases, and over 1,500 staff have died from Covid, making nursing home caregiver the most dangerous job in America. Many staff have not received hazard or hero pay or any additional benefits during the pandemic. Many nursing homes have experienced severe staff shortages, with limited access to personal protective equipment and rapid Covid testing. The jobs are so low paid that staff often work in multiple facilities, which contributed to the virus spreading across facilities. Not surprisingly, many nursing home staff report feeling “worn down and stressed out.”
Why do we undervalue staff? Some of this relates to who they are. The majority of the nursing home workforce are certified nursing assistants. These direct care workers are predominantly women, and many are people of color and recent immigrants. Relatively few nursing homes are unionized, and many staff lack the ability to advocate for better pay and benefits.
"here" - Google News
March 11, 2021 at 04:30PM
https://ift.tt/3rElZy3
Opinion | Nursing homes need fixing. Here's where to start. - POLITICO
"here" - Google News
https://ift.tt/2z7PfXP
https://ift.tt/2Yv8ZPx
No comments:
Post a Comment