The Toxicity of Long-Term Care

Minimizing the Nurse Shortage

Nurse Bailey

It has been three years since Covid-19 changed the course of healthcare. Whether that change has been good or bad is up for debate. Relatively speaking, the business-as-usual prototype for long term care still dictates how facilities operate. It is within these models where underpaid and understaffed scenarios are the norm exposing the most abused profession in the workforce, the American nurse. Within reason nurse disparities have doubled since the onset of Covid giving rise to trending shortages without considering a failing health system.

If you question the validity of this claim refer to the nursing board and examine what each state considers safe ratios for skilled nursing facilities.

Many agencies justify ratios of 1:30 sometime even 1:40 as acceptable. How is this even legal? Keep in mind the same boards who regulate staffing are the same organizations who opt to suspend or revoke a nursing license for deviation of care.

How can you rightfully determine one nurse can manage the med pass, chart, do skin assessments, answer the phone, do admissions, speak with families, perform treatments and keep the residents from falling?

LTC befittingly compares to a mad house of mirrors and is full of illusion.

Let us take a look at the LTC expectation.

Charting- Who are you required to chart? Patients on antibiotics. Skilled nursing charting which defines the rationale for skilled services. Incident charting- includes falls, behaviors, elopement, and exceptional charting. How long does the charting process take?
(2–4 hours per shift)

Med pass- LTC facilities typically have a medication pass at 8am, 10am and 1pm for dayshift. How long does the med pass take per shift? (3–4 hours)
Keep in mind each resident receives ten to fifteen pills three times a shift.

Vital signs- Each patient receives two sets of vitals. One in the morning and one in the afternoon. Total time (2 hours)

Lunch- The standard lunch break is 30 minutes with two 15-minute breaks per 8 hours. (1 hour)