The lack of staff in nursing homes in Texas is fueled by various causes. There are other medical settings where the staff is paid more money per hour, making the nursing home setting less competitive. The turnover rate for staff such as janitorial technicians and certified nurses’ aides continues to be elevated. Nurses with experience and should get paid more and they are aware of the fact that there are other jobs available. The other reason people quit is because they are over extended whenever the staff to patient ratio is increased. Both the underpaid and the overworked staff make mistakes and save time by taking short cuts. Administrative personnel are then held accountable for counseling and eventually firing employees. Nursing homes provide services to many people who re unable to be in their own home due to illness or age-related issues. There is a long list of daily responsibilities for each staff member to take good care of the patients or residents in each facility (U.S. Newswire, 2000). That being said, yet another consideration on the lack of staff and the high turnover rate is the fact that some people get jobs in nursing homes, intending to do a good job and get paid well, but later discover that working with the elderly and terminally ill patients is more than they can handle (Kapp, 2003).
The second challenge in providing good care in nursing home facilities there has been an uprising of new regulations and health codes specifically designated to nursing homes. The purpose of these rules is to ensure that residents are getting cared for and in a dignified manner across the board (Health and Safety Code, 2008). Whenever the government has decided to make a new list of laws, they must then decide on how to investigate and enforce the laws. For the purpose of nursing homes, this means that there will not only be more monitoring from state and federal commissions, but that there will be more fines to deal with. When the state sends a surveyor to a facility to investigate a claim that there is some kind of neglect, abuse, or otherwise illegal activity, there is an anxious and tense air that the residents and the staff both deal with. It has been noted that the inspections that are called surveys are not set up in a way that is most beneficial for both sides. A lot of things are missed and other smaller issues are cited and the fine is too high, especially for some of the smaller facilities (Dicken, 2008). Fines can be quite substantial and can close nursing home facilities if they cannot pay them in the allotted time. Because of the fines growing and the amount of the fines getting higher, the only way a smaller facility can hope to stay in business is with the Medicare contracts. A Medicare contract allows the facility to take Medicare patients. Patients can then be treated without the worry or burden of costs to their family. These contracts are important to small facilities because the turnaround for payment is faster and Medicare can refer patients to facilities that are equipped to deal with their individual illnesses and provide special accommodations as Medicare sees fit.
The last issue pertaining to the challenges nursing homes face when trying to provide excellent care has been technology. As the world grows smaller by means of technology, “technology represents one of the big reasons that nursing homes have been challenged in giving good care to residents” (Child, 2004). New programs and software that allows doctors to communicate with the other people involved in each patient’s care have been developed and continue to grow. Therefore, every person who is involved with the program or special equipment must commit to being trained to use the system or other technology. Some nurses in the nursing home settings have been working in their field since before many of the technological advances we have now ever existed and they may find a better fit where there is less emphasis on software experience. Another aspect of how technology has affected the nursing homes is that the internet now allows potential clients to look up a nursing home that they are interested in and find out how well they have performed according to not only the state surveyors, but also individuals can post their thoughts on their experience and sway customers away.
In conclusion, because it is believable that there will be twice as many people living in nursing homes in the next decade, as a country, we should develop a sense of what is right and necessary that still allows employees to feel fulfilled in a way that encourages them to give great service everyday to nursing home residents (Burkhalter, 2009). Perhaps some technology is useful, but the cost of the newest cool gadgets may be the number of available staff in the facility. Regulations and laws definitely have to exist so that if there is a clear answer to any question about what is appropriate for nursing home residents’ quality of life. In order to run a nursing home on an everyday basis that is physically possible and pleasant for the patients, reform must be made in regards to monitoring and fines. Learning how we can create an efficient and comfortable environment inside the walls of those facilities is imperative.
References
Burkhalter, C. L. (2009). Examining the effectiveness of traditional audiological assessments for nursing home residents with dementia-related behaviors. Journal of the American Academy of Audiology , 20 (9), 529.
Dicken, J. (2008, May 15). Nursing Homes. GAO Reports , p. 57.
Kapp, M. B. (2003). Legal anxieties and end-of-life care in the nursing homes. Issues in Law & Medicine , 19 (2), 111.
U.S. Newswire. (2000, July 26). Gephardt Statement on the Nursing Home Quality Protection Act. U.S. Newswire , p. 1008207n8698.
Health and Safety Code Chapter 242. (2008, September 1). Retrieved from Convalescent and Nursing Homes and Related Institutions: http://www.statutes.legis.state.tx.us/Doc/HS/htm/HS.242.htm
