Keeping Unions Out, Part One
Posted by Kim on February 12th, 2007 / Print This Post
This is the first in a series of articles we will be writing on topics related to nursing home staff turnover, keeping the aides happy and keeping the UNIONS out.
About nursing staff turnover, in nursing homes.
Nurses are at a premium throughout California, but high nursing home employee turnover is leaving some facilities scrambling just to fill ranks.Nursing homes are not an attractive post for certified nursing assistants because they work extremely hard for minimal wages, said Tippy Irwin, coordinator of the Long-Term Care Ombudsman Program for San Mateo County.
As a result, the industry turnover rate is 8 percent. Nurses who are employed at nursing homes often have to work two jobs and come to work under enormous stress, which hurts the residents for which they care, Irwin said.
“The system needs to change,” Irwin said. “They need to recognize that (CNAs) are the pivotal people because that’s where the care is all happening. CNAs need to be paid what they’re worth. They’re lowest on the economic ladder, and yet they are the ones doing the heavy hands-on work.”
Even when given comparable wages, however, some nursing home administrators say they still can’t attract enough nurses. The reasons why nurses avoid long-term care facilities — and why they are sometimes attracted to them — appear to be a mystery.
Let’s list some reasons why this work is unattractive, to CNA’s:
1) The obvious- very low pay
2) The work itself…physically brutal, demanding, hard, non stop…
3) Poor Management
* Good aides are not recognized via pay raises, special bonuses, a write up based on their GOOD traits ect.
* Bad aides are given too much slack and leeway, and they are often the ass kissers to management
* Managers/DON types don’t come out to the units often to see who is working hard and who is not
* New CNA’s are not given adequate training/orientation periods. Who mentors the new aides?
* Families: Some are very rude, abusive and have too many expectations. Management needs to be supportive of staff!
* Aides who abuse policies are allowed to continue employment. Call out queens, those who are late or leave early…
* The other side- being TOO strict with policies can lower morale and cause turnover (POINT SYSTEM anyone?)
* A DON who disrespects CNA’s- where there is high turnover there should be a BIG question as to the worthiness of the DON
* Charge nurses with BIG HEADS and little anything else- they ruin the atmosphere and morale
* Schedules- no creativity. It’s always every other weekend; every other holiday…CNA’s are given little leeway in this
* The work we do is often over supervised or under supervised- there is little middle ground (AKA trust)
* Assignments are not always fair, spread out evenly; aides get stuck working with the same residents and it can get OLD
4) Lack of autonomy
* CNA’s are given little voice in the work they are asked to perform. Their input is rarely asked for when decisions are being made about policies, procedures, ratios, new admissions and budgetary issues. How many CNA’s are invited to join safety committees and daily rounds? How many CNA’s are asked to give feedback when a care plan is being written? (and not just the ass kissers; aides from all 3 shifts)
* CNA’s are not trusted in the work they are asked to perform. Nurses, especially those with big heads and egos, are always out to make aides look bad or to “catch” them doing something wrong. Why not catch them doing things RIGHT and being positive about it?
* Ratios make this work difficult to manage. Resident demands vs. real needs are lost in the daily shuffle and it makes the shift very difficult to work. Expectations of overzealous families, catering nurses dictate which residents are priorities, vs. real and true medically needy residents.
These are things management can think about. What can be controlled and what can’t? How can these issues be addressed? Culture change is hard work. The mindset of so many who work in the nursing home, from the Administrator to the aide to the housekeeper to the dietary worker can and should change.
February 13th, 2007 at 6:52 am
Now, this was an excellent piece.
February 13th, 2007 at 7:09 am
About raises: Where I work, CNA’s all get the same percentage of raise no matter what…a good eval means nothing. A bad eval means nothing.
The best aides get the same 3% everyone else gets. Why is this? Why not give the bad aides 0 % and take give the good one the 3%? If this makes sense.
February 13th, 2007 at 7:14 am
Well Kevin let’s hear some input from you.
Solutions?
Another thing to add to this list:
Forced overtime. Aides are made to stay to work another shift and management seems to become dependant upon this, it seems. It’s almost as if they have use us as a back up to staffing problems. Not use us. Abuse us. We’re human beings who have lives; we have kids and families who need us. We cannot be forced to work extra shifts on a whim nor on an on-call, take turns basis. This is a BIG problem and it’s poor planning on the part of management.
February 13th, 2007 at 5:35 pm
Kevin what are your ideas and solutions?? Do you have any?
February 13th, 2007 at 5:38 pm
Cheryl I really like the idea with those raises going to those who deserve them. There is no reason this could not be implemented in most health care facilities. You are very correct in this thinking of the 3% going to everyone irregardless to how their performance has been.
There have been times, believe it or not when I have worked with exceptional aides across the board…they all deserve good raises. What happens when this is the case? When there is no one to cut a raise down? Esp. if the good aides get used to getting those better-than-average raises??
Excellent feedback.
February 13th, 2007 at 5:43 pm
Cheryl– mandated over time is just wrong too. Once in a while I can see the need. But it becomes a habit with many places and…this business of using this as a \”back up\” staffing solution is piss poor management. I know an aide who got forced to stay over three times in a week (several years ago) and her babysitter reported her to the state for neglecting her kids!
She lost them during the so called investigation of this. In the end her work ended up \”providing\” documentation of their need for her to stay the extra shifts vs her own need to be with her children. THAT facility changed it\’s policies within a week of this ordeal. It was awful that it even happened.
February 13th, 2007 at 8:47 pm
Kim you forgot this–
floating to other units
it’s not bad when you’ve been orientated to the residents, not neccessarily “trained”- we all say that yet we KNOW how to do the tasks of this work…it’s the fact we don’t KNOW the residents that bothers us.
this is a small thing but it sure can ruin morale when it happens a lot, to one aide or a few. We aides need to be flexible, for sure.
A place i know of has float aides- who work each shift and they’re job is to float to the other units if needed. They get paid extra, not much- a couple dimes- to know ALL the residents and their cares and all that. If the float aides aren’t needed- they stay for a few hours and help with cares then go home. I think, now, they are on call too. WHich means they call in to see if they are needed before coming to work.
February 15th, 2007 at 3:30 pm
I am a CNA in New Mexico and this hit the spot when it comes to a lack of CNAs to do the job. I have to agree with Cheryl on the forced overtime. We are made to work 16 hour shifts when someone calls off. If anyone doesn’t volenteer to stay over, then we have to pick. Then we have some that try to call off when they are accually sick and the DON calls them and tells them if they don’t come in and work they will be terminated. A lot of CNAs will just walk out if they are forced, due to this. A lot of the CNAs will not show up for their shifts as a way to tell Management they are quitting. We have that instance happening this weekend. We are just running to short and our DON is saying we are working tired. Its more like we are working exhausted to the point where it is a serious safety issue.
We are human beings that have lives and we are talked to about having sacrifies. Why should we have to sacrifies our lives just because the Higher ups can’t manage their homes?
February 16th, 2007 at 7:43 pm
Leave it to Kim to rally up a cause LOL…
Everything she put up here is true. And I don’t know what the answers are to it all. Nursing homes don’t get enough money to pay the aides decent wages. That’s fact. SOME nursing homes are run by companies that are expert are bleeding resources to the point of just BAD ethics- the for profit places that always seem to make that profit in these times…makes me wonder what kind of real harm is done to residents who reside in those places.
The management issues are real and tangible…and they can be fixed without money. Good leaders recognize the assets of the business, and good aides are always something to be prized.
Good aides should be treated with kid gloves and should be given the best treatment. But they should not be given a free pass either. I have seen good aides go sour when they get big heads. They get this way when they are never held to account for things…including kissing up to the bosses.
I’ll have more next week…
February 24th, 2007 at 3:43 pm
As a Nursing Home Administrator, I really enjoying reading everyone’s feedback here. I hope you know that there are good long term care leaders out there paying attention to your ideas. Remember, people that come to the table with solutions are the heroes of an organization. Here are a couple of things we are working on in our organization:
1. Cross-training all staff. Our environmental, recreation, and social services staff are all certified nursing assistants. They still maintain their “traditional” job descriptions, but when we are in a situation, they can assist where needed. This is a much better alternative to the mandatory overtime someone mentioned above.
2. In-house blog. Still in the works, but staff will see our internal blog as the homepage where the clock in on our computers. Not only will it host daily organization information for everyone to see, but staff will be able to have an interactive conversation just like this. We hope it will be an innovative new tool for including all staff in new ideas and initiatives.
3. True interdisciplinary careplan meetings. Our meetings may at any given time include a recreation assistant, housekeeper, and CNA. It’s about who is involved with the resident, not who would traditionally attend.
Keep up the good work.
February 25th, 2007 at 8:30 pm
Well now Matt…this is excellent stuff. JUST knowing that others are trained to be back ups for the CNA role is empowering. A day in my shoes, takes on a new meaning. It validates the empathy so many claim to have of the work we do. Are the aides cross trained to fill the shoes of the housekeeper and kitchen worker? if you have enough staff that should be done too…AND, for me, a BIG thing is ACTIVITIES. Residents look forward to them. Activities and nursing always seem to BUCK one another. Residents depend on nursing to get them to their daily activities and it would be AWESOME if the nurses AND aides spent some time in this area.
February 25th, 2007 at 8:31 pm
See this:
CHOICE ACTIVITIES
February 26th, 2007 at 5:06 am
I don\’t think a union can solve all these problems nursing home employees face on a daily basis. I would *hate* to see aides and others think differently.
Some things are in place because they have to be. A nursing home cannot leave it\’s patients unattended…sometimes requiring aides to stay over is the only option. When this is used rarely and in true emergency situations most aides I know *will* volunteer to stay.
Money? Unions can gain healthcare workers small raises and they can guarantee yearly increases by the percentage- more of a small cost of living increase than a merit raise though. Since aides are paid so poorly ANY increase is good even if it is not based on the quality of their work. The problem arises when the poor performers get raises-they don\’t deserve them. Union pay raises are not based on the actual good or bad work, they are just token. A given. A right. It takes away the desire of some to DO good work. Why show up all the time? When you know your attendance isn\’t going to matter come raise time?
February 26th, 2007 at 5:18 am
Also unions can and do get better benefit packages. That is a major plus.
Work place *rules* are altered as well…a nurse cannot just write an aide up. They have to have solid proof of an issue and they have to document these things very well. Unions *do* protect employees from unfair attacks from management- often based on personality conflicts.
So there are pros and cons to unions.
February 28th, 2007 at 1:10 pm
I am not a CNA but my daughter is one here in Oregon. The pay…not minimum wage but not enough. But if it is okay I would like to comment on the union issue. I’ve been an airline pilot for years and a proud Air Line Pilot’s Assn. member for years including an officer in the local (called the MEC) at times.
A union is not a cure-all. However it can improve things in many ways and to be honest at times the threat of a union can improve conditions. As an industy gets more unions the pay and working conditions for all will improve since all of the companies have to compete for workers. In the airlines it has made the treatment of the pilots more even, no favorites, no whipping boys. The union makes a company have to prove there is a reason to fire you. A good union will work for improved regulations in your industry and work against bad regulations. ALPA spends a lot of time and effort on aviation safety issues, not just the ones concerning the pilots. I don’t mind paying my dues! Cheap for what I get.
A union can improve pay and working conditions. But if the money isn’t there…it isn’t there. If that is true all the time there is something very wrong with that industy or company, but that is another issue. However they can have the muscle to make the company prove that there is indeed no money. Yes, I have taken pay cuts and had pay freezes but the union made efforts to make sure that they were needed and that the pilots were not the only group taking the cuts. Non-union jobs I have had left one with the feeling that the pilots got the increased work, drop in working conditions, drop in pay and managment didn’t join us in efforts to keep the company going, not fair at all.
The best way to keep a union out is to pay and treat the workers in a fair manner. I still feel that most of the time a company works to get a union on the property (in a negative sense). I have been at airlines when an organizing effort was being done. The company that could not afford to improve our pay and working conditions could afford to pay hundreds of thousands of dollars to a company (a law firm, one of several that do this) that exists to fight unions and union organizing efforts. If the money had been spent on efforts to improve things for the workers I doubt if the union would have been succesful. The waste of money on the anti-union effort pushed many anti-union pilots into voting for the union. “Gee, they can afford to pay them all that money while they complain they can’t afford us decent pay…? Let me think about that!” I find just find it very strange that the company that cannot afford to improve pay and working conditions for the people doing the work can find money (lots of money, those guys don’t come cheap!) to pay outsiders to try to keep a union out.
One last thing, if you do work in a union covered job…be active in the union. It will be your union so really make it your union and be active! The officers cannot do a good job without the members being active and letting them know their concerns and needs. If the union is not responsive to the members the members have only to look in the mirror to figure out why it isn’t working.
February 28th, 2007 at 1:40 pm
I’m puzzled by the comment that a union means you can be a bad workers and still get pay raises. Most contracts I have seen have probation periods, during that time you can be fired for no reason. Also you still have work rules, excessive tardiness or absence will still cause the worker problems such as extending probation or other discipline. As a MEC officer I have had pilots fired and I had NO regret to see them gone. What I did do was work to make sure that there was reason for it and the company had documented it. You don’t want to play the game and establish a precedence that a person can be fired without written and documented cause. If you are a professional you want all the people in your profession to reflect well on it. You should not allow people that do not reflect the proper standards.
You might want to think of it more like a union levels the playing field. The company can afford lawyers and all sorts of things if you try to fight a termination without good cause. As an “at will” worker your rights are very limited to start with. If you get fired without cause (it does happen) all the cost of your defense, if you try to mount one, will be out of your pocket. With a union there is an established way to fire someone. If it is indeed a “bad” firing the union should fight it. It had better fight it since that is big part of the reason you pay your dues. It means there is someone with deeper pockets than you there to help you when you need it.
Also as a CNA your company or a supervisor might have you do something that is ilegal or unethical. Your ticket might be on the line. Your union should help fight either trouble with the company if you refuse to violate the law or if by orders and ignorance you do violate the law. I have seen companies order a pilot to do something against the rules and when caught want to claim the guy did it on his own and fire him. Lawyers to fight the FAA get expensive very fast. Your ticket is your career, your life. I hope you never have to defend CNA ticket but if you do it is nice to have a union with a bigger wallet (as well as the experience in that field) than your own to help you.
February 28th, 2007 at 3:34 pm
Yeah Michael?? Look at GM, Ford and Chrysler. Look at what unions did for those companies. The nursing home industry cannot afford it like the auto industry did for so long. The AU depended upon consumers for the bucks…nursing homes depend upon the government for bucks…this boils down to YOU AND ME…our tax dollars. Big difference. Same with your pilot union. Big difference.
This article is about HOW TO AVOID unions. Not why they are good.
Unions could care less about residents and patients. They care about increasing membership, they care about MONEY. And nothing else.
February 28th, 2007 at 9:15 pm
Sounds like Michael is trying to convince us that unions are the end all solution for the problems we face. I don’t agree. But I admit I am from a very small group of aides who feel this way.
In fairness, I have seen unions do good things- not so much in nursing homes but in factories and similar places. Unions once had their place in history; but we- the US anyway- has come along way in regards to workplace safety laws, wage and hour laws, worker comp, ect ect. Our industry (I hate that term)-LTC- is funded by our government. Therefore the money is very tight. I think it’s better to stay away from the big chain run nursing homes- they DO tend to be profit motivated and that means cuts for resident supplies and needs and the pay is pretty much WORSE at these places…than for NFP run homes.
August 4th, 2008 at 8:09 am
not getting the proper 40 hour pay every 2weeks in assistant living work place being cheated out of 30 minutes.
August 6th, 2008 at 12:35 pm
CALL YOUR STATE LABOR BOARD.
August 7th, 2008 at 7:47 am
where i work we only get paid on the 10 and 25 of each week,they way they do there pay if we work 50 hrs the first week and 40 the next week we do not get over time pay and we dont get paid for our 1 half hr dinner break. we get no pto time either is this leagle.
August 7th, 2008 at 9:37 am
I did call labor awaiting response Im a medtech -supervisorin charge only getting 9.50an hour been there nowfor 7months no raises at all.