"Official" people are putting it into writing:
"[T]he reductions in the nursing home industry are a symptom of a major issue for nurses in the sector . . . That may mean a general move away from the sector . . . which inevitably would hit nurses remaining in the nursing home industry with heavier workloads and less qualified help."
-Paul Wallis, Nursing Homes Cut Back as Budget Trauma Hits Bottom Line, 13 October 2009, nursingjobs.org
Where I work, I know there have been budget cuts, but I think we feel it most with the lack of supplies. No bed alarms, no heel pads, two clean towels for 60 residents for the shift, no ice cream. There seems to be a heavier workload now, and I expect it to only increase. We have to go into more detail for everything and complete more duplicate paperwork. We have the same staffing levels that the more experienced nurses say were in effect twenty years ago, yet the workload has magnified. Most residents are on twenty or more medications and require frequent blood pressure monitoring.
While there are no salary increases, there is overtime because the work can't get done before the shift is over and there are not enough nurses to cover all of the shifts on straight time. I don't think that any nurse is hurting for money, as long as she didn't assume massive debt. The aides, though, are severely underpaid for the amount and type of work that they do. The nursing home industry is not unique in its pay inequities.
I have a few great aides. They are my eyes and ears, letting me know if a resident is sick, unhappy, even "just doesn't look right." They do what they are supposed to do without being told again and again. They know how to properly changed and turn a resident in the bed. They offer fluids. They frequently round the floor to check on the residents. They anticipate needs so that residents are less likely to try to get out of bed by themselves and fall.
Then there is the newer generation of aides. Their first task of the shift is to get to the kitchen to grab food for themselves. Can they also pick up juice and applesauce for the med pass? They forgot and don't feel like going back. Residents ring for assistance- are they supposed to answer that? Like a magical coma, they fall asleep faster than any resident and can't hear alarms blaring next to their heads. When they do eventually change and reposition a resident, they can't see the iv lines or feeding tubes and twist or disconnect them.
One nurse was written up because an aide left the supervised lounge unattended and a resident fell. Her defense was that they company purposely hired substandard employees to save money, this is a natural consequence of that decision, and she is not liable for it. I can't get my own work done in an eight hour time frame, never mind the work of the aides as well.
I went into nursing home care because I enjoy working with the elderly. I so rarely get to spend more than a moment with any resident and they know how pressured I am for time.