Can a Quality Work Environment Yield Better Care?

I think my grandparents’ nursing home staff must have had my number on speed-dial:

“Mr. Meade set off the alarm on the door today–again.”

“Mrs. Meade keeps eating food off of Mr. Meade’s tray.”

“Mr. Meade pulled Mrs. Meade’s P.E.G. tube out.”

“Mr. and Mrs. Meade are asking for a ‘street car’ so they can go home.”

“Mr. Meade is being aggressive with the staff–again.”

“Mrs. Meade is demanding to be taken home so she can start cooking supper.”

The number of calls I received during the Meades’ nearly three years at Waverly was utterly astonishing.

Let’s take a moment and consider the number of residents in any given nursing home; now think about the number of staff members who work at that nursing home. Their work load in just putting out “fires” like the ones I’ve listed above is staggering—and that’s before any pills are administered, any wounds are cleaned and dressed, any charts are updated or any other custodial care matters are seen to.

I remember being amazed at how frequently employees came and went in my grandparents’ nursing home more than 20 years ago. Turnover in nursing homes is nothing new, but its current volume is alarming—and there’s no apparent end in sight. According to a September 2022 article published by The National Consumer Voice for Quality Long-Term Care, nursing homes experience an average annual turnover rate of 52 percent; that means every year the typical nursing facility must replace half of its direct care staff. The article cites a variety of studies indicating the reason for this alarmingly high number is due to “poor pay, lack of benefits, high workloads, inadequate training, poor management and lack of career advancement.”

When my grandparents were in their nursing home, there were some amazing nurses, certified nursing assistants (CNAs) and other medical professionals who interacted with my grandparents with such tenderness and warmth, it felt like they had always been there, caring, encouraging, protecting.

And then there were others, the workers with short tempers who made it clear they didn’t have any patience for questions or concerns. I maintained a fairly constant state of frustration as I noted that it was the really good people who seemed to leave quickly while it felt like the difficult ones stayed firmly in place.

I realized that, as a family caregiver, I had nothing to do with staff salaries, benefits, workloads, etc., but I frequently recall having staff members tell me they truly appreciated me being a family member they could work with. This is a big deal, and it’s one aspect over which caregivers do have control.

Please consider this: these are the folks who are taking care of our loved ones, so what can we do to make their jobs more pleasant and maybe a little easier?

1. Be sure to thank them for their efforts; verbal appreciation can carry a lot of weight.
2. If a staff member has gone over and above the call of duty, be sure to recognize them to their supervisor as well as the nursing home’s upper management.
3. Be receptive to their questions or any suggestions they may have for you; it might result in something that makes life better for your loved one.

I would definitely like to see fundamental changes in job quality for nursing home workers. More specialized training, better pay and benefits, as well as opportunities for career growth would all help cultivate a more attractive work environment for nursing home employees—and better working conditions for the staff will always translate to better care for our loved ones.