The Short-Staffed Story

 

May

It’s staring me in the face the entire time I’m getting my coat on. It’s mocking me with its very existence. I want to smash it into nothing, I want to scream insults at it. Mostly, though, I want to go home and not come back until I feel like a human being again.
“It” is a list of all the open shifts for the month…there’s enough to fill a full-time position or two. Or several.

We’re all in overtime already: we few who have stuck it out during this incredibly rough period. Every place has its bad stretches–we’re in the middle of one right now.
Every aide that leaves puts more work on the rest of us. The heavier the workload, the more aides that get fed up and leave…and when it’s like this, overworked and understaffed, it is hard to convince the new aides to stay.
Why would they? It’s crazy and ridiculous and nobody is happy to be at work. Another newbie quits and we all sigh and try to prepare ourselves for another week of 10-12 residents per aide.
When CNAs are short-staffed, they’re also overworked. It’s just the way it goes.

According to the charts in the office, twelve isn’t that much more than a standard group of 8-10 residents per aide–no big deal, right? It’s an acceptable solution to the problem of not-enough staff. Just give every CNA a couple more people, maybe three or four and there you go: we’re covered for today. Whew. Saved by simple mathematics.
But on the floor, having twelve people instead of eight means more call lights going off at the same time, it means no ten-minute breathers. It means later lunches, messy rooms, soiled pants, too-long finger nails and unshaven faces. On the floor, it becomes a problem of subtraction, not addition. What it really means is that you’re taking time and care away from all twelve residents.
What it means is I don’t have time to change Mrs. Q’s sheets because Mr. W needs to get dressed. I don’t have time to walk Mrs. E because Mrs. R’s call light has been going off for 20 minutes. I can’t spend a few minutes chatting with Mr. T because Mr. Y’s alarm is going off. Mrs. U and Mrs. I can’t go to bed yet because they are mechanical lifts and I don’t have anybody to help me right now. Mr. O has to feed himself, even though he really needs supervision because Mrs. P can’t feed herself at all. I can’t brush Mrs. A’s teeth, because I can see Mr. S coming down the hall with soaked pants–understandable, since I haven’t had a chance to touch him all shift.
Understandable to an overwhelmed CNA, that is. Try explaining that to his family. Try explaining that to him.

And while it might be “understandable” to the aides, these kinds of situation are most certainly not acceptable. Not to the good aides. We who take pride in our work, we do not enjoy seeing our residents unkempt, soaked and soiled. But what can we do? Stop time, clone ourselves, refuse to work unless safe staffing laws are passed?
If only.
What we can do is come in early and stay over late; we can skip our ten-minute breaks, we can pick up extra shifts so that our residents can get the high quality care that only comes with adequate staffing. We can take on extra work during a shift in hopes of keeping the newbies for more than two weeks.
Sometimes these measures, so wearing on us, seem like fingers in the dike. It’s not enough. It’s never enough. We go above and beyond but we still can’t reach. Bad days and double shifts stack up into a wall of weariness; the higher it gets, the harder it is to remember why we cared enough to make these sacrifices.

I’m not quite there yet. I can still feel the shame and the anger that comes from a job badly done. I’ve failed them. I’ve failed my residents, who are both my responsibility and my friends.
But it’s not my fault. I didn’t ask to have a group of 12 residents. I didn’t ask to have a whole hall to myself. This wasn’t my choice, this isn’t on me. I’m only human, I can only power through so many short-staffed shifts. I am aware that at other facilities, the ratios are much higher–up to 20 residents per aide–but this doesn’t make me feel better about the twelve people whose care has seen a noticeable decline since we’ve been short-staffed. What more can I do? What more should I do? Is it always going to be this way? How much more can I take? How much more should I take?

There’s a note on the sign-up sheet. “Thank you for all you do,” it says. “It doesn’t go unnoticed. We know it has been rough. Hang in there, we’re trying to get more staff in. Just keep being awesome for a bit longer.”
I start to tear up. They see. They see. Some would say it’s a ploy to milk more hours from us, but from the dollar signs offered next to the note, I’d say they’ve got their money where their mouth is.
Okay, I think. Between the note and the big bonuses, I’ve changed my mind. I can work nine days in a row. I can handle a double in that mix. I can do it. My back hurts, I’m always tired, I never see my friends or my family, but I can do it. I can do it again.
Next week, though. Next week I cut back. Next week I rest.
Maybe next week, they’ll have a new aide in. Maybe.
I won’t burn out; I’m not drinking that poison again. I’ll fix a smile on my face and I’ll work this week because my residents need me. My employers need me and they’re acknowledging that. They see and they appreciate me; I’ll give them one more week of my free time.
Next week I’ll cut all the way back to 40 hours and I’ll take care of myself…because my residents are going to need me in a month, a year.
I’ll damn the broken system and laugh with my residents because I chose and am choosing to be a CNA. Nobody and nothing is taking away my joy in my vocation.