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I have recently talked to staff to find out nurses at ALF only have their LPN degrees which is 1-2 yr college program. I'd like to hear if others know and would share. Thanks.
Just for information in case anyone’s interested, here’s a list of the minimum staffing requirements by state. There are quite a few, surprisingly including NY which regulates every breath we take, that have “no minimum requirement” for CNAs. In NY CNAs are certified nursing assistants and they have to go through a BOCES or similar CC training. In Moms NH they then shadow an existing Mentor before they’re allowed to do anything on their own.
There is more to being a competent nurse than a formal education, think of it this way... the earliest nurses had no college at all, they learned on the job. Later nurses began to take classes along with gaining practical experience. Still later most women got their caps after a two year nursing program, only the head nurse or ward nurse had a bachelor's degree. Were the nurses who staffed the hospitals of our childhoods not competent?
At Moms facility the CNAs provide most of the hands on care. There usually are 4 for 38 residents per floor. They are stretched thin. There is no minimum numerical standard in NY, just whatever is “safe”. There are 2 LPNs for these same # residents who dispense the meds and can handle things like insulin and simple wound treatment. There is 1 RN in a floor supervisory position for these same people. There are 6 floors so this repeats on each floor. There is a Nurse Practitioner which is shared between 2 floors and can write scripts, so there are 3 on site. There is 1 doctor for the building, but I don’t think he’s there full time as I rarely see him.
At the SNF where my mom was there was one RN per shift, several LPN’s, and many CNA’s whomprovided care. We found it wasn’t so much the level of education as the level of commitment, a “calling” if you will, to working with the frail elderly that made the difference in great caregivers. There’s a huge difference in those working to be paid and those working there because they feel it’s exactly where they’re supposed to be, I’ve never forgotten the good ones.
Had one disastrous AL place, I moved Dad to a different one after two scary months.
In both places, meds were given by LPNs (Ohio). The LPNs in both places, for the most part, were great people. The difference was the first AL place was a for-profit chain. They hired young women fresh out of school and were always short-staffed. These poor girls burned out quickly and moved on. Hard to get continuity of care for Dad in those circumstances.
The second AL was a not-for-profit (non-chain) retirement community. They had LPNs who had been there for years, they had adequate staffing. They also had aides who had made the place their career, some had gone to nursing school and came back to the AL as LPNs.
The LPNs in both ALs that Dad was in did not do most of the caregiving, that fell to the aides (PCAs). After the bad choice I made with the first AL place, I asked more questions about staffing when I interviewed other places. I also did an internet search of job postings at each place I considered. That gave me important info about the experience and training requirements the AL asked for in potential employees.
The for-profit chain AL did not require their PCAs have any prior experience or training, at least for the location my Dad had been at. Supposedly, they provided on-the-job training. What that meant was you saw them in front of a computer wearing earphones during their shift, getting “training”. Their aides had the same qualifications to get a job at a fast food restaurant. The aides are the ones to focus on, they will interact with your loved one more than the nursing staff throughout the day.
I just find it difficult when the charges are so high and yet the skill level so minimum. The Director of Nursing at NH only has an LPN degree one or two yrs of college. I understand that in the old days there wasn't much education for nurses but now there are many opportunities and many complicated patients living longer. I always just assumed the nurses all were Registered nurses..got that wrong.
Better check out your state laws. In a AL where I live, there must be an RN in charge. She has to be on call. In some states LPNs are limited in what they are aloud to do.
Moms AL had 39 rooms. An RN was in charge an LPN backed her up. There were Med techs and CNAs.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
theconsumervoice.org/uploads/files/issues/Harrington-state-staffing-table-2010.pdf
In both places, meds were given by LPNs (Ohio). The LPNs in both places, for the most part, were great people. The difference was the first AL place was a for-profit chain. They hired young women fresh out of school and were always short-staffed. These poor girls burned out quickly and moved on. Hard to get continuity of care for Dad in those circumstances.
The second AL was a not-for-profit (non-chain) retirement community. They had LPNs who had been there for years, they had adequate staffing. They also had aides who had made the place their career, some had gone to nursing school and came back to the AL as LPNs.
The LPNs in both ALs that Dad was in did not do most of the caregiving, that fell to the aides (PCAs). After the bad choice I made with the first AL place, I asked more questions about staffing when I interviewed other places. I also did an internet search of job postings at each place I considered. That gave me important info about the experience and training requirements the AL asked for in potential employees.
The for-profit chain AL did not require their PCAs have any prior experience or training, at least for the location my Dad had been at. Supposedly, they provided on-the-job training. What that meant was you saw them in front of a computer wearing earphones during their shift, getting “training”. Their aides had the same qualifications to get a job at a fast food restaurant. The aides are the ones to focus on, they will interact with your loved one more than the nursing staff throughout the day.
Good luck in your search.
Debbie1955
Moms AL had 39 rooms. An RN was in charge an LPN backed her up. There were Med techs and CNAs.