The importance of a familiar face during a difficult time

Nurses in long term care facilities across Texas have a more than 90 percent turnover rate. That’s one of the highest turnover rates in the nation.

For the long term care administrator trying to staff a skilled nursing facility, that number represents an immense human resource task just to keep the doors open. For the long term care nurse, it often means picking up extra shifts and working longer hours to cover the schedule because there just aren’t enough nurses.

But for long term care residents, 90 percent turnover means an endless parade of strangers knocking on their door and coming into their rooms to help them attend to their most personal daily routines.

“A familiar face can make all the difference in the world when it comes to quality of long term care,” said Spencer Comstock, administrator of senior care at West Oaks in Austin. “It takes time to get to know a resident and understand their routines.”

High staff turnover rates not only wreck the emotional comfort residents get from knowing they have a friend on staff, they can have serious physical consequences.

“When a nurse spends time with a resident and is really able to get to know them, they are better able to notice subtle changes in their condition, or appetite, that can be important early warnings,” Comstock said.

The reasons for such high staff turnover are many. The state’s low reimbursement rate — just about $6 per resident, per hour — keeps nurses’ wages hovering around $11 an hour, about what they can make at a nearby fast-food restaurant. The job can be stressful because people’s lives literally depend on them. And not only are their bosses looking over their shoulders every day, but as many as 34 local, state and federal authorities are as well.

“A CNA needs to pass a test to be certified just to walk in the door,” Comstock said. “Or they can skip school and find a far easier job for about the same money they would earn as a caregiver. It is getting harder and harder to find good CNAs.”

The combination of strict state regulations and low state reimbursements have set up a precarious situation, pushing many Texas nursing homes to a tipping point.

“The bottom line is, high staff turnover rates hurt the quality of care in Texas nursing homes, and that’s unacceptable, because we’re not allowed to fail in this business,” said Kevin Warren, president and CEO of the Texas Health Care Association. “When we fail, it affects someone’s family member.”