Texas Health Care Briefing No. 4
Taking time to care
In the intimacy of person-centered care, every minute of bedside attention counts.
But in Texas — where state underfunding of long term care is a significant contributor to high staff turnover — nursing staff often are forced to rush through their care routines. Chronic staffing challenges invariably leave staff in a hurry to change sheets, bathe residents or take care of a myriad of other personal daily details as they race against the clock.
“There’s simply not enough time to deliver the care and attention the staff want to be able to provide,” say quality of care advocates like Gloria Bean-Williams, director of clinical and quality services for the Texas Health Care Association.
“Being forced to rush through the day results in task-driven care, which reduces the bedside caregiver’s ability to provide person-centered care,” Bean-Williams said.
Staff that can take the extra minute and get to know their residents are better able to meet their specific needs. “It’s no different than when you feel rushed when you go to the doctor’s office. You want to be listened to and not feel like your needs are simply part of a process,” Bean-Williams said. “A nurse who is always forced to rush may unintentionally overlook a resident’s change in condition and not document that change or communicate it to other members of the health care team.”
Nurses in Texas nursing homes are in a rush because Texas has had one of the lowest nursing home Medicaid reimbursement rates in the nation for the past 15 years. And that’s put a strain on the caretakers who watch out for the most vulnerable among us with low wages and high stress, resulting in more than 90 percent turnover and caregiver shortages, and placing many facilities in financial jeopardy.
“The men and women who work in these facilities care deeply about their residents, and want to spend more time with them. But when you’re constantly worrying about staffing and covering shifts because you lose staff to higher paying jobs, you lose those opportunities for personal connections that you know your residents need and the staff want to provide,” said Kevin Warren, president and CEO of the Texas Health Care Association. “Our nurses and nurse aides are on the front line of the Texas nursing home crisis and we need to give them the support they need to care for us.”