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Staffing concerns arise at new health facility

Posted on October 6, 2015 by Maple Creek

By Marcia Love
Talk of issues arising at the new Southwest Integrated Healthcare Facility due to staffing shortages have surfaced in the community.
Staff and members of the public have stated there are challenges being faced due to the amount of work  required and fewer feet on the ground to complete it.
But Cypress Health Region attributes the shortages occurring at the facility to short-notice leave, which happens when employees are unable to make it in for their shift due to an illness or family emergency.
“There are times where we’re not able to fill all shifts,” said Trent Regier, Cypress Health Region’s director of rural health.
That was the case when only one continuing care assistant was in a long-term care home for a day shift last month. There are supposed to be three CCAs in each home during the day, two later in the afternoon, and one through the night. In this case, Regier said a CCA from another home came over to assist for the day.
According to the health region, while there have been reductions at the facility there have also been additions. Regier stated housekeeping hours were reduced through attrition as well as kitchen staff hours. But through the transition to the new facility he said normal staffing has been maintained and three full-time CCA positions were added — one to each home. One licensed practical nurse position previously in acute care was reallocated to serve the entire building.
But eventually all nursing staff in the facility will be trained to work in both long-term care and acute care. Regier said this is to avoid putting the hospital on diversion.
“If the acute care nurse calls in sick, I would have a nurse down in long-term care. If we train everybody to be competent in long-term care and acute care, I just move the nursing staff to where I need them,” he said, adding this is expected to take place within the next six to 12 months.
In long-term care, the new model of care involves CCAs providing a more home-like environment to residents. This means CCAs are cooking meals, doing laundry and doing housekeeping as well as tending to residents.
Regier said the pool of casual CCAs is thin.
This summer, the health region introduced its high school care aide program, which allows students at least 16 years of age to begin working as care givers in a long-term care home. There are currently two students working. They receive orientation and a two-day personal care worker course. Regier said it is a possibility these students could be on a night shift in a home by themselves, but only if they are deemed capable of doing so.
There have also been concerns voiced regarding the amount of responsibilities of the registered nurse and licensed practical nurse in acute care. There is a nurse at the long-term care facility during the day, but the LPN in acute care is required to attend to residents in long-term care from 11 p.m. to 7 a.m., as well as attending to any in-patients or patients that arrive in the emergency room.
According to the health region, this is “within their capacity and their scope of practice.”
“The average amount of individuals that present to our emergency department from 11 p.m. until 7 a.m. is very, very minimal, so there is no risk,” Regier stated. “They will prioritize each individual client and then respond appropriately depending on what the patient’s need is.”
The director said the hospital has had periods of time where there is a high in-patient count. Three to five patients is the daily average, which means there hasn’t been additional staff necessary, he said.
When the new health facility first opened its doors staff were extremely busy, Regier said. But he attributed this to more people returning to see their local health care providers instead of travelling out of town as it was a new facility. However, he said this has started to stabilize, and emergency room visits have not increased.
“If we have an influx of in-patients in acute care and we require additional help, our managers have the authority to bring in extra staff outside of their regular budget to help with that workload,” the director said.
Regier said there have been discussions with staff surrounding the new processes and models of care at the facility, and that it will take eight to 12 months to finalize it.
“We’ve been tweaking processes, adding processes, refining processes to try to help them, and the staff will be heavily involved in that process,” he said.
Staff members are not permitted to speak with media regarding health region matters without the permission of the health region.
As of the end of September, the health region had three vacancies for RN positions at the integrated healthcare facility listed on its website — two part-time and one casual. It was also seeking to hire one LPN for casual work in acute and long-term care, five CCAs — all casual or part-time — for long-term care or home care, and eight other casual positions within the facility.
Regier said he is confident the facility can operate to meet expectations with the staffing complement that it has.
“Is this a bit of a bump in the road as we go through the transition? Absolutely. Are our staff somewhat frustrated with things? Absolutely,” he admitted. “It’s change management, it’s that transitional work that we continue to do on a day-to-day basis with them. We’re going to continue to work with our staff and allow them to be part of that process. But it’s a challenge and it takes work.”

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