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Staffing Shortages Lead to Neglect in Nursing Homes

Inadequate nursing home staffing puts elderly residents at risk of neglect. When nursing home facilities do not have enough staff to give all the patients adequate attention, the standard of care reduces, and residents are put at risk.

Date:   1/6/2021 4:40:24 PM   ( 22 mon ) ... viewed 315 times

Inadequate nursing home staffing puts elderly residents at risk of neglect. When nursing home facilities do not have enough staff to give all the patients adequate attention, the standard of care reduces, and residents are put at risk. Workers are forced to prioritize certain duties over others. For instance, they may overlook responsibilities like controlling accident hazards, preventing infections, improving resident well-being, and maintaining sanitary conditions. At the same time, there’s a greater risk that nursing home staff will commit abusive acts when they’re extremely overworked and stressed.

Staffing shortage is a serious problem that has plagued nursing homes for decades. In fact, 90% of nursing homes in the US are significantly understaffed. Some states don’t have a legal mandate on the ratio of caregivers to residents, which makes it possible for problems to go unnoticed. Residents in understaffed nursing homes are at great risk of infections, malnutrition, dehydration, weight loss, pneumonia, bedsores, and deadly falls.

Why Are There Staffing Shortages in Nursing Homes?

The growth of nursing homes is primarily propelled by the burgeoning elderly population that greatly depends on these facilities. By 2030, it’s expected that more than 3 million elderly will be in nursing homes, but most of these facilities are still short-staffed. The demand is there, the jobs are there, there are many unemployed people who could work in these facilities, but the staffing shortage remains a big issue.

There are several reasons why understaffing in nursing homes is prevalent. Interestingly, financial gain is one of the reasons. Nursing homes are for-profit ventures. Though tasked with offering care for the elderly in society, they’re businesses and must generate a return for the owners. To make the most out of this investment, some unscrupulous investment groups and owners choose to cut corners and deliberately understaff their facilities. They may reduce the number of employees to minimum levels and any savings go right to the bottom line. Due to nursing home negligence, the staff often ends up overworked, resulting in fatigue, exhaustion, stress, and life-threatening conditions for residents.

Cost is another reason for the staffing shortage in nursing homes. The labor costs for nursing homes are very high. This limits the number of registered nurses and certified nursing assistants a nursing home can have. The employees are forced to overwork and cater to many residents at a go. Cost of labor is also one of the reasons nursing homes employ foreign-born workers because many are willing to provide low-wage care.

Nursing homes are difficult and high-stress environments, prompting many nurses and nurses’ aides to work in hospitals. Finding and holding on to enough highly-skilled workers in small towns and rural towns is also very difficult.

Understaffing Causes Exhaustion, Stress, and High Turn Over

Since most nursing homes lack the indispensable amount of staff, the current manpower is forced to work as swiftly and as long as they can. Consider this scenario: a nursing home has only 4 registered nurses on a shift with roughly 80 residents who may require their help with going to the bathroom, taking medication, or handling acute medical needs. It would be impossible for the four nurses to provide 2.5 hours of straight care for every single patient. To actualize that, the facility may have to recruit more than 14 employees, each working 12-hour shifts.

Understaffing causes caregivers to become overwhelmed. Most of them suffer from exhaustion as they work through their designated break times and experiencing mandatory overtime. Some nurses consider overtime and long hours to be beneficial since they will earn more, but others feel overworked and underpaid even with overtime. The fatigue resulting from working for long hours can cause a nurse to make mistakes and miss critical changes in a patient’s condition.

Professionals in these facilities are forced to put in a significant amount of overtime to compensate for the shifts that would have been handled by other personnel. It can be extremely overwhelming and many nurses find the job too stressful. Some leave for greener pastures. While this may be the best option for them both personally and career-wise, it aggravates the problem for elders living in understaffed nursing homes. As stress increases for staff, the likelihood of neglect increases.

Significant Effects of Understaffing on Care

The negative effects resulting from understaffing in nursing homes are many. Because of understaffing, a facility fails to offer a high level of care that is personalized for each patient. Neglect, especially when prolonged, could lead to physical health issues, emotional distress, psychological ailments, or fatal incidents.

Some of the issues that can be caused by a staffing shortage in nursing homes include:

  • Medication errors: Many residents in nursing homes require daily medications to manage multiple conditions. Usually, the staff needs to administer these medications. Medication errors, however, can occur if the facility is understaffed. Nurses in understaffed facilities don’t have enough time to pay attention to details or are too distracted to provide medication to a resident. Types of medication errors likely to happen in these facilities include skipping doses of vital drugs, issuance of wrong medication, administering improper quantities, or disregarding medication orders. Understaffing compromises the lives of residents since it can directly affect their ability to receive necessary treatment.

  • Poor personal hygiene: Nursing home residents depend on the facility for some or all of their basic needs, including grooming, bathing, and going to the restroom. When a facility is understaffed, the residents do not receive proper attention and are exposed to unsanitary conditions. Overworked staff may ignore changing a resident’s bedding, clothes, or taking him or her to shower. When the needs of each resident are not met, he or she may develop dangerous infections and health conditions may quickly deteriorate.

  • Inadequate mobility management: Nursing home residents may be wheelchair-bound or bedridden and if they aren’t turned, moved, or repositioned often enough, they can develop pressure ulcers (bedsores). This can damage the skin and underlying tissue, leading to infection, sepsis, or death if left untreated or improperly treated. Bedsores are preventable, but when there are inadequate staff levels, the caregivers may avoid the most basic medical protocol. Neglect by nursing home staff may also lead to falls and fall-related injuries. If the staff isn’t checking up on them, the residents may try to get up by themselves and fall.

  • Failure to meet nutritional needs: Many nursing home residents are on special diets, or require assistance or supervision while eating. Improper staff ratios can result in neglect in the form of lack of nutritional monitoring or failure to provide meals at the appropriate time. Residents are more likely to suffer malnutrition and dehydration. Choking is another problem caused by neglect as a result of the staffing shortage. If a resident requires help or supervision while taking meals due to a physical or mental impairment, it’s negligent to not have a caregiver present to help them eat and ensure his or her safety. Things like clogged breathing tubes also present a greater risk for choking. Overworked staff may not notice debris clogged in these tubes, exposing residents to choking.

Staffing Shortage in Nursing Homes Violate a Legal Duty of Care

Nursing homes owe a duty of care to all the residents. They must comply with certain federal and state safety requirements. Because of the vulnerability of elderly people, nursing homes are held to heightened legal obligations. Nursing homes can be held liable for injuries from neglect. Family members who place their loved ones in a nursing home typically place a great deal of trust in the facility. They expect them to abide by the law and reasonable standards of the industry.

Part of the duty of care owed by nursing homes is to ensure the caregivers adequately manage the needs of residents and address all health issues. If a nursing home is understaffed, it violates the trust placed in it and the legal duty of care owed to its residents. An aggrieved party may be able to recover compensation for injuries and damages caused by neglect stemming from a staffing shortage.


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