Oklahoma is one of the states that has a minimum staff requirement for nursing centers. It sounds great until you realize that the staff that they can "count" are not necessarily staff that are working the floor.
We were short again last night. Short by my standards. I would like to see 6 CNA's, 2 CMA's and 3 LPN's. We had 4 CNA's, 2 CMA's, and 2 LPN's. According to the staff requirements, that's enough people to take care of the number of resident's in my facility. The nurses don't work the floor and the CMA's are limited by what they can do between dishing out medication. (Technically, they are not supposed to stop their med passes to help out on the floor, but they never get through a med pass without taking someone to the bathroom or helping someone to bed or something.)
I understand that I should be thankful that the state has minimum staff requirements because it's likely that we wouldn't have had even that many if they didn't. (I work for a "for profit" nursing center.) But we would have been more effective if we'd had more help. Minimum staff just means the resident's are getting the minimum amount of care. In some cases, barely that.
I've been trying to think of a solution. I'm sure that if someone asked the Administrator, she'd say that her nurse's and CMA's help out on the floor. This is not usually the case and when they do, the help is limited as they have to get their work done too. Maybe the state needs to require a certain number of staff who are specifically dedicated to working the floor, regardless of their title. That way, a nurse could stand in for a CNA only if she was not also required to perform LPN duties.
In the meantime, I use my feet as a barometer. If they really hurt at the end of the night, we didn't have enough help. They were still tender this morning. (Yes, I also need new shoes, but that's another post for another day.)