Nurses stressed by overtime
Nursing staff at the Wisconsin Veterans Home (WVH) in King are working 64-hour weeks, according to the union that represents them. Marty Beil, executive director of the Wisconsin State Employees Union, AFSCME Council 24, said staff vacancies at WVH have led to forced overtime. "Three weeks ago, all employees were given their schedules for the next 30 days," Beil said. "Without accounting for any sick leave, the schedule had 950 shifts of overtime." Beil said employees, especially frontline health care staff, are working 16-hour shifts three days a week, in addition to two eight-hour days. It is not uncommon for nursing staff to work more than 60 hours per week, he said. "These are direct care workers. How can anyone work that amount of time and it not affect the quality of care?" Beil said. Beil attributed the overtime to staff shortages at WVH. He said that although the Legislature has authorized hiring more than 30 new nurses this year, most of those positions remain unfilled, in part because new hires at the home are not staying due to the stress associated with long overtime hours. "Recruitment and retention are horrible," according to Troy Bauch, an AFSCME field representative who works with WVH employees. "The home hired 10 new CNAs and three of them quit on the same day." Beil also said the administration needed to consider "open recruitment," if it wanted to fill the positions in a more timely manner. "Open recruitment has been rejected at King," Beil said. "AFSCME Council 24’s allegations that chronic staff shortages threaten the quality of care at the King Home are 100 percent false," according to John Scocos, Secretary of the Wisconsin Department of Veterans Affairs. Scocos said the WDVA has been given authority to hire nearly 40 new health care staff at the vets home, has adopted open recruitment policies and is holding a job fair in King specifically to recruit RNs, LPNs and CNAs. "The WDVA has been working aggressively to fill direct care positions," Scocos said in a memo released in response to AFSCME criticism of administrative policies. "As of July 30, 2012, the WVH-King will only have 18 direct-care positions open of a total of 494 direct care positions." Bauch took issue with the WDVA numbers regarding open positions. "It’s their anticipation that they will fill those positions by July 30, but it’s not going to happen," Bauch said. "If they are really only 18 positions short, then why do they have to fill 950 eight-hour slots of overtime in a month?" In his memo, Scocos said that only four of the home’s direct care staff have been forced to work three additional eight-hour shifts a week of overtime in the past three months. "When the administration say it’s not forced overtime, they’re ignoring the facts," Bauch said. "When the schedule comes out, the staff can either ‘volunteer’ for overtime and pick which additional shifts are more convenient for their families and personal schedules or be assigned which overtime shifts they’ll work," Beil said forced overtime has become so unbearable that many long-term employees are quitting. Some are sacrificing their benefits to return as LTEs (limited term employee), where at least they have some say about their schedule. This puts even greater stress on the family life and health of remaining staff members, who are forced to pick up even more shifts," Beil said. In response, Scocos said, "Over the past three months, of the 30 WVH-King employees who resigned, only four reported that overtime was a factor in their decision." Scocos attributed the nursing shortage to growth in the number of residents at the home. He noted that the census at WVH-King had been shrinking since November 2008. The home’s population dropped to 650 veterans in April 2011, resulting in a $5 million deficit that fiscal year. In July 2011, WVH streamlined its admissions process and the census levels improved. Since November 2011, the home has had an average population of 700 veterans, according to WDVA figures. "Overall, the campus is growing while overtime has remained stable and is actually decreasing," Scocos said, Beil said that admitting more veterans is contributing to the problem. He noted that many of the new admissions require higher levels of care and are stretching thin resources even thinner. The union will host a special listening session with King employees from noon to 3 p.m. Thursday, July 26, at Local 555 Union House, directly across from the WVH.
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15 Comments for "Nurses stressed by overtime"
Union House? Looks more like a fireworks-hawking shack, and not a very lucrative one, at that. You're not going to be taken seriously (or as seriously as you would like), if you look like you're running a rummage sale - all day, every day.
[quote]In July 2011, WVH streamlined its admissions process and the census levels improved.[/quote]
Are they saying that the admissions process itself was reducing the census? It would be one thing if the admissions [i]criteria[/i] kept veterans out, but if it was the inefficient handling of paperwork - that's egregious.
lastpercentile Jul 25, 2012 11:03 AM
I can tell you right now based on first hand experience that a lot of what Scocos is saying is false and/or twisted to cast the blame on the Union and get the heat off of him and his department. He claims that there is only a hand full of people who have worked these ludicrous hours, I implore you to seek out a direct care employee at the WVH and ask them how much they have had to work in the past 12 months.
As far as the admissions are concerned, it seems to me that before the new Admissions Director was hired, there was more discretion when it came to the admissions screening process, veterans with mental illnesses that were not appropriate for the care available at the facility would be able to receive recommendations to other facilities that would better suit their needs. It appears now that the director will take any veteran whether they will receive the best care based on their diagnosis or not just to fill beds and raise the census, this in turn leads to special circumstances where 1 staff member is assigned to watch over this patient and no others because of certain behaviors which leads to more holes and thus more overtime.
It's a never ending cycle. Mandatory overtime may have worked before but it is failing now, long term employee's can't keep up with the hours and new employees won't stand for it. Mandatory overtime is a terrible poison which must be purged if this facility wishes to continue working at a high level. Good, hard working people are being forced to choose between their home life and their jobs.
Take care and God bless!
Whitewood Jul 26, 2012 7:00 PM
Abraham Lincoln was a federal surveyor.
If you expect anybody to believe this - name the agency where these "surveyors" work.
[quote]As far as the admissions are concerned, it seems to me that before the new Admissions Director was hired, there was more [b]discretion[/b] when it came to the admissions screening process, veterans with mental illnesses [b]that were not appropriate for the care available[/b] at the facility would be able to receive recommendations to other facilities that would better suit their needs.[/quote]
WOW. That is a disturbing revelation. It sounds like the Veterans Home has been "cherry-picking" veterans with lesser needs - in direct violation of state law and the charter of the GAR Home, when it was established.
[b]Perhaps we should be investigating these "previous practices" for illegal discrimination against applicant-veterans, based on their (mental) health needs; which is blatant violation of federal civil rights laws.[/b]
I wonder how much overtime will be needed after the state loses a $50MIL class-action lawsuit?
[quote]It appears now that the director will take any veteran[/quote]
THAT'S WHAT IS SUPPOSED TO BE HAPPENING!
This new director should be promoted to Commandant - tomorrow.
____________________
This is what happens when "veterans" agencies are managed and operated by people who have never served in uniform, never stepped foot on a military base, and never zipped up a body bag.
Veterans become "problems" or "cases" or worse "needy cases" - a long impersonal list of them.
I see the billboards touting the caring atmosphere in the Veterans Home, but then you hear about how [b]the neediest veterans have been systematically turned away from THEIR Home for YEARS[/b].
lastpercentile Jul 26, 2012 8:08 PM
In either case, the director's boss is asleep at the wheel.
[quote]Veterans Home depending on the shift it can be up to 100:1[/quote]
If the nursing staff is 494, how could the ratio ever reach 100:1? With a patient census of 700, that would mean only 7 nursing staff on duty - out of 494. With hundreds of forced overtime shifts, when are there only 7 staff on duty?
(Or 1 employee in a wing of 100 residents and 150 staff with the other 600 residents.)
These numbers just don't sync with the union blowhard's numbers.
[quote]One Veteran admitted onto an improper unit, can disrupt the lives of the other 50 residents trying to make the facility their home.[/quote]
You do understand that it's not the veteran's fault, right? The veteran isn't disrupting anybody's life - the veteran is trying to live his life, under difficult circumstances.
It's the incompetent staff that caused the disruption; whether it was the policy writer, the admissions director, or the nursing staff that feels "put out", because the "veteran is being disruptive" - or all three.
You prove my point.
[b]In the Veterans Home - the veterans are the problems. There are too many of them, the new ones are disruptive, and the staff are suffering the consequences.[/b]
Have I distilled your argument succinctly?
lastpercentile Jul 26, 2012 10:28 PM
[quote]RN means registered nurse[/quote]
What does condescension mean? Maybe you should explain the difference to your union blowhard, who makes no distinction between RN and CNA.
[quote]It would like sending a man with prostate cancer to a OB/GYN doctor[/quote]
A doctor is a doctor is a doctor. See their Hippocratic oath. Everything else is a business decision.
So you're saying that the current admissions director is incompetent, and the entire chain of command above the director is incompetent?
[quote]as apparently you aren't in healthcare and are blissfully ignorant of the rules and regulations that comes with nursing[/quote]
I'll guarantee you that it can't be that apparent, and I'm not blissfully ignorant of anything.
I think that there is a distinct line between mentally ill residents and cantankerous, obstinate residents. (And the current admissions director probably agrees with me)
[b]The Home has been coasting along, excluding any applicant that might be the slightest trouble for staff, and enjoying the "low need" population, at the DIRECT expense of veterans in this state.[/b]
This "commitment to veterans" that the staff has been pretending to have had over the past 30 years - is finally coming to roost.
Nursing is not an easy career, but there's evidence (posted above) that strongly suggests that the Veterans Home was proactively trying to make it much easier by excluding applicants who weren't docile enough.
What sympathy you had coming - has evaporated.
lastpercentile Jul 27, 2012 5:55 AM
And, yet the staff has benefited, hasn't it?
So, in order to provide the "best" care for current members, some applicants get no care at all?
[quote]there was inappropriate sexual touching to the alzheimers patient who currently was living at wvh and this was reported to BQA. (State surveyors)[/quote]
First, it's the DQA, and they are not "surveyors", they are regulators.
A felony crime was committed - did they dial 911?
This turns out to be an example of the mindset of the staff. Instead of recognizing a crime, they see it as an opportunity to report their institution for a policy they don't agree with.
And don't get me wrong, the DQA should have been called. But who is investigating the sexual assault?
Is the sheriff reading this?
Oh - and the person who made the room assignment - s/he should be charged with aiding and abetting the crime.
[quote]$$$ is the utmost goal at WVH...not good quality care.[/quote]
I agree this is a big part of the problem, but it's because the state sets up the Home's budget based on the current census, rather than a [u]projected[/u] census. That's short-sightedness by all of the leaders and/or a failure of the legislature to accept their recommendations. Based on what I've heard, it's more likely the former - these people don't have the wherewithal to run the Home competently.
lastpercentile Jul 27, 2012 8:55 AM
Re-thinking your PR campaign, Marty?
lastpercentile Jul 27, 2012 10:08 AM
A veteran may be admitted to a veterans home if the veteran meets all of the following conditions:
1) Is a resident of the state
2) Is permanently incapacitated due to physical disability or age
3) Has not been convicted of a felony or of a crime involving moral turpitude or, if so, has produced sufficient evidence of subsequent good conduct and reformation of character
4) Provides a complete financial statement
5) [b]Has care needs that the veterans home is able to provide[/b] within the resources allocated for the care of members, including chronic alcoholism, drug addiction, psychosis, or active tuberculosis.
________________________
I don't see language that allows the state to "use discretion" as to whether the veteran will be a "good fit" or that the home is "best place" for the particular veteran's needs.
In terms of the veteran's medical needs, if the home is [b]capable[/b] of caring for the veteran - the veteran should be admitted.
lastpercentile Jul 27, 2012 2:19 PM
Yes, has care needs that the veterans are able to provide, the only problem is they can't provide it. That was the point I was making. It's common place for care facilities to say "We cannot meet the needs of this person." Which is why you don't see overly violent individuals in a normal nursing home setting, you see them in a psych unit fitted to their needs and behaviors. It's not doing them an injustice, if anything you're doing them a great deed by referring them to a place where they get the best care suited to their diagnosis.
Also, last I checked Abraham Lincoln passed away in 1865 so I doubt he was responsible for overseeing the survey, but I'm sure I didn't imagine surveyors I did see. As to your question about what agency they worked for I'm guessing either the United States Department of Veterans Affairs or the Centers for Medicare and Medicaid Services. Federal observation surveys are not uncommon, what is uncommon is asking employees about their work hours.
Also, I'm done with this argument. It's obvious you have an axe to grind and no matter what is brought to the table you've found an opinion you've fallen in love with.
Whitewood Jul 27, 2012 9:32 PM
The VA does not inspect anything.
CMS inspects no more than 5% of facilities each year; I wouldn't call that "common", in fact, it meets the definition of "uncommon".
"Observational survey" means the feds are observing the state inspectors (not observing the facility), and those are done even less frequently. They don't question the facility employees during these surveys.
CMS is not interested in work schedules. They are interested in adequately qualified staff, adequate staff to patient ratios, etc - but how the facility meets those standards is not a CMS concern.
The first finding I saw in the 2011 surveys of the Veterans Home is that the retention rate for each nursing staff sub-population was MUCH HIGHER than the state average:
Full-time RNs: 97% (WI avg: 79%)
Part-time RNs: 86% (WI avg: 69%)
Full-time LPNs: 98% (WI avg: 88%)
Part-time LPNs: 82% (WI avg: 71%)
Full-time CNAs: 97% (WI avg: 77%)
Part-time CNAs: 72% (WI avg: 63%)
The union rep said, "retention is horrible!" Not according to the official data. Which leads me to believe that he was just lying to the reporter - trying to drum up fervor for the union. He's the one who needs to worry about retention - his own.
[quote]no matter what is [b]brought to the table[/b][/quote]
Where have we heard that phrase before?
Whitewood...white wood...? Is that some kind of allusion to white wash?
lastpercentile Jul 27, 2012 10:53 PM
Unions never make arguments based on facts...they would lose everytime.
badgerfan54981 Jul 29, 2012 4:45 PM
areyoucrazy Jul 30, 2012 10:26 PM
[quote]RN means registered nurse[/quote]
What does condescension mean? Maybe you should explain the difference to your union blowhard, who makes no distinction between RN and CNA.
[quote]It would like sending a man with prostate cancer to a OB/GYN doctor[/quote]
A doctor is a doctor is a doctor. See their Hippocratic oath. Everything else is a business decision.
So you're saying that the current admissions director is incompetent, and the entire chain of command above the director is incompetent?
[quote]as apparently you aren't in healthcare and are blissfully ignorant of the rules and regulations that comes with nursing[/quote]
I'll guarantee you that it can't be that apparent, and I'm not blissfully ignorant of anything.
I think that there is a distinct line between mentally ill residents and cantankerous, obstinate residents. (And the current admissions director probably agrees with me)
[b]The Home has been coasting along, excluding any applicant that might be the slightest trouble for staff, and enjoying the "low need" population, at the DIRECT expense of veterans in this state.[/b]
This "commitment to veterans" that the staff has been pretending to have had over the past 30 years - is finally coming to roost.
Nursing is not an easy career, but there's evidence (posted above) that strongly suggests that the Veterans Home was proactively trying to make it much easier by excluding applicants who weren't docile enough.
What sympathy you had coming - has evaporated.[/quote]
melcook Jul 31, 2012 9:53 AM
1) a low patient to nurse ratio
2) a specially trained nursing staff
3) several psychiatrists on staff so one is always on-call,
4) a building that is set-up to keep patients safe during treatment.
Wisconsin Veterans Home at King is a skilled nursing facility or Rest Home, not a specialized treatment facility. It has a high nurse to patient ratio, a psychiatrist who visits once a month and an older facility that was set to care for the elderly.
Wisconsin Veterans Home at King should be not be admitting veterans with these [b]untreated[/b], [b]un-stablized[/b] medical conditions because they won’t get the specialized medical care they need and deserve.
King Veterans Home should help these veterans by referring them to a specialized treatment facility and assist in set up the veteran's first appointment. After the veteran has received treated and is stabilized, the King Veterans Home should be able to expedite the veteran's admittance into the Veterans Home at King.
LibertyBell Aug 01, 2012 11:03 AM
Do you agree with others (posting on here) that the Home is admitting "un-stabilized" veterans?
[quote]After the veteran has received treated and is stabilized, the King Veterans Home should be able to expedite the veteran's admittance into the Veterans Home at King.[/quote]
Are they followed and invited back after they are stabilized? Or, is the application closed on the first review?
lastpercentile Aug 01, 2012 11:24 AM