Guest Author
Times have changed since I first joined the health care profession and became a registered nurse in 1998. Over the course of my 26-year career in nursing, I’ve seen changes in everything from types of equipment to facility quality to medical technology — all of them intended to keep up with changes in the needs of our aging residents. Along came COVID-19, and our approach to how we deliver care became even more important — addressing residents’ physical conditions is matched by the importance of caring for their behavioral and mental health needs.
Florida has always been a forerunner in quality, innovative long-term care. We have continued to make great strides over the years, thanks to improvements in state and federal oversight and enhanced understanding and commitment by providers. Now, with Senate Bill 804 and House Bill 1239, we have another opportunity to be a model for the nation regarding staffing in our nursing homes.
When Florida’s current staffing standards were developed in 2001, the focus was on ensuring that Certified Nursing Assistants provided enough hands-on care to assure quality. Back then, the primary focus of CNAs was on resident self-care, things like feeding, bathing, using the restroom, and dining. CNAs still play an important role on our care teams, but today the involvement of multiple specialists is necessary to ensure that we help our long-term residents maximize their independence or adapt as their conditions progress and that our short-term residents recover so they can return home.
The nature of health care and the way people age have both changed dramatically over the last several decades. This means a much greater need for specialized care. Patients with tracheostomies and breathing problems require the help of respiratory therapists, who have an advanced level of training to recognize if their condition changes so we can reduce the risk of these residents returning to the hospital.
Physical and occupational therapists help individuals restore movement and regain their strength, which helps our short-term patients get back to their life roles. Social and mental health services are helping meet psychosocial needs, which helps reduce the need for antipsychotic medications. This shift in resident needs spans all areas of long-term care, from admission to continued care to post-discharge services.
There’s a lot of misinformation out there about the current legislation, but it’s important to understand that it does NOT reduce the number of hours that nursing home residents receive direct care. It will simply allow skilled professionals besides CNAs to be defined as direct-care staff — so trained individuals with clinical expertise can spend productive time with residents. This will result in a higher level of quality care and quality of life.
Eventually, many of us will need the kind of care available in a skilled nursing center. When that happens, don’t we all want to be treated like individuals — where the care we receive is tailored to our own particular needs?
It’s time that regulations focus on what’s best to meet the needs of each individual, not a standardized approach. The care needs of nursing center residents have changed. Isn’t it time our staffing regulations change with them? Please urge your lawmakers to support SB 804 and HB 1239.
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Amina Dubuisson is vice president of Clinical Services with Ventura Health Services, which operates 7 skilled nursing centers in Florida. She can be reached at [email protected].
