Even before nursing homes became the epicenter of a world-historic pandemic, the setting was rarely the first choice for young nurses looking to build a long-term career.
Often perceived as a less-exciting workplace than other settings — such as the emergency room or private practice — post-acute and long-term care facilities have long been considered the minor leagues for newly minted registered nurses (RNs) and other nursing professionals: Do your time for a few years, gain some resume-burnishing skills, and then move on to a place with cutting-edge technology and bigger challenges.
But as health care providers lay off their nursing staffs amid a blanket ban on all non-emergency procedures, the largest nursing home chain in Florida hopes to attract those professionals in need of work — and convince them to stay on once the system returns to normal.
The Maitland, Fla.-based Consulate Health Care, which operates 82 facilities across the Sunshine State, last week announced a major push to hire RNs, licensed practical nurses (LPNs), and certified nursing assistants (CNAs) who may have lost their jobs at hospitals and other clinics that provide elective and non-essential care.
SNN spoke with Consulate chief nursing officer Andi Clark last Thursday, April 16, to learn more about the nursing home heavyweight’s plan to sell available nurses on the space while keeping their residents safe during this trying time.
Walk me through the development of this plan.
I think for nurses that work in hospitals, CNAs that work in a hospital or a different health care setting, probably a post-acute skilled facility/nursing home is the last place they might consider going for a job. The opportunity is to introduce them — even if it’s for a short time, because we’re hopeful that short time turns into permanent. We believe that as they come into our setting, and they start to meet our patients, and they understand that you have technology — we have many, many things that nurses desire.
Once they are introduced to our setting, frankly, they’ll fall in love with our patients. They’ll see how we champion them; they’ll see other opportunities, I think, for their careers. So that’s kind of the second part — yes, we would love to come and have them support our staff. Our whole industry is staffing-challenged. But the bigger piece is just introducing them to us.
I’ve been in this industry a long time. I don’t see how you can work in a nursing home and not love our patients. We’re hoping that’s what we get from this.
I’m definitely familiar with the perception of post-acute and long-term care as the “minor leagues” of nursing, but this is the first I’ve heard the idea that this crisis could actually turn people on to the setting into the future.
We don’t have perhaps as much technology as a hospital, but we do telemedicine. We have electronic medical records, we do a lot of things virtually — we’ve learned how to really be able to communicate.
We use Zoom meetings, and we do a fair amount of conference calls. But what we’ve learned is that we can also really be a part of our centers when we can’t be there in person. It’s been really tough to stay out of our buildings right now because — especially for nurses and even our operators — we are used to going to our centers and interacting in person.
I tell everybody — operators, our nurses — that this is an amazing time to be in our setting of post-acute skilled, simply because we are a huge, important piece of the continuum of care. Hospital stays are three to five days; nursing home stays have certainly shrunk, but we’re that conduit in the middle to really offer good care, good education, rehabilitation, and to work with families and patients so that they get home safely.
Nurses really get to use their skills in our setting, because we don’t have doctors 24/7, and we don’t have labs; they really become very good at assessments, recognizing change of condition, and using leadership skills.
Even in this temporary setting, looking for temporary folks, we’re not looking for just licenses. We’re looking for nurses who are smart. They are compassionate, and they have integrity. So I think we clearly want these folks, as they interview with us, to understand that — that there’s certain things that we expect out of Consulate nurses, and really anybody that works at Consulate.
What are some of the other methods you’re exploring for recruitment — what about hazard pay or additional training opportunities?
A couple of things. We do have compassionate pay. The other thing we’re doing — that Florida as well as the American Health Care Association is putting out there for us to see if we want to use it — is called training for patient care assistants. We are definitely full-on looking at that; we started classes this week. These are also temporary positions for patient assistants, [who] really have to do very specific things. They can’t work closely with patients, but they can make beds, pass water, push wheelchairs, talk with our patients, maybe help our activity folks. So there are many things that they can do to assist our nursing assistants.
We started classes this week, and we really first started targeting all of our staff in our centers. For instance, administrators are taking this course. Activity directors, social workers, HR folks, business office — just that little extra help on days when we can use a little bit of extra help, especially around some of the things that take up a CNA’s time.
Are there any specific areas where you still really need assistance from the state and federal governments?
I think we have really struggled to get PPE — particularly gowns. We seem now to be catching up on masks; we’re catching up on face shields, N95s. We certainly have, I think, a better supply of that. Hand sanitizers, we’ve been able to really lately have a lot of deliveries for that. I think the PPE — gowns are the most precious thing.
Not only do all of our staff wear masks, but we ask that for safety purposes that our patients cover their mouths either with a handkerchief or a washcloth, just during care, so that they’re safe.
People in the community have been amazing; they’re making masks, and they’re making them out of very colorful material. Now, for our nurses, they’re not certainly as strong as a regular mask that we purchase from suppliers, but they’re colorful and they can be used. And for a while, when we were really in a crunch, having folks make hundreds of these masks was very helpful. So those are the things I think we require.
I’m very disheartened, frankly, about the press that we receive. We have heroes working in all of our nursing homes across this country. And I love it that our hospital partners get a lot of attention; I so admire those nurses. I’ve been a nurse for a long time. But when I get up every morning, I think about every one of our directors of nursing that come to work every day. I think about our administrators, our CNAs, all the staff in our centers. They’re heroes too.
I don’t know if you’ve heard about the “hope huddles” that have come out of the hospitals, where at the end of the day, the staff — even over loudspeakers and going up and down the halls — talk about what good things happened that day. So all of our calls that I do with all of our teams, and we’ve been having calls daily, since this started — start with hope.
All of our administrators, our directors of nursing, our regions, our divisions — we want them to be hopeful. There’s a rainbow ahead, and we’re going to work really hard, and we’re going to get through this. And we can do that every day, but it’d be really great if the media would do the same thing, because it’s tough right now.
It has been fascinating for me, as someone who reads a lot of local news coverage, to see the differences in the framing — hospitals are generally seen as heroic, whereas there’s a lot more skepticism about what’s happening in long-term care. But obviously there needs to be a way forward for everyone into the future.
We’ve just engaged with a telemedicine company. It used to be telemedicine was really more evident in rural areas. But right now, we’re putting it in almost half of our buildings now. We’re looking forward to that, because our doctors are getting sick, too.
We’re just trying to think of every avenue, and [CEO] Chris Bryson says that we really now are looking at: What’s our new normal going to be? We’re starting to talk about that: What will our new normal be like?
It’s always going to be about taking care of patients and touching our patients. We all miss going in buildings right now, being able to hug a patient and hold a hand. But we’ll get back to that. I’m very, very optimistic about that.
Anything else you want the industry and the public to know about what’s happening right now?
Right now, I think we’re still really focusing on what’s in front of us. But I also think we need to focus on what comes next. Patients will always be at the forefront of everything we do in health care — and patients and their families, how we communicate with them, how we collaborate with them. But I think the bigger thing I see is [about] the health care community in general.
I’m hoping our hospitals will look at us a little bit differently. I’m hoping the communities will; I hope our regulators will. We’ve had, I will say, wonderful collaboration with all of our state associations, our regulatory, the survey agencies. They have been true partners. And that’s a bit different for us, but it’s a good thing.
This interview has been condensed and edited for clarity.