Wednesday January 12, 2010
I woke up this morning thinking about the Ministry of Health and Long Term Care.
Strange thoughts for one to have you might think. But I have been spending my time trying to determine what the problems are in this convoluted system. it just is not working. Where are our dollars going? Certainly not in front line service where it should be, but in the justification of front line service. There are expensive layers of function purely for the sake of justification that do not benefit The Resident directly. There are registered staff whose whole days are spent inputting information to say; see how many dollars we need, see us use the right words, the right turn of a phrase to ensure you credit us with dollars, see us make reports to the Ministry, to Corporate, to boards to ensure our existence. To justify.
Every company spouts words like dignity, care, rights. But really, whose dignity, whose care, whose rights?
The Ministry of Health and Long Term Care has become an endless layer of bandages repeatedly placed over many festering wounds. When in fact the wound needs to be stripped down and all the purulent gangrenous tissue removed to allow for some real healing.
Meanwhile on the front lines staff are enduring ridiculous workloads. The primary care workers are called PSWs and they are at the bedside. Their function is to deliver the hands on care. They are also the lowest paid in the nursing structure. Their assignments (The Residents) total nine or ten on any given day. In their day of 7.5 hours they are expected to wash/shower/bathe, assist with meals, transfer, toilet and provide care and support. Working organized and together at a team this may not be unreasonable, although in my opinion an assignment of six would provide better quality of care because care at the bedside entails more than just physical care. True care is not rushed. It is the time to talk, to listen. Instead they must just give physical care.
But this is not what makes their workloads ridiculous. They are then expected to document. Now some documentation is necessary to reflect the care delivered and to have a record for The Resident’s status. This is essential information. But for the sake of justification the process has become complicated by intricate forms. In some Homes this entails five double sized pages for each Resident, each shift. So if you “care” for ten residents in your shift and document thoroughly and accurately it may take ten minutes for each resident. You have just spent a minimum of fifty minutes that could have been devoted to care. In addition there are intake sheets to fill in (what your resident ate and drank), restraint forms to complete, and report to give to the charge nurse. Some companies have even more forms.
It just ain’t working folks. How dare anyone, usually in Administration or Corporately, based on Ministry requirements institute processes that take away from care? Take away from The Resident?
And those problems do not even come close to the misuse of registered staff. But that is for another day.