How to Survive a CNA Shortage at Your Facility

Certified nursing assistants, or CNAs, are core members of a direct care nursing team. Also called nurse’s aides, they provide hands-on care to patients or residents in a number of care settings. The care they provide is invaluable — without CNAs, the burden shifts to licensed nursing staff (who are often overburdened themselves), and patients’ needs may go unmet.

If your facility is experiencing the effects of the nationwide CNA shortage, it’s time to face the crisis head-on. We discuss how to approach the situation so patients, residents, and staff can have a positive experience at your facility.

What Is a CNA Shortage?

A shortage occurs when there are not enough CNAs to meet the demand for patient care. Without assistive personnel to efficiently aid all the nurses on the floor, care quality can be compromised. Patients may face delays in care, have less face-to-face time with staff, and even be at increased risk of suffering consequences from medical errors.

So, what exactly causes a shortage? The reasons for this are multifaceted, but it ultimately comes down to CNAs leaving their jobs due to burnout without enough personnel entering the industry to combat turnover.

What’s Causing CNA Burnout?

As the aging population in America increases, so does the demand for caregivers in nursing homes and residential care facilities. Between 2021 and 2031, the employment outlook is projected to grow by 4%. This doesn’t look good for a career with a burnout rate between 26-51%.

In a survey examining why CNAs left their jobs, participants discussed what they believed were the key contributors to the CNA shortage. These factors are outlined in the table below.

These certified nursing assistant shortage statistics should come as no surprise when you consider the working conditions CNAs endure. Their primary job duties are physically straining, like turning, assisting with toileting, and bathing patients.

CNAs often have few opportunities for career growth, which can lead to resentment and job dissatisfaction. The risk of burnout increases when CNAs join a facility where staff neglect patients or turn a blind eye to unethical practices. They have the choice to stay and become part of a toxic work culture — for an average pay of $18.33 per hour — or leave.

5 Ways to Approach a CNA Shortage

If you’re experiencing a staffing shortage, take a look at your company’s culture and practices to determine what’s causing an exodus. As you strategize ways to retain staff, it’s important to take care of those who are left working in a shortage. Below are action items you can take to make the experience better for patients, residents, and staff in your facility.

1. Be Transparent

Patients and residents have a right to know if a facility is affected by staffing shortages that could negatively impact their care. If your facility is navigating a CNA shortage, inform residents and families about the situation and the steps you’re taking to fix it.

Facilities must report auditable data like employee turnover rates and staffing levels to the Centers for Medicaid Services (CMS). This information is displayed on Medicare’s Care Compare website, which allows the public to make informed decisions about where to get care.

All long-term care residents have the right to speak to a resident advocate called an ombudsman, who has the authority to investigate issues related to their care. Long-term care facilities are federally mandated to post the name of the state ombudsman in a visible location in the facility. Having access to an ombudsman is especially beneficial in a staffing shortage, as resident needs are more likely to be overlooked.

2. Demonstrate a Commitment to Safety

Many CNAs leave facilities due to unsafe working conditions. Their absence creates bigger staffing shortages, which creates an even more unsafe environment. It’s a vicious cycle.

Facilities must create a healthy work culture that lends itself to a safe working environment. Elements of a culture of safety include:

• Policy and procedure guides that leave no room for cutting corners.
• Zero-tolerance for abuse.
• Shared decision-making between staff and leadership.
• Organizational policies outlining safe CNA patient ratios.

3. Offer Shift Flexibility

Long hours and rigorous schedules may be causing CNA burnout at your facility, so consider offering flexible schedule options to attract and retain staff. This opens up opportunities for CNAs who prefer to work on their own terms in a wider variety of positions, such as:

• Per diem
• Per diem travel shifts
• Contracts

4. Lean on a Staffing Partner for Support

Elicit the support of a staffing partner with the tools and resources to address staffing challenges in your facility. A staffing partner brings you qualified nursing personnel like CNAs, LPNs, and RNs who are ready to take care of patients right away. They handle recruiting, onboarding, and relationship management so facilities can focus efforts elsewhere. Consider a partnership to achieve long-term solutions to staffing challenges while also addressing immediate needs.

5. Reduce the Burden on Staff

CNA shortages increase the workload on CNAs and licensed nursing staff. It’s important to ensure that those working through short-staffing don’t absorb additional tasks that take them away from their duties. Facility leaders should identify areas to reduce the burden on staff, such as:

• Ensuring adequate employment of clerical staff. It’s common for CNAs and nurses in short-staffed facilities to absorb tasks like answering the phones and transferring calls, or taking out trash and meal trays. This takes them away from direct care. Ensure your facility has sufficient clerical, environmental, and kitchen staff to keep operations in balance.
• Addressing residents’ social concerns. Direct care staff are the first-line caregivers with residents and families. Often, they bring up social concerns or complaints that are outside of the caregiver’s scope of practice. Nursing administrators in long-term care settings should address this by rounding with residents to address these types of concerns.
• Reviewing hours per resident day (HPRD). This is a measurement used to determine how much time a patient or resident gets with a direct care provider on a given day. In the long-term care setting, direct care hours are divided among CNAs, licensed nurses, and nursing leadership. Facilities can use this data to review how the staff is allocating their time between residents and determine what changes need to be made and whether there’s a need to hire for new positions.

Are You Equipped to Prevent a Shortage at Your Facility?

Each day that goes by in a CNA shortage is time patients or residents lose with a caregiver. If your facility is struggling to maintain adequate staff, take action now to improve CNA staffing. Partner with IntelyCare to get the CNA help you need today.