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Employer Quotes

The quotes below are from employers in this industry: Health Care

They are talking about this topic: Workforce Trends & Challenges


The quotes below are about this issue:
Long-Term Care: Long-term care facilities, in particular, have difficulty attracting and retaining health care professionals. Because long-term facilities are not reimbursed at the same rates as hospitals, they cannot always provide competitive compensation. Additionally, the image of long-term care is generally seen as less "glamorous" than other health care environments. Employers need more health care professionals who are dedicated to a career in geriatric care and/or in nursing home facilities. Students also need a greater understanding of the nursing home model, which includes the social model of aging in addition to the medical model of aging.

Employer Quote Region
"I discovered yesterday, and I knew it was bad, that the wage difference between acute care and long-term care for an RN is now $30,000 a year. That's impacting who we are getting for applicants. We are also a clinical site for [MnSCU college] Licensed Practical Nursing Program, and we probably had 25 or 30 applicants come in over the last year, students coming in over the last few years. We always meet with them at the end of their clinical experience to see how it's going, and we always ask the question, 'How many of you are planning to go into long-term care after graduation?' And we have yet to have the first hand go up. So, the people that we are getting don't want to be in our world." Central
"Think of that employee that's in the hospital, for instance. And you have your elderly patients going to the hospital. I stood outside of the emergency room, right outside of a hospital here, and a resident was screaming because she was afraid. I had the EMT in front of me say, 'You should have heard her on the way over, but she's finally quiet. She has dementia—she doesn't understand what's going on.' She was put on a gurney, and she didn't recognize the faces, and she was whipping by the lights, and she was afraid. But some people don't understand that part of it—to just understand the concept that she was afraid, and that's how she was communicating it. It's just frustrating to me to stand there and to hear them say that." Central
"It's nice with our nursing assistants. They come and do the clinicals in our nursing home, and so they get that feel for it already. I don't know if the RNs or LPNs do clinicals in a nursing home. They often use the nursing home as their stepping stone. They can get a job there, it's their first job, and as soon as they have that experience, they move on to the hospitals or the clinics where the pay is better and the hours are better. So, we get a lot of the new graduates. We are kind of a training field; we're their clinical training field to move on to something else. So, it would be nice if they did some of their clinical studies in a nursing home instead of walking into us kind of unprepared. We have our best success with the ones that we grow ourselves, our nursing assistants, and our LPNs. And we've paid for all of their tuition, and their books, and their fees to go on to their next step. And they have that background already in the long-term care." Central
"Employer 1: Coming from the memory care side, it's really hard to find nurses that have experience with dementia and Alzheimer's patients. I need somebody who is going to know medications and who knows what's going on. Because that person may not be able to communicate in order to say, 'I have pain,' or 'I have these needs.' It's hard to find nurses that have that experience. And you can't throw somebody in that's never had experience with dementia and say, 'Here you go. This person is hitting out—or whatever it may be—how are you going to deal with that?' I think it's scary for some nurses.

Employer 2: It's a lack of exposure to that type of behavior."
"I'm wondering whether some sort of coursework, or concentration, for those that are interested in working with the elderly—if there was an emphasis for people to be able to move in that direction? To understand these complex seniors that are, on average, 85-years-old? If people are interested in working in that field, then there has to be more specialized training." Central
"I think when you talked about doing clinicals in nursing homes, one of the nursing homes—we are a clinical site—but we were one of the last ones to be chosen. They want to go to obstetrics or they want to go to pediatrics. So, I think that's part of the issue, we are not the glamorous part of the medical field or the nursing field. The attitude seems to be, 'Well, I could just get a job at a nursing home, or I can get a job in home care.' So, they do that for a while until they can get something else. I think there should be some more emphasis in the training that they need to have, not that they choose to have. Because sooner or later they are going to end up working with some type of elderly or chronic population. And I think that, like I said, we are not the first choice to do the clinicals. We get a few, but not many, and usually it's somebody who's worked prior as a student." Central
"Anybody that's worked in the area knows how many are coming up, and how soon people are diagnosed with dementia, and how fast it can progress for some of them. Most nurses just don't have that experience." Central
"And then, the opposite is that there will be a growth in geriatric populations in our health care system, too, so you have twofold...

Question: And, the experienced folks are going to retire, and...

Employer: They're going to be patients now."
"I think that's one of the things maybe the colleges could help with—in terms of identifying who may have an interest in long-term care nursing. It really is changing. It's not, you know, the traditional setting of the 1970s. It's sub-acute. It's like a medical-surgical unit. It's fast-paced. We need someone who can multi-task and who can be very organized. In terms of the colleges, they could offer more or suggest more people go into long-term care for their preceptorship. Or encourage people to look at that as a possible career, not just as a stepping stone." Metro
"The biggest complication or biggest downside is that we get—I'm in transitional and long-term care—we get new grads, a lot of new grads, but then after a year, they go to the hospitals because they can make $10 an hour more. We're just a huge stepping stone, and it's just a vicious cycle where I'm forever feeding it, and it's very frustrating. We can't compete with hospital wages, and you have a lot more patients in long-term care than you do in the hospital, and it's very frustrating to my staff when they see how much more they can make down the road." Metro
"I'd have more geriatric information and training across the board because, even if we're not focusing on the last two or three years of life, you're still going to have an older, more chronic, more complicated set of cases when people present." Northeast
"When folks present, they're going to present with more complicated and with more serious issues—and probably more geriatric. So that kind of specialty information, whether it's just a class along the way or even a special focus." Northeast
"We need more people who are geriatric-focused." Northeast
"We talk about nursing homes changing and the need for higher skills. You know, we see that all the time. But residents coming into our facility need a skill level that is more applicable to an RN, but you cannot necessarily afford the RN wages all the time, so the RNs are going to hospitals." Northwest
"Employer 1: I think as far as the clinical skills—definitely—I hear what you're saying; those skills are there. But, nowadays, many nursing homes are swinging away from the medical model. It's more of a social model. So, that brings a new light on nursing, too.

Question: So, are you saying that we've got to have more of these students in this new nursing home model? When you study to be a nurse, do you specifically say that you want to work in a nursing home? Or in a hospital? Or a...?

Employer 1: You get it all. From OB, to med-surg, to nursing home, you get it all. You do rotations.

Question: But it sounds like the nurse that's going to work in a nursing home is going to need a whole different skill set?

Employer 1: They need strengths in soft skills. It's a social—it's a medical model, but it has a very social model feel to it. It deals with families and [lost in translation].

Question: And is the social aspect becoming more important?

Employer 1: Absolutely.

Employer 2: Yeah.

Employer 1: It is very important."
"We can't—we're not funded so that we can pay our licensed nurses what they can get paid in a hospital. Sometimes I hear that it's upwards of ten dollars an hour difference. So, that's what we struggle with in long-term care." Northwest
"You know, I've been a CNA, an LPN, and an RN. And it's hard work working in a nursing home. Yeah, maybe it's not as glamorous as an emergency room or whatever. But you deal with some complex cases, and you can actually build some excellent skills. But I don't think it's being sold in programs—it's not portrayed as a glamorous place to work. But we do wonderful things to extend the lives of the elderly population, and nobody wants to do it. Because I don't think it's—I don't know if it's seen as just not good enough for a lot of the people who are coming out of colleges?" Northwest
"There are some areas—including senior services—where it's a little bit more difficult to attract in general across the field." Southeast
"Long-term care, I think, represented over half the folks that attended these meetings, which was delightful because the data now is going to reflect a more broad-based acute and older adult services perspective." Southeast
"In our business sector, in senior services, we're not a glamorous place to work. And often senior services organizations aren't able to pay the same rate that some acute organizations will. We're fortunate in being part of a non-profit health organization. But when I hear from other organizations, often you can see quite a gap between what a long-term care facility can offer versus the acute side. The other issue is whether you're considered urban or rural because those areas are paid differently by the state. You don't make that decision yourself about what you reimburse. So, those constraints are really a problem for people. Even being able to pay—even if they would like to pay their staff more—often they just can't in a rural organization versus an urban organization. Here in Winona, we are reimbursed less from the state than we would be in Rochester because Rochester is considered urban. So, those are challenges that we have behind the scenes in terms of attracting people. And that is eventually going to really be a challenge for the future. Because you certainly know that we're probably going to serve institutionally—we're going to serve them in the community—but we still need people available to do that. So we're going to have to figure out how we're going to face those challenges in going forward and still figure out our model of care. We're changing a lot of that. But how are we going to pay them competitively in order to make that work?" Southeast
"What we've found is that people are graduating with the practical nursing, and then pursuing their RN degree quickly. So, the turnover and replacement is pretty frequent in our long-term care and home health care setting with the LPNs. That's where we've seen challenges. That's great career growth for the individual, but it's just a challenge from the employer perspective." Southeast
"I don't know that in higher education there's much emphasis on geriatrics or gerontology. I think most of the nurses are trained in acute care and then, when they get into the long-term setting, we have to train them on geriatric care, hospice care, how to do rehab, and how to work with therapists. It just doesn't seem like they come out ready for long-term care." Southeast
"I would agree that the curriculum doesn't prepare the nurses for long-term care and I think we, as long-term care providers, would be willing to be a resource to the colleges if they wanted some help in offering a course or at least getting more knowledge in that." Southeast
"As health care changes and as senior care changes and we see more of a shift towards community-based care, I guess the concern is that there is a gap in terms of the need for more registered nursing assistants. And, as the other respondent pointed out, there is the issue of reimbursements as well." Southeast
"It's difficult to convince new graduates that the long-term care work with the geriatric populations is a place where their skills are going to be utilized. They are not going to be narrowly focused in terms of their skill set—they're actually going to use all of their assessment skills and all of their nursing skills. I think there's a misconception that, in long-term care, that your practice becomes very narrow. It's not an accurate reflection of how it really is. That makes it difficult to hire." Southeast