My wife is a nurse at an 80 bed skilled nursing facility. Most of the staff is out with COVID-19 and more than half of the 80 patients have COVID-19.

She is the only nurse there today with 3 CNAs. For 80 patients. Many are dying of covid. How is the facility even legally allowed to be open and not have to move patients out? My wife is in fear of losing her nursing license not to mention the stress.

Please help us with some advice! Are there any administrators familiar with these situations that can help calm fears or just let us know what to do?

I'm assuming by your handle that you are in Missouri. If so, I do not know the rules. IF in Tex, there is no minimum staffing requirement. The regulations say to "meet the needs of the residents."

In this particular incident, it would be easy to say that this does not meet the needs of the residents.

Finding staff right now is incredibly challenging to impossible. I have a fellow admin that has run a good facility, r about 15 years at the same place, needing nurses and has had a $5k signing bonus for 3 months with no applications.

I feel for your wife and those aides. It is impossible. They will work all day and still not feel good about it when they leave. That is not their fault.

Schu, the other option is for her to get in touch with her local hospital and see if they would accept the most critically ill COVID. They might be able to help or they might be underwater also.

I also would not think the board would pulling her license in this instance. I believe they would be more critical if she left the facility during the shift today as the only nurse. That is just my opinion.

I hate that she is in that position. I would start calling anyone that is on staff and not sick to come in and help, no matter their position (housekeeping, laundry, dietary, therapy, admin).

Unfortunately, if the facility can show they are trying to do their due diligence and bring in staff there isn't much that can be done. There is always contract, agency, and state nurses from an agency that can be lent to the facility (we have a few here at the community hospital I am a director at) but honestly, as much as it may suck, those resources are going to the place where they are more acutely ill. Having a better plan to send the residents to a hospital that can manage them is the best option, but that can be limited severely at this time as well.

Best of luck to your wife though. Hope she stays safe. She always has the opportunity, which I am sure she knows, to claim Safe Harbor if she feels it is inappropriate for her to be directing the care of that many people.

If Missouri has a safe harbor statute, she needs to get online and sign the paperwork pronto.

Also, the director of nursing should be there helping out. If not, and they aren't out with Covid that's a big red flag.

The good nursing homes tend to be really good but unfortunately the bad ones are really really bad.

nortex97 said:

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Skilled nursing facilities in DFW have all been for at least two decades a tragic comedy of staffing/indifference by management, so I expect the same in Missouri. High, high staff turnover, constant death, and patients in poor condition/generally inattentive/inadequate family support are the rule, not the exception today.

I can see this only being worse today with covid, and wouldn't ever advise a young person to seek a career in this business.

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It is indeed quite sad. So many factors playing into it. It still baffles me how we are 9+ months into this and we still haven't caught up to the demand in PPE getting to the places that need it most. We're so focused on schools and children, we're forgetting the people proven to be the most vulnerable in all of this.


On another note, this is a metric that is hard to account for when someone only wants to look at the death rate to determine whether or not this virus is a big deal or not. Just because people aren't dying doesn't mean this isn't taxing the healthcare system, AND, maybe more importantly, the healthcare workers. Then they like to point to the doctors and nurses being laid off, not understanding the difference between and orthopedist and a critical care specialist, and ICU nurse and a psych nurse.