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July 1, 2005
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The Basic Staffing Solution by Richard L. Peck, Editor-in-Chief


The basic staffing solution Staffing has always been a major issue for our readers-never more so than now, when the financing to pay for staff has grown so tight and the competition for nursing, at every skill level, has become intense. An undoubted sign of the recent emergence of this issue was the observation by attendees at a recent long-term care preconference for the White House Conference on Aging that staffing concerns predominated in most of the recommendations coming out of that conference.

There has never been a shortage of ideas for coping with the staffing challenge-mentoring, therapy teams, career ladders, subsidized education, and more. But when I think about especially the lower rungs of the staffing scale, so predisposed to training difficulties and massive turnover, I hearken back to my own days as a grunt in the industrial front lines.

I was 16 and it was my first summer job, working as a loading dock jack-of-all-trades for an ice cream manufacturing company. We had a large incinerator under the loading dock and, as people often will, someone decided to take the easiest approach to disposing of two large crates of spoiled ice cream by kicking them down the incinerator. That meant someone else had to be enlisted to crawl into the shut-down incinerator and scrape the thick, charred, gooey coating of "baked Alaska" off its walls. That someone was your humble correspondent.

My (relatively) lithe teenage body climbed into the thing in my coveralls and started scraping and shoveling with a will. After about an hour, though, I had to emerge to get a carbon-free breath. At that moment, as luck would have it, I noticed the plant manager in his sparkling white shirt along with several well-dressed executives marching across the loading dock. I knew in that instant what my life's work would be-white collar or bust.

Resubmerging into the muck, I indulged in a bit of self-pity: No one much cared about my tacky, blackened coveralls, my matted hair, my burning lungs. (Gee, it's lonely down here.) But I finished the job, relit the incinerator, and went on to other things, similarly uninspiring if not quite so messy. No one made much of it-I was basically the penniless kid who was working where he belonged.

I sometimes recall that feeling as I read about nursing assistants as they go about the daily lifting and hauling and cleaning up and, occasionally, fighting off terribly sick residents. I wonder if they feel like I did. What sort of attitude do they perceive from those who manage them and sign their paychecks? Do they feel ignored, cut off from civilized life, stuck where they belong?

That feeling is at the heart of the staffing problem, I'm convinced. Acknowledge it, begin to deal with it, and the staffing solutions will follow. Ignore it, and all the best intentions in the world will be blown away, blown into the serving lines of McDonald's, the offices that need cleaning, the other less-demanding minimum-wage jobs. They'll go up with the smoke of a burning Eskimo Pie.

To comment on this editorial, please send e-mail to peck0705@nursinghomesmagazine.com.