Enhancing Employment in Long Term Care:
A Guide to Retention

Chapter Two

Flexible Staffing
Suggestions:

• Establish a set schedule for full-time employees.
  
• Allow employees to switch days.
  
• Accept employee requests prior to schedule completion.
  
• Allow job sharing.
  
• Develop and utilize an internal pool.
  
• Explore switching to an extended night shift, such as 11:00 p.m. to 10:00 a.m., to give additional help to the day shift. Those individuals who work extended hours would only be required to work every third weekend.
  
• Develop a "master schedule" so that full-time and most part-time employees have the same days off each pay period. This allows them to schedule appointments and other life events on their days off. Keep several positions as flexible positions that allows you to fill in the blanks for days off for the regularly scheduled employees.
  
• Hire one or two positions above your staffing pattern that are scheduled for one-half of the weekends each year rather than every other weekend. This allows you to schedule them to meet your needs for coverage on weekends. This also provides you with a trained person to take on a regularly scheduled position when you have an opening.
  
• If an employee wants a day off after the schedule has been posted, allow that person to trade, no matter what your schedule looks like. This will keep your employees happy!
  

• Allow your employees to choose their work days with maximum and minimum requirements in mind.
  
• 12 hour shifts/3 per week.
  
• Employees make out their own schedule with supervisor's guidance.
  
• List preferred days off; post blank schedule and staff will fill in preferences for 4 weeks; DON then negotiates any changes that need to take place.
  
• Incentive programs to reward employees for working extra shifts.
  

• Establish a standard weekend and holiday schedule using schedule A or B.
  
• Offer a bonus ($1.50 per hour) to an employee who volunteers to work his/her regular weekend off.
  
• Offer a $20 per shift bonus for working extra weekend days.
  
• Offer 25% differential to work 5 out of 6 weekends. Must work at least 24 hours between Friday, 3 p.m. and Monday, 7 a.m.
  
• Schedule to work every weekend Saturday and Sunday at approximately $2.00 more per hour.
  

• Have employees "on call" for absences. Have each CNA give one available shift to be on call every week.
  
• Allow employees to accumulate points for working extra. These points would lead to a cash bonus, for example 10 points equals $50.
  
• Schedule back up from ancillary departments (dietary, housekeeping, activities) at a specified level of staffing.
  
• Award one hour of additional pay for every four hours worked if an employee is called in with less than 24 hours notice.
  
• Provide a free meal for an employee who is working extra.
  

• Schedule peak hour staffing: Determine your facility's busiest times and arrange your schedule so you have more staff available during the busiest times.
  
• Delegate non-nursing duties to other employees.  (Ensure compliance with certification requirements.)
  

• Have your housekeepers make residents' beds.
  
• Ask your volunteers to assist by passing water and transporting residents to activities or to the dining room, especially on weekends. Access church groups for this.
  
• Cross train your health unit coordinators, nurse techs, and medication aides to assist with CNA duties.
  
• Hire lower-paid support service aides to help wherever needed, including watering plants, passing ice water, linens, transporting residents, passing trays, one-to-one time with residents who have behavior problems.  (Ensure compliance with certification requirements.)  This person would not be trained as a CNA and would be hired at minimum wage. 
  
• Ask your dietary staff to pass trays and to assist in the dining room.
  

• Allow two weeks of vacation after one full year of employment and progress from that point.
  
• Allow some vacation time to be used at six months versus one year of employment.
  
• Can add 2 vacation days to sick time.
  
• Paid Time Off Plan -- sick days personal days, vacation, holidays rolled into one bank called Paid Time Off; not paid overtime for holiday; might have to change attendance policy.
  
• Buy back vacation time or personal days if not used.
  

• Post the vacation schedule for all to see so employees can see the times available.
  
• Try to accommodate vacations on a seniority basis, or allow seniority to rule until April 1, and after April 1 the policy is first-come-first-served.
  

• Allow for a birthday holiday.
  
• Allow two personal days per year for full-time employees and one personal day per year for part-time employees.
  
• Provide the ability for employees to earn extra personal days for good attendance or for working extra hours/shifts.
  
• Add personal days for longevity.
  
• Full time employee with one year of service receives 5 personal days in January; must give supervisor 24 hours notice.
  

• Offer compliments often, especially at the time you see a positive.
  
• Let others hear your compliments.
  
• Attend CNA meetings and give positive feedback.
  
• Food is always a good reward. Provide treats such as soup on blizzard days, lemonade on hot days, donuts on those "bizarre days," and pizza is good for all shifts anytime.
  
• Insist that all employees treat CNAs with respect.
  
• Treat an employee to dinner at an offsite location to recognize the employee's five year anniversary with the facility.
  
• For the first week on the job, offer a small treat every day for the new employee (lifesavers, note of thanks, etc.).
  
• Give "gift certificates" for ice cream cones, popcorn, etc. that are made in the building.
  
• Present awards for five-year increments of an individual's employment anniversary.
  
• Give a small corsage to each employee to wear on their anniversary date. For a facility with 230 employees, this costs approximately $30 to $40 per month. Try to negotiate a contract with a florist for a discount.
  
• Host employee recognition banquets. Employees of five years are treated to a luncheon and 10-year employees are treated to a dinner.
  
• Recognize employees in the bi-weekly newsletter for working extra shifts, volunteering for activity outings, donating supplies to activities, etc.
  
• Post thank you's for working safely, for example -- GREAT JOB! YOU HAVE BEEN WORKING SAFELY FOR ____ DAYS!
  
• Give a $20 gift certificate to the mall or the grocery store for "no lost-time injuries" in the month.
  
• Give a 19-inch television for three months of no lost-time injuries.
  
• Give an apple or banana with each paycheck for safe working.
  
• Give all employees a facility calendar printed with safety tips.
  
• Present awards for perfect attendance.
  
• Develop incentive programs and recognition programs for working safely.
  
• Give gift certificates for working a full shift on a scheduled weekend off or double shift anytime.
  
• Present plaques for "heroic" actions such as Heimlich or instituting CPR.
  
• Host an all day open house for nurses during the holidays at the home of the director of nurses.
  

• Occasionally eat lunch and take breaks with an employee.
  
• Talk one-on-one with employees; ask about their family, activities, hobbies, life, and concerns.
  
• Comment on local news involving employees and their family (sports, band, academics).
  

• Compliment quality performance (good positioning, new uniform, appropriate interaction in a difficult situation, etc.).
  
• Make it a point to look for positives (no skin tears, resident looks good, etc.). When you identify a positive, write a note or give a certificate.
  
• Have notepads with a "warm fuzzy" on it for anyone to leave a note about something good.
  

• Make the Employee of the Month process very official: establish a committee of peers, establish criteria, and formalize the nomination procedures.
  
• A rating sheet goes to each manager; if there are enough points the name goes into a box for a resident to draw; $50 for each winner (one per month); employee then is eligible for "Employee of the Year."
  
• Employee of the Year wins $100, a plaque, dinner, recognition in local paper, special parking spot, certificate and a pin.
  
• Employee of the Year wins $100 savings bond, mall gift certificate, picture at time clock, banner in work area, and a special pin.
  
• Recognize the Employee of the Month in various ways; consider name pins a special parking spot, pictures throughout your facility, a happy ad, lunch with the boss, and gift certificates.
  
• Add the employee's picture and name to a plaque.
  
• Present a special pin to the Employee of the Month.
  
• Treat the Employee of the Month to a free meal.
  
• Recognize the Employee of the Month at a special resident activity.
  

• Watch the newspaper for articles about your employees and their families; clip these articles for display on a facility bulletin board.
  
• Develop a "wall of fame" to display clippings about your employees and their families.
  
• Make a personal comment when you see a clipping about an employee or his/her family.
  
• Send the employee a note or card of congratulations when appropriate.
  
• "Staff in the News" Bulletin Board -- for accomplishments of employees' children such as athletic and/or academic achievements, honors.
  

• If staffing is down by a predetermined amount, treat the employees who helped cover the shortage.
  
• Institute a working short bonus: If an employee is called to work within 12 hours of the shift give an additional hour of pay. If an employee is called to work within three hours of the shift, give an additional two hours of pay.
  

• An employee's name goes in for the drawing for each extra shift she worked.
  
• Unit care coordinators could sponsor their own drawings.
  
• Solicit prizes from area businesses.
  
• Use pop can recycling money and vending machine money to pay for prizes.
  

• Reward longevity with a cash bonus, an hourly increase, or with extra time off with pay.
  
• If an employee has perfect attendance for six months, reward him/her with one or two days off with pay. Allow employees to accrue more paid time off by increasing the number of hours of employment.
  
• Reward good attendance with a cash bonus, with an hourly increase, or with extra time off with pay.
  
• Reward orientating new employees.
  

• Provide a vehicle that ensures informal time for the director of nursing and the administrator to get to know new employees.
  
• Encourage the director of nursing and/or the administrator to join the new night shift employees for a quarterly breakfast and to join new PM shift employees for dinner.
  

Preface
Chapter One: Good Wages and Working Conditions
Chapter Three: Recognition
Chapter Four: Feeling In on Things
Chapter Five: Fringe Benefits and Other Incentives
Chapter Six: Growth and Opportunities
Additional Resources

WAHSA 204 South Hamilton Street Madison, WI 53703
Telephone: (608)255-7060 FAX:(608)255-7064