The lack of staff in a nursing home during the covid19

The lack of staff in a nursing home during the covid19

The social problem

The social problem that I have selected is the lack of staff in a nursing home especially during the Covid 19 pandemic. The working conditions during the COVID 19 pandemic were complex and stressful. These challenging circumstances have added a profound challenge to a workforce that is already strained and vulnerable and has a high probability of contributing towards increased staff shortages, turnover, burnout, and low quality care (Ouslander & Grabowski, 2020). Therefore, the pandemic worsened the existing problem of inadequate workers in nursing homes and if policymakers fail to prioritize this concern, the residents in long term care will continuously be at a high disadvantage in the pandemic.

The rational for selecting social problem

The reason for selecting this social problem is because staff shortage in nursing homes has been a problem a problem since historical period. However, the situation worsened during the Covid 19 pandemic. According to Ouslander and Grabowski (2020), the pandemic has caused devastating impacts on nursing homes presenting complex, challenging, and evolving conditions that affected the ability of nursing staff to effectively care for the vulnerable resident population. Evidence reveals that the staff working in nursing homes experienced high physical and mental exhaustion due to new responsibilities, increased workloads, and staff shortages, which resulted in high burnout, chronic staffing shortages, and high levels of turnover. Burnout is a significant contributor to high staff turnover, which is a prevalent problem in nursing homes, which has been worsened by the pandemic. Previous evidence has shown a high correlation of staff burnout and high turnover to missed care and poor residents’ outcomes. Missed care has been associated to adverse events among residents including new infections, medication errors, and pressure ulcers among others.

Staff shortages also contributed to more COVID outbreaks in nursing homes affecting both staff and residents. According to the Centers for Medicare and Medicaid Services, nursing homes experienced high spread of COVID 19 pandemic killing over 1900 staff members and 132,000 resident. The high level of personalized care required in nursing homes exposed the nursing staff to COVID 19. Some cited fears of contacting the virus and probably infecting their families, which saw most of the quit their jobs. More cases of Covid infection means that staff experienced more stress and more of them are exposed to or contract the virus, prompting more staff to quit thereby leading to more staff shortages. Ultimately, lack of adequate staff causes suffering among patients. They will feel isolated, which lead to depression and worsens their cognitive condition. Therefore, it is evident that staff shortages have a negative impact on overall care.

Describe state and federal policies that impact the social problem

The state and federal policies that impact on staff shortages in nursing homes include the American Recovery and Reinvestment Act of 2009, the Nurse Reinvestment Act of 2002, the Affordable Care Act, and the nursing home policies related to delivery of care, quality reporting, staffing, regulation, and nursing home payment.  The nursing home payment should be adjusted to realign the Medicare with Medicaid payments. This will require the federal to make greater contributions to achieve delivery of high quality care to vulnerable populations. The policy should increase the number of clinicians to work on site facilities. The federal government should ensure better pay and enhance their efforts to recruit and retain workers in nursing homes to improve the quality of care. Moreover, policy makers should increase quality in transparency by implementing measures that make the information delivered to Nursing Home Compare meaningful. The federal government should conduct regulatory reforms by ensuring the states have sufficient resources to implement existing nursing home regulations. Furthermore, Medicaid should pay more for nursing home services to promote delivery reform. The State Medicaid programs should invest in home and community based services, which allow individuals to remain in their homes (Birkenmaier & Berg-Weger, 2018).

Specific methods to address the social problems

The specific methods to address the shortage of staff in nursing homes include hiring more staff and better pay to help staff get through the pandemic. The low pay and demanding work has made it challenging to recruit new staff and maintaining the existing ones. The job is hard and most people are not willing to do the job for low pay. Nursing home staffs are demanding for better pay and change within their workforce and requesting the government to provide more funding to address the staffing problem. The aim is to recruit and keeping them through better pay and balanced work to avoid heavy workload that leads to burnout. Receiving help with staff shortages from state officials and governors, who will inspire medical professionals to volunteer to work in hospitals. In addition, the state and federal government should resolve the long standing problem of staff shortage (Ouslander & Grabowski, 2020).

How the agency and student can advocate to change the social problem

The agency and students can advocate to change the problem of staff shortage by reporting the issue to the state and federal governments to pass laws and regulations, which may regulate and support strategies that will strengthen the nursing workforce by focusing on retention and recruitment.


Birkenmaier, J., & Berg-Weger, M. (2018). The practicum companion for social work: Integrating class and fieldwork (4th ed.). New York, NY: Pearson.

Ouslander, J. G., & Grabowski, D. C. (2020). COVID‐19 in nursing homes: calming the perfect storm. Journal of the American Geriatrics Society68(10), 2153-2162.

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