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Selected Themes in Nursing Home Management: A Cna's Critique
Selected Themes in Nursing Home Management: A Cna's Critique
Selected Themes in Nursing Home Management: A Cna's Critique
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Selected Themes in Nursing Home Management: A Cna's Critique

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Selected Themes in Nursing Home Management presents a critical examination of traditional practices by managements of nursing homespractices that have rendered illusory the accomplishment of the noble goals of providing needed care for the elderly population. Anchored in real floor experiences of the author, the book provides a roadmap toward the destination of compassionate care for the elderly. It is a compelling read for policy makers, department of health regulators and supervisors, nursing home managers and staff, and students of healthcare management.
LanguageEnglish
PublisherAuthorHouse
Release dateOct 26, 2012
ISBN9781477279823
Selected Themes in Nursing Home Management: A Cna's Critique
Author

Edwin A. Ngeri

Edwin A. Ngeri was born and raised in Nigeria, but he relocated to the United States in 2001. He earned a bachelor of science in economics from the University of Port Harcourt, Nigeria and an MBA from the University of Phoenix, United States. He has completed over 60 percent of the coursework for a PhD in organization and management at Capella University, United States. He aspires to be a management thinker and consultant. He previously worked as a high school economics teacher and a commercial banker, and he is also a certified nursing assistant in the state of Minnesota (where he currently lives).

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    Book preview

    Selected Themes in Nursing Home Management - Edwin A. Ngeri

    © 2012 by Edwin A. Ngeri. All rights reserved.

    No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

    Published by AuthorHouse 10/16/2012

    ISBN: 978-1-4772-7983-0 (sc)

    ISBN: 978-1-4772-7981-6 (hc)

    ISBN: 978-1-4772-7982-3 (e)

    Library of Congress Control Number: 2012919189

    Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

    Certain stock imagery © Thinkstock.

    Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

    Contents

    Dedication

    Acknowledgement

    Introduction

    List of Abbreviations and Meanings

    Chapter One:   The Nursing Home

    Chapter Two:   Resident Rights and Care Delivery

    Chapter Three:   Difficult Residents and Difficult Family Members

    Chapter Four:   Diversity Management:

    The African-Born CNA

    Chapter Five:   A Model for Nursing Home Management

    Bibliography/References

    Executives are constrained not by resources but by their imagination.

    C. K. Prahalad

    1941-2010

    Dedication

    To late Perry A. Ngeri, my beloved brother who passed to the great beyond on the 6th of September, 2012—as I was putting finishing touches to this work. Even as I type the lines on this page I cannot help but wonder why you did not wait a bit longer to see your brother’s first book. I take condolence in the fact that He, who gave you life, has called you to a better place. Perry, may your gentle soul rest in the Lord’s bosom. Adieu, my brother.

    Also to all the hardworking nursing assistants in the United States, especially those who work in the nursing home environment, may you be rewarded by competitive America for the great job you do. Enough love to all of you.

    Acknowledgement

    Even a book, as small as this one is did not just come to be by the dual efforts of the author, and the publishers. True, I spent so many days and nights, pounding on the keyboard of my laptop computer to put down the content here-in, and communicating with the publishers to make the book a reality, this reality would probably still be elusive without the formidable support I enjoyed from family and friends chosen by my creator for this purpose. I thank God almighty, for the unmerited gift of a purposeful life, which only partly manifests here in the form of knowledge gained through education.

    To my wife, Mrs Toni Edwin-Ngeri, and children, Mudiaga, Ayebaifie, and Jacqueline, I am not unaware of the real price you paid as I stubbornly went after my pursuits. I may have, timely, fallen short of your collective expectations of me, both as a husband, and a daddy, but it is my assurance to you, that though popular eyes and ears could not have seen or heard what I saw and heard, I saw clearly, and listened attentively, as they were designed for my eyes and ears. At the appropriate time, He, who showed me what I saw, and spoke the words I heard, will cause these to manifest upon your lives. I truly love you all.

    To Boma Iruene, and Walkie Cheah; a true brother, and a true sister, you were called to be to me, I cannot stop thanking God for knowing you. Katrina Lavette Sweet, meeting you at the Capella doctoral classes was awesome, but with Silent Screams you have remained a wonderful source of inspiration. To Emmanuel Ebitimi George, who saw the vision of my writing a book, in 2002, I thank you so much. I could not have talked about team work, in this book, without the live lessons learnt from working with Dauda and Katrina Parks. To say we were the greatest team in the block, at the time, is only stating an objective truth.

    To Irigha J. Obuala, Emmanuel Young, and Victor Clement, I feel humbled by the magnitude of your belief in me, especially in recent times when holding on became really challenging for me. I wholeheartedly appreciate your unrelenting support. I am also thankful to Akpos, Alfani, Thomas, Udeh, Ikiogha, Barine, Alanso, Lucky Nwosu, Lucky, Manny, Ayebaemi, Ebinyo, Pastor Levi, Evangelist Ike, Lemlem, Amadi, Aye, Idowu, Madam Helena Olotu Asu, Emmanuel & Gifty, and Paul & Lori Hinton, for your thoughtfulness.

    To Madam Juliana Ogobiri, my lovely mother, I will ever remain grateful to God for choosing you to be my mom. I cannot thank you enough. And to all my brothers and sisters, though your brother may be separated from you, by distance, I daily live with you mentally and spiritually, especially at this time when we collectively mourn our late brother, Perry. Finally, to my extended family of nursing assistants and nurses, I salute you all.

    May God bless all of you, including those others that, space, memory, and time will not permit me to mention here. It is my prayer that HE raises men and women to support you, at your times of need.

    Introduction

    According to a 2004, National Nursing Home Survey report, 16, 100 nursing homes existed, in the United States of America. These nursing homes held a collective capacity of 1.7million beds, though actual occupancy was 1.5 million, at the time. Since then, various performance evaluation surveys on nursing homes classified these nursing homes into five stars, four stars, three stars, two stars, and one star categories, based on yardsticks used by the evaluators. Amongst other findings, performance surveys showed, by their ratings, that some nursing homes did perform better than others, as if, that by itself is anything out of the usual. Outperformance, whether by an organization or an individual, over a counterpart is most often linked to resource differentials (especially the combination and deployment) between the outperformer, and the underperformer. What the performance evaluation report and other similar reports may very well shy away from is, whether or if, even the best practices of the five star earning nursing homes truly approximate well defined and broad based expectations of how care providing facilities should cater for the elder, frail, and most likely totally dependent member of society, especially that of a modern society.

    In this small-sized book, I present the perspective that the nursing home is still far away from even the ideals they profess to uphold. Armed with an almost ten-year experience of running around the floors of nursing homes providing direct care services to elder residents, I reason that the gap between the present state of nursing homes, and the desired end state, as far as meeting what is expected of them, could be explained from some deep-seated managerial practices. At the core of such practices, in my view, is the popular CNA to residents’ ratio which ranges from an aide to eight or ten residents. I throw my weight around a thought frame that unless nursing homes effectively manage the primary core care giver, the certified nursing assistant, the end state which they desire will continue to remain a mirage.

    Based on my experience, I have selected a few themes that have direct bearing on the daily life of a nursing home and its residents. My approach is to start with definitional bases of the chosen themes as they relate to the nursing home environment, from where I move to presentations of practices extant in nursing homes. I conclude on each theme by critically examining what nursing homes do, and providing recommendations for improvement. And of course, for better understanding, I have provided some ‘real time’ scenarios

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