​Nursing staff from two facilities sat down with Provider and shared their thoughts and experiences regarding consistent assignment. Here are some of their insights:

• “I’ve been on one floor for six years. I like knowing where I’m going when I get to work. We have a routine, and we get it done. Everyone works together.”
• “Building a bond with families gives them a sense of security. I take care of a 104-year-old resident, and she doesn’t like anyone else to care for her. … Residents get to know when your days off are, and they like knowing who they will see and when.”
• “For the most part, each floor is the same here. We all get about the same number of residents. There’s a good balance between those people who need more hands-on care and those who are more independent.”
• “Team building is an important part of this concept [consistent assignment]. Mrs. Jones might be well on Wednesday, but you don’t know what will happen on Thursday. You have to build a strong team so that everyone can help out if there is a problem. We call it global duty. Everyone pitches in.”
• “You have to build a relationship with co-workers so that you can say, ‘I need a break from Mrs. Smith.’ We re-evaluate assignments from time to time to give people breaks as they need them. We try to work among ourselves to figure out assignments.”
• “I have one resident who declined when I went on a business trip for a week. She became very upset and would call my name. I have another resident who I take to my home for visits or out to lunch. My job is my home.”
• “I have one resident with a very involved family. Her daughter is happy to know that I can spot anything out of the ordinary in her behavior or habits. She’s gotten to know me, and she feels much more confident and secure about her mother’s care. But you have to be careful not to give families the idea that you’re the only person who can care for their mother or father.”
• “I can count on the CNAs to detect even minor changes in residents. When residents leave for some reason, they often request to come back.”
• “Consistent assignment has helped with efficiency. We can determine what people want before they ask.”
• “It’s nice to have the same people caring for residents for even simple things like knowing what Mrs. Smith wore yesterday so she isn’t dressed in the same outfit today. You don’t have to bring in a tray and then take it back because you discover Mr. Jones doesn’t like scrambled eggs. You know this in advance.”
• “We have one resident with dementia. He would get agitated every time it snowed because he would think he should get out there with his plow. So we learned to close the blinds when it would snow, and he would stay calm.”
• “We actually have a long reservation list. People want to come here, and they want to come back when they leave. We get many referrals from families and others, and we’re very proud of that.”
• “We have a resident now who has been here several times for various reasons. She always tells me how comfortable she is here. There is not a ‘getting to know you stage.’ We just pick up where we left off, and she gets what she needs from the start.”
• “I took care of one resident for a long time. When she passed away, I was working on a different unit, but I requested to do her aftercare. Her family contacted me later and thanked me for what I did.”