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ver feel that you cannot go on? Never seem to get caught up? Have more responsibilities because of a shortage of nurses in your facility? You are not alone. The Health Resources and Service Administration (HRSA)’s National Center for Health Workforce Analysis, the primary federal agency responsible for providing information and analysis relating to the supply and demand for health professionals, projects the national supply of full-time equivalent (FTE) registered nurses in 2006 at 2.02 million and demand at 2.19 million, a deficit of about 8%. (Visit http://bhpr.hrsa.gov/healthworkforce for more data.)
       Not only are nurses in short supply, but so are nursing assistants, dietitians, therapists, social workers, directors of nursing (DONs), and administrators. A recent New York Times help ad for a Minimum Data Set (MDS) coordinator not only listed typical MDS responsibilities (eg, managing, directing, and coordinating the MDS and transmitting assessments to the state) but also requested someone to perform nursing duties in any capacity. It sounds like that MDS coordinator might not only manage the MDS assessment process but also “take call” and have other managerial or charge nurse responsibilities. This MDS coordinator must also be a team player, but where does it end? Some recent questions submitted on this topic follow.

Questions and Answers

       Question: I’m up to my eyeballs with work, and now I’ve been told I have to feed residents. Can you help me? (licensed practical nurse, Alabama)
       Answer: If you find yourself in a bind over time, there are several strategies I have found that might work to assist you in your attempt to stay on time with assessments. First, remember that you have 14 days to complete an assessment. Determine the time it takes you to complete each assessment, and plan your time accordingly. Prioritize your work. Pace yourself. Enlist help for fact finding with some of the details for the assessment. Enlist the help of your team to complete the MDS. This might mean reassigning sections and the completion of the Resident Assessment Protocols (RAPs). What worked last year in getting the job done might not work this year, and a reorganization of the procedure would be indicated.
       Have you thought about changing your hours to honor the request of the facility and get your work done? Sometimes working early in the morning will allow you quiet, uninterrupted time to be the most productive. It might be a good idea for the MDS coordinator to talk with his/her supervisor (most likely the DON or administrator) about the problem. Lastly, do not forget about the possibility of moving on.
       In an informal poll presented in the “Mastering the MDS” article in the May ECPN, exciting, challenging work was listed first on the list for job satisfaction. One must evaluate whether your job has this quality. Look at all the ups and downs of the job to provide a better picture of your job satisfaction.
       Question: I’m bored with my job. I had more fun as a floor nurse. Should I give up this job? (licensed practical nurse, Pennsylvania)
       Answer: We are in unique position as MDS coordinators. It takes some introspection to decide what we want out of our job. Job satisfaction is a key role in deciding whether to stay or change roles. It might be possible to get new responsibilities where you are at, if you want to stay with the same company. Many nurses also work the floor in order to stay in contact with residents, and they have variety. It is hard to tell a person what he or she should do. If necessary, talk it over with someone you trust.
       Question: One team member is extremely difficult to work with and never gets her assessments completed on time. I am at the point where I just want to do the work for her. Is this okay? (registered nurse, California)
       Answer: Discuss this with your supervisor. All disciplines are required to participate in the MDS. There are times when other disciplines are required to do other functions beyond their job descriptions, causing a delay in the completion of their work for the MDS. You can sit down and strategize with him or her and decide in which situations you should complete those sections to get the job done. The nurse can complete all sections. There are times when someone is also tied up, sick, or on vacation and the nurse must complete that person’s section. Make every attempt for an appropriate substitute to complete the appropriate section. But if not, proceed.
       Question: The dietitian just left our facility, and now we are left without one. Our social worker is new and doesn’t know how to do an MDS. It seems like all the work is left to me. What can I do? (registered nurse, Michigan)
       Answer: Sometimes this happens. While we as nurses seem to think that we are the only ones in short supply, other disciplines are, too. It is a good idea to familiarize yourself with all the sections of the MDS, the questions asked in the RAP, and how to develop a meaningful care plan. All facilities attempt to get input from the appropriate disciplines. Hopefully, this is a temporary arrangement until you get a dietitian and train the social worker.
       Question: Is it ever okay to backdate? (licensed practical nurse, Washington)
       Answer: No. Always put the current date when signing. Make sure your assessments are on time. Plan time in your day to get everything organized for your team so that they can sign several assessments at once at a convenient time.
       Question: We’re changing to a new computer system in the near future. How much say should I have in which one we pick? (licensed practical nurse, Texas)
       Answer: While most MDS coordinators are the ones who use the system, you may have little input into which system your company is going to use. This may be because another system allows the facility greater opportunities to generate valuable information. Remember, you are the expert on completing the MDS; hopefully, you will adjust to a new system, learn the quirks, and find that newer is better.
       Question: I’m in the middle of an annual survey. I’ve heard that every few years, the surveyors focus on MDS assessments. What if they find a discrepancy or error? (licensed practical nurse, New Mexico)
       Answer: Don’t fret too much. If the documentation supports their claim, correct the error immediately. Otherwise, ask the person who signed the section to explain the coding. If the reasoning seems correct, there should be no problem with the assessment.
       Question: Upon auditing the charts, I found that I forgot to sign Section R when I completed the MDS. How do I fix it? (registered nurse, New York)
       Answer: Sign in the area and put the current date, with a note stating that it was not signed at the time of completion. You want to be honest that the omission took place. If you find that it is a trend, this would be an item to take to your quality assurance (QA) meetings.