it is the management issues...our management is more concerned their bottom line (we are a private pay facility) than with good patient care, although they would deny this. In the 8 months I have been working here the patient to staff ratio has gone up from 10-11 patients per staff to as many as 18 to 1, and we are constantly being given extra collateral duties..vacuum the dining hall three times a day, do extra activities because the activities person can't keep everyone occupied, etc. Plus continual mandatory overtime, because people quit often. Getting time off is impossible and people are told to work sick or be terminated. Add to all that the fact that we are given equipment that doesn't work, blamed for anything that goes wrong and never allowed to have input into patient care needs even though we are alone on our unit all day and Everyone is exhausted and frustrated and management is oblivious..actually told us at a meeting the other day we are considered the "go to" facility for employment in the area...well maybe, we have the highest unemployment in PA...so people will do anything for a job...even put up with this kind of abuse...but as I have begun to talk to other CNA's and look through online forums I am finding this to be rather universal for this field. I just find it sad and a bit frustrating. I love my work...but should not have to be treated with no respect in order to do it.