Category: Motivating staff
Posted by Dr. El - January 4, 2018 - Business Strategies, Communication, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
Ahhh. A new year. It’s time for a fresh start, the chance to take life in a different direction.
Many of my friends have remarked to me that they want more focus on family and friends this year. They’d like to achieve a better balance between work and home.
On the job in long-term care, perhaps the goal is to tackle the staff turnover problem or increase profitability. Or maybe the hope is that resident, staff and family satisfaction ratings will be better in 2018 or that this might be the year to achieve a five-star rating.
The common thread between these goals is deepening the attention paid to the people in our personal and business lives.
When staff members don’t feel valued, or inspired by the mission of the company, turnover increases, making it virtually impossible to have high satisfaction scores and five-star ratings. Repeatedly recruiting and training new staff cuts into profit margins and damages worker morale.
To turn things around in one’s personal life, conscious decisions can be made around limiting time on electronics or choosing to fill the new calendar year with events that connect loved ones. At work, changes can occur by prioritizing the way staff members are treated and revamping the culture of the company, altering the way people interact.
Whatever our roles in LTC, there are steps each of us can take to enhance the way we treat each other and to have a positive impact on workplace culture.
• Reevaluate mission and culture. Readers in a position to revise the organizational customs as a whole might enlist experienced guides in the process. A consulting and coaching company such as Drive, with which I’m affiliated, evaluates the strengths and weaknesses of a healthcare organization and provides ongoing support to meet goals throughout the culture change process. As a Drive team member notes in this article onCreating and Sustaining a Strong Culture, follow-through is essential. A consulting team can ensure that bumps in the road don’t become dead ends.
• Investigate known culture change programs. Thankfully, there are many people in our field who have undertaken the daunting task of creating a more gratifying long-term care environment while still following regulations. The new year is an excellent time to take a class with the Pioneer Network or the Eden Alternative, or to learn more about The Green House Model at their 1/9 webinar.
• Promote kindness. If your job in long-term care doesn’t allow you the opportunity to change the overall organizational framework, you can still be an important influence on others with whom you interact by focusing on kindness.
Posted by Dr. El - November 22, 2017 - Business Strategies, Customer service, McKnight's Long-Term Care News, Motivating staff, Resident care, Something Good About Nursing Homes
Here’s my latest article on McKnight’s Long-Term Care News:
In 2014, I wrote, “I finally visit a Green House (and it blows my mind).” The Green House is designed with a spacious common area, private bedrooms and showers, unobtrusive medical items and universal workers practicing person-centered care. The model shows that it’s possible to make dramatic lifestyle improvements in long-term care.
It seemed that Green Houses were the answer, if only there weren’t so many traditional facilities already in place. Traditional nursing homes can participate in culture change programs with great success if their leadership is committed to the philosophy through the transition period and beyond. They can retrain staff, add plants and pets and remove nursing stations, but the standard long hallways have remained – until now.
Last week I had the opportunity to speak with Rebecca Priest, LNHA, LMSW, Vice President of Skilled Services, at St. John’s Home in Rochester, NY. She’s presiding over one of the most exciting changes in LTC to come down the pike since, well, Green Houses.
St. John’s is taking a conventional nursing home built in the 1960’s with 32 beds to a hall and turning it into 22 small homes modeled after the Green House Project. Each floor is being systematically transformed into homelike environments with a large space for cooking, dining and socializing and universal workers called “Shahbazim” who are central to the model’s success.
Rather than having aides, housekeepers and laundry workers, the Shahbazim do it all. “The Shahbaz role,” Priest says, “is highly skilled and not for everyone. Shahbazim need to collaborate and be part of a highly sophisticated work team.”
Cross-training staff and flattening the work hierarchy reduces the likelihood that workers will find themselves in “systematically disempowered situations where they are set up to fail.” As a resident I knew used to say, “Amen to that!”
Posted by Dr. El - September 13, 2017 - Business Strategies, Communication, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
I often speak with healthcare groups, giving psychological insights about a variety of issues within long-term care. Sometimes I address a C-suite audience; other times I train direct care staff.
I noticed during the course of these talks that some of the group exercises that generated excitement and intense discussion among direct care staff were met with relative restraint when presented to executives.
After pondering the discrepancy in reactions, I adjusted my talks accordingly and came to this conclusion: Healthcare executives and managers are very different from those they manage.
Understanding and utilizing these differences can facilitate leadership in a variety of ways.
How execs differ from direct care staff
We can consider the discrepancies between the two groups by looking at the traits generally exhibited by each. I’ve borrowed a tool from career counselors, who test their clients’ personality traits to determine what types of jobs best suit them.
One such test is the Myers-Briggs Type Indicator, which examines four different aspects of an individual’s personality as it relates to career choice. The summary below is from an article with a handy chart based on the book, “Do What You Are.”
For the entire article, visit:
Posted by Dr. El - July 6, 2017 - Business Strategies, Customer service, McKnight's Long-Term Care News, Motivating staff, Resident care
Here’s my latest article on McKnight’s Long-Term Care News:
The team huddled around the nursing station talking in panicked whispers after the management meeting ended.
“How do they expect us to do that?” a young nurse wondered.
“Yeah,” an aide replied, “we’re stretched thin enough already!”
A more experienced worker piped up. “Don’t worry,” he said bluntly. “I’ve seen these ideas come and go. It’ll never happen.”
There was a collective sigh of relief and everybody went back to business as usual.
The scenario above illustrates some of the many ways organizations are resistant to change.
In this situation, the new procedure is viewed as a temporary fad not worth investing time and energy. The workers haven’t been consulted for their input prior to implementation, they fear that they won’t be able to handle the work and the benefits of doing so aren’t clear. In addition, the employees don’t trust their management to guide them through the process of change.
Think of how hard it is to adjust our own routines and then multiply that by, say, every employee, resident and family member. Then cube that number.
Speaking of adjusting personal routines, a few months ago I wrote that I was going to try to meditate daily this year. I haven’t.
Consider trying to make changes in the context of family life, such as going for a walk after dinner (a good idea that never happened) or eating healthy food (I do, she does, he doesn’t). Pushback and inertia can make it difficult for even the most well-intentioned modifications to take hold.
This is why it’s necessary to have a guide along the way for changes to take hold, whether it’s a friend to meet you at the gym or the Pioneer Network to help your organization navigate through the culture change process.
Full disclosure: While I don’t get paid to say this, as a psychologist I find that culture change principles are better for the mental health of the residents, staff and families. As a change agent, I know how important it is to enlist an agent of change.
For the entire article, visit:
Posted by Dr. El - April 13, 2017 - Business Strategies, Communication, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
Having enough of it at work, I tend to avoid drama in my entertainment choices unless it involves aliens or post-apocalyptic nonsense. My family and I are currently enjoying the creative spectacle of Project Runway “Teams” version from a few seasons ago. In it, the judges of the clothing design competition repeatedly make the point that “teams are only as strong as their weakest link.”
A significant part of the Project Runway teamwork challenges involve communication. Collaborators who take over the project and those don’t speak up can both get penalized by the judges. Similarly, teamwork within the long-term care setting heavily relies on communication. For the best healthcare outcomes, it’s essential for all team members to contribute their expertise.
An article in the American Psychological Association Monitor, however, suggests that people who feel powerful are more likely than those who don’t feel powerful to share “opinions that differed from the norm,” a important element of team interactions.
Further, the authors cite research that describes how “people who feel powerless are more likely to…behave in inhibited ways. People in positions of greater power, on the other hand, are more likely to…act in uninhibited ways.” A care team member who feels inhibited is less likely to speak up and contribute to a group discussion.
In the hierarchical world of LTC, administrators, nursing directors and medical directors have more perceived power than, say, charge nurses or recreation therapists, despite whatever layers of upper management and accountability exist.
In my conversations with aides and residents, there is consistent disagreement among them regarding who has the power. Aides will argue that the “Resident’s Bill of Rights” gives the residents control, while residents, waiting on aides for intimate care, feel that the aides are in charge. Both struggle to deal with the moods and behaviors of the other.
Family members can be considered a part of the team that wields power in the form of potential phone calls to senior staff, the ability to transfer their loved one to a different facility, a negative social media review or a lawsuit. At the same time, relatives are often overwhelmed by the new and unfamiliar situation and the shifting dynamics within their families and many feel powerless in relation to the staff members upon whom they depend for good care for their loved one.
The challenge for LTC is to empower all team members to overcome their “inhibitions,” so that they offer their expertise despite the imbalance of power and in perceptions of power.
For the entire article, visit:
Posted by Dr. El - March 14, 2017 - McKnight's Long-Term Care News, Motivating staff, Stress/Crisis management
Here’s my latest article on McKnight’s Long-Term Care News:
I was putting the finishing touches on my article for this week’s column when I paused to consider the headlines on McKnight’s right now.
“Don’t be worried about Medicaid funding, be very afraid,” advises Editorial Director John O’Connor.
Staff Writer Emily Mongan alerts readers with these articles: “Access to nursing homes would dim under Republican proposal, AGS warns” and “Medicare could be next on Trump’s chopping block, experts say.”
In “The LTC industry should be ashamed,” guest columnist Buffy Howard admonishes long-term care leadership because their treatment of nursing staff is leading caring professionals to leave the field.
Reduced funding, departing staff members, widespread uncertainty in the industry … even the most stalwart individuals might feel uneasy. I’ve postponed my earlier topic to consider what I could say as a psychologist to help.
Perhaps you’ve heard the tale about the boss who yells at the worker, who comes home and grouses at his wife, who is short-tempered with her child, who kicks the dog. Anxiety can spread like that too, from CEO to administrator to supervisor to charge nurse to aide to resident.
In order to better face whatever is ahead — and to avoid causing panic in those around us — we can make an effort to be serene and centered. Below are some tried and true calming techniques to help you remain levelheaded despite unnerving times.
Posted by Dr. El - January 31, 2017 - Business Strategies, Depression/Mental illness/Substance Abuse, For Fun, Inspiration, McKnight's Long-Term Care News, Motivating staff, Stress/Crisis management
Here’s my latest article on McKnight’s Long-Term Care News:
Cold weather. An uncertain world. Rogue shrinks making the rest of us caring, diligent professionals look bad. I don’t know about you, but I need a mood lifter.
I came across an article that suggests that exercise of all kinds, even small movements, can make us feel less depressed. In “Get up and move. It may make you happier,” New York Times health writer Gretchen Reynolds notes that people in a University at Cambridge study “turned out to feel happier when they had been moving in the past quarter-hour than when they had been sitting or lying down, even though most of the time they were not engaged in rigorous activity.”
How can we incorporate more movement into our days across the spectrum of long-term care?
Personally, I purposely forego my car so I can walk to and from the subway and I take the stairs instead of the elevator whenever possible. I encounter surprisingly few coworkers doing the same, so perhaps that can be number one on this list of get-moving ideas:
1. Take the stairs.
2. Use public transportation. Sign up for or offer workers a transit tax exemption if a program, such as TransitChek in New York City, is available in your area.
3. Kill two birds with one stone by walking around the facility on rounds and checking in with staff members and residents.
4. Join or begin a lunchtime walking program. Find a buddy to add fun and accountability.
For the entire article, visit:
Posted by Dr. El - October 27, 2016 - Business Strategies, For Fun, Inspiration, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
After reading a recent New York Times Opinion piece about the uses of lotteries to solve social problems, I began contemplating their potential application to long-term care.
According to “For Better Citizenship, Scratch and Win,” lotteries have been used to encourage voting, reduce speeding and even to attend to health needs such as getting tuberculosis screening, practicing safer sex and keeping medical appointments.
In one example, to combat tax evasion on small purchases, the Chinese government encouraged people to obtain receipts by turning them into scratch-off lottery tickets — leading to tax revenue amounting to 30 times the cost of the lottery prizes!
The theory is that lotteries are appealing because people want rewards and they enjoy playing games. As the CEO of a company that designs games for businesses put it, “They could… have everyone get an incentive for $15. But they’d get better results for the same average price by having variability — some get $10, some get $100.”
An element of fun might be a welcome addition to what’s typically the very serious business of long-term care. Presenting awards with humor and the thrill of winning a game could help offset the strain of coping with the ongoing losses inherent in direct care.
In addition, offering a lottery might appeal to a larger pool of workers. I often hear about the challenges of inducing less-engaged employees to improve their performance. Typical rewards, such as “employee of the month” programs, tend to honor those who are already committed and doing their best. Perhaps a lottery would engage disenfranchised workers in a way that other incentives have not.
Here are some playful ideas for applying lottery-style encouragement to long-term care:
1. The Show Up on Time Game: In the SHOUT Game, all employees who arrive to work on a timely basis for the week get entered into a lottery, which takes place at the end of the month. Each employee therefore has the opportunity to enter four or five times, depending on their timeliness and the number of weeks in the month. Winners of the drawing would get various prizes, which could be monetary, gift certificates to local enterprises or perks such as a good parking spot.
For the entire article, visit:
Posted by Dr. El - September 28, 2016 - Books/media of note, Business Strategies, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
Once, when I worked for a managed care company, I rode down a packed elevator with the CEO, who commented drily on the crowd, saying, “It must be 5:01.”
What I thought, but did not say, was that there were reasons his staff members weren’t staying more than a minute past the hour. It was a reflection of a disengaged workforce without connections to the job or each other that might extend to a post-work conversation. (It should come as no surprise that I left my position shortly after this elevator ride.)
To stem the tide of departures, it’s important to find out why certified nursing aides are flying out the door either for the evening or for good. Here are some methods for getting the inside scoop:
1. Ask them — It might sound obvious, but it isn’t often done. The National Nursing Assistant Survey (NNAS), conducted in 2004, is an eye-opening view into the lives and challenges of working as an aide on a national level. Adapting the NNAS questions for use in a particular facility — or using an assessment company to measure employee satisfaction — can help determine, among other things, whether the initial training programs you offer meet the needs of your staff or if transportation problems are interfering with their ability to report to work. Such information could lead to relatively easy fixes that reduce turnover.
2. Join them — I spoke with Sarah Poat Stewart, LNHA, CNA, an administrator who trained as an aide and recently worked the 3-11 shift. Stewart, who is based at Signature HealthCARE’s Oakview Nursing & Rehabilitation Center in Kentucky, finds her participation as an aide reduces the barriers between management and employees and leads to more respect on both sides. In a video about Signature’s goal to have all staff trained as CNAs, managers who worked on the floor had a better understanding of the jobs done by aides and the tools they need to do so.
3. Read the minds of those who stay — If you can’t roll up your sleeves and help a resident into a Hoyer lift yourself, reading CNA Edge is the next best thing.
For the entire article, visit:
Posted by Dr. El - September 16, 2016 - Business Strategies, McKnight's Long-Term Care News, Motivating staff
Here’s my latest article on McKnight’s Long-Term Care News:
When I spoke about the challenges of staff turnover at the Louisiana Nursing Home Association convention last week, I asked the group, “If you were able to bring in the same salary you were currently making, would you want to have the job of an aide?”
The response was a ratio that would likely hold at any LTC convention – in an audience of close to two hundred people, only one person said yes.
“You do realize what we’re doing here,” I commented. “Over the next hour or so we’re going to talk about how to get people to take and remain with jobs we wouldn’t want to have ourselves.”
As attendees pointed out, being an aide is physically and emotionally demanding work for low pay, little autonomy and not enough respect. These downsides – once partially offset by longstanding, gratifying relationships with medically stable, cognitively intact residents – have given way to more challenges as facilities take in increasing numbers of shorter-term, higher acuity residents.
To woo workers to the field – and keep them from the lure of relatively stress-free retail positions at the same pay – it might be time to re-envision our role as employers.
They come for the “special sauce” – and they’ll stay for the buffet
The main appeal of jobs in long-term care (our “special sauce,” if you will) is the opportunity to help others. No fast food joint can compete with that. We need to offer more, however, if we want our workers to stick with us.
In addition to traditional benefits, we can enhance our appeal by providing a “buffet” of nontraditional benefits that build on our missions and on employees’ desires to help others.
One of the unique features of LTC is our access to wisdom from elders, which can offer perspective on life and how to live it. If we envision ourselves not just as caregivers for the aged and ailing but also as organizations that can impart life wisdom to those with whom we come into contact, we can strengthen our allure as employers.
For the entire article, visit:
