I had a conversation with a leadership team recently that was incredibly frustrated by the initiative being taken by aides in the building. The complaint was that they were sitting around at the nurse’s station when they weren’t busy with cares. Leadership wanted them to be engaging with residents. But in most traditional nursing homes, this is not what CNA’s understand as their job. To get to this place we have to create a culture where engaging with residents is everyone’s job.
We don’t grow up understanding our national culture or our religious traditions. We learn these things over time. We study history in school. We learn over time how to behave in social situations. And by the time we are adults all of this learning gives us a sense of our culture. The learning process is similar within an organization, and many of our staff members will need time to internalize the culture we want in our community. Here are four things that leadership can do to facilitate that process.
Give specific praise when you see staff doing things you like.
Don’t just tell an associate “you’re doing a good job,” but thank them for getting creative and helping Mary fix her famous nachos for movie night. Positive feedback goes a long way in helping staff be clear on what they should be doing. And when appropriate, praising staff in front of their peers teaches this lesson as well.
The staff you hire will either never have worked in another long-term care community, or they will be bringing learned habits from other places that likely operate in an institutional manner. Share stories about good things that have happened, about the times you’ve seen staff assist someone in a different role, the instances where teams have used critical thinking to solve a problem, or figured out how to facilitate a resident riding a horse again. These positive examples will provide your team with something to celebrate and new staff with a perception of the culture we want.
Make time for education and reflection.
Your team is probably incredibly busy. It’s a 24-hour a day job, and there is always something different to deal with. Often that means we’re running around, making things happen, putting out fires, admitting new residents, finding lost socks. We don’t take the time to stop, step back and think about whether we are doing things in our community in the most person-centered way. Make it a priority to make this happen. And create space where all staff have the opportunity to consider how we operate. Ongoing reflection and education is key to becoming a learning organization that is focused on creating true home.
When you’re looking for ways to make this happen, check out the Trainer’s Guide to Self-Led Teams in your Household Matters Toolkit (link). There are 26 team activities staff can train themselves to do. Make a plan to spend 20 – 30 minutes once or twice a month on these activities in each household or neighborhood. Working through this plan will help the team talk about what’s important, reflect on the culture and understand that a healthy, relationship culture is as important to them as it is to the residents.
Start with the recruiting process.
You probably already try to assess how team friendly a person is when we interview them. But let’s go a step further and find out how resident-directed our applicants are. Begin the conversation about how we interact with residents and who is responsible for creating vibrant life before a person is even hired. Find out what the applicant is passionate about and what talents they’d be willing to share within your community. Ask him to share a time he did something creative to make a resident’s day more interesting. Tell them what it is like to work here. This not only helps you eliminate those applicants who don’t play well, but sets an expectation before day one of what a CNA role is like here, and how it would be different than other places.