Long-Term Care Survey Alert

Published on Thu May 26, 2011 PDF

Also find out free ways to help staff in need and how to turn around chronic complainers.

Looking for ways to keep staff satisfied with their jobs and able to do their best for residents?

Start by encouraging them to toot their own horns, which can get everyone working to a more upbeat tune, according to Diana Waugh, BSN, RN, principal of Waugh Consulting in Waterville, Ohio. To do that, Waugh uses the "Positive Incident Report," which asks care providers to describe what they did in the past week that made a helpful difference in a resident's life (see the form on page 37).

Waugh finds that when caregivers complete the form, "they don't say, 'I did a great job starting an IV.' It's more about how the nurse had a talk with Mrs. S about end of life care and Mrs. S seemed to feel better" as a result.

Goal: The purpose of using the form is to teach people to reward themselves, says Waugh. "I think people hesitate to do this sometimes due to the belief that you shouldn't brag." In her view, however, saying, "'I did this and that means I'm better than you are' is bragging. But if you say, 'I was caring for Mary and did this and she spoke for the first time in months,' that's simply telling a good story."

As the form indicates, Waugh encourages people to share what they put on the positive incident report form with their managers. She also suggests people complete the form on a regular basis. Doing so "helps people see what they are doing and gets rid of the "I'm just a nurse aide or a nurse, etc." mindset, says Waugh.

Waugh, in fact, saw the "positive incident report" approach work very well with a nurse aide whom she saw dancing with a resident with dementia who had been a former dancer. The dancing involved "wiggling around the hall to a tempo," but the activity caused the resident to speak for the first time in months. Impressed, Waugh asked the aide to put what she'd done on the Positive Incident Report, "and this seemed to motivate her."

"Some facilities are helping CNAs and other direct-care staff out in small ways," says Francis Battisti, PhD, LCSW, CEO of Battisti Seminars in Binghamton, N.Y. "You don't want to become a social service agency for employees but you want people to feel seen and appreciated," he says. Examples include the following:

More ideas: "Put in a walking trail for staff. Bring in a massage therapist who gives people a three-minute shoulder massage with their permission. You can have the massage therapist come in for $45 for an hour," he says.

Battisti also recommends getting staff together before each shift to say a prayer, read a poem or do something to stay focused on what they are doing, which is caring for residents.

Staff members who continually find fault with everything can zap other people's morale and fan F tags.

Potential solution: What consistently works well in dealing with negative staff is to ask them to come up with a solution to their complaints, says Cheryl Boldt, RN, a consultant with Maun Lemke in Omaha, Neb. "Anybody can find problems but it takes talent to think of a solution," she says.

Boomerang effect: Managers should also keep in mind that spending a lot of time with negative staff members "sends a message that you have to be negative to get attention around here," Boldt warns.