morale/teamwork - page 2

I am a DON of a 104-bed facility. We are going through a rough time right now. I have been there for about 3 months. Prior to my arrival, the weekend program was changed and people were to be paid... Read More

  1. by   Nursinrox
    I have felt the frustrations you are going through working in many LTC facilities throughout the years as a Physical therapist, I have seen exactly what you write about. As a therapist I also became frustrated at the level of control I had over the same type of situations. I love the medical field and working with paitents, and felt I needed to choose a different career path at a level where I felt I could make an impact. I decided to go back to school in January of 2001 and Graduated in December of 2002! So to my fellow college, May I suggest that you read the book Fish Tales, by Stephen C. Lundin, and Harry Paul. It is a very quick and easy read, that will get you started and you will be infected with the fish philosophy!!!! And it has been proven to work!!!! You can get in at Amazon, Barnes and Nobles, Your local library may even have it. I found it on the new book shelf at my nursing school library.
    This is a spin off of the first book, Fish, which is ok, but if your looking for a shortcut and want to make a difference with medical professionals I would read fish tales first!

    This company also has many many tremendous videos for health professionals on patient care, and professionalism. You can buy them or rent them and use them as part of your continuing ed program.
    You can read and order the videos and other items at http://www.employeeuniversity.com
    I hope this will inspire you from within we need all the nurses to help and love each other in times of frustration! You can do it!!!
    Best wishes to you
    Take care---Darci, R.N.:kiss
  2. by   ChainedChaosRN
    LTC has lost many, many good nurses, CNA's and other professionals due to current conditions. I urge every one of you with the bad experiences that left, ( and stay) to write a brief synopis (snail mail or e-mail) to your state politicians.

    Nothing will ever change until state and federal funding is increased. In my state, and the previous state I worked in, paid more per day to house an inmate in jail then they pay for LTC per day. So who is really the criminal?
    You guys are professional, articulate and your politicians want your vote...make your voice heard. Please...for all the residents and staff still left in LTC.

    Peace, Dawn
  3. by   adrienurse
    Change is not generally handled well in the work place (even when it is a good or needed change). It's gonna take a while for things to stablize.
    I don't pretend to know what being a DON is about, but these are somethings that I have seen help. My current manager decided that she would start holding post conferences after all the day shifts on a daily basis (for a little while), when we were going through a period of severe low morale. This gave the chance for everybody to vent their concerns and frustrations. The talk got heated at times, but she handled the situation using couselling skills. It gave her the chance to a) allow some conflicts to be resolved and b) see what were the real issues. This really did help to increase morale.
  4. by   Hellllllo Nurse
    Originally posted by adrienurse
    Change is not generally handled well in the work place (even when it is a good or needed change). It's gonna take a while for things to stablize.
    Change is what I want! Change is what I have been suggesting, then repeatedly asking for, then actively seeking, then desperate for, for years!

    Change is what is needed, but change is what I have ultimately given up on.

    Signed a hard-working, organized, intelligent, elderly loving FORMER LTC Nurse and CNA.
  5. by   karenann
    I have two things to add to this thread...zuchRN, honey, I would work for you in a heart beat!! Your attitude and honesty really are what every facility needs to survive. I'm a simple LVN in a 52 bed facility with all the same frustrations mentioned above. I am also at present one of two NOC nurses pulling 12's . There aren't enough of us to go around. We rarely get back up from corporate, and I don't feel secure going to the DON..she listens with one ear and seems to be working on some excuse to pass the buck with the other. I love my job, I work hard, and by the way so do my CNA's or they're OUT the door...period. We have a good working relationship...it's all hands on for all three of us every night or it's nothing and they know it. If I can't depend on them, and let them do their job, I'm doomed. I really am, because I know I can't do all the stupid stuff (like writing nurses notes on binder paper copied on the machine with the corporation cut off the bottom corner of a pamplet from the lobby-yes, there's always plenty of THOSE around- and glued to the bottom corner to LOOK like our nurses notes. I haven't been doing this long...but I really am amazed at how clever I've had to be to survive...not just use the years of schooling to know what's important for my residents...but to just survive!
  6. by   VivaLasViejas
    I'm with Deb and HellllloNurse on this one....I too loved working with LTC residents, but the chronic understaffing (why do administrators continue to confuse minimum staffing with SAFE staffing?!), dirty politics and lack of supplies, organization & leadership finally did me in, and I'm not going back either. I am, however, going to keep working at bringing public attention to the problems in LTC........I've already written an article that was published in my state's biggest newspaper, and I'm working on another one that I'm trying to sell to Newsweek. If I have to go to Washington and speak to Congress, I'll do that too---anything it takes to make the powers that be sit up and take notice!! Our "Greatest Generation" paid into the system their entire working lives, believing the health care our government promised them would be available to them when they needed it. Guess what? If I had a dime for every time I've had to tell a resident or his family that a prescription would no longer be covered, wrapped a wheelchair arm with washcloths to protect fragile skin from the ripped vinyl, or used a piece of duct tape to hold a merri-walker together, I'd be driving a Lexus instead of a fifteen-year-old Buick. And frankly, it infuriates me that I'm paying taxes so the political ruling class can have free health care while they dream up new ways to cut Medicare and Medicaid, and keep drug price controls and prescription coverage on the back burner!!!:angryfire
    Last edit by VivaLasViejas on Feb 1, '03
  7. by   zuchRN
    Ok- I am hearing the frustrations. there are 3 main ones that I am hearing. 1) staffing 2) supplies 3) systems in place

    Our facility--and yes...it is ours (nurses, nursing assistants, managers, housekeeping, dietary--everyone who works here)--we do have adequate supplies. We have every type of dressing available, gerisleeves, cups, straws, spoons, paper towels-you name it we have it. The nurses have access to these supplies.

    we have systems in place. They always need fine tuning. But, we do have our systems in place. At times it is very difficult to keep them in place because people choose not to follow systems.

    Staffing is a constant struggle. I hire people, they no call no show. A few stay and work out really well. We start every day with a full schedule and by the end of the day the call-ins kill us. I will be the first to stand firm and say that the majority of people are fibbing when they call-in. They do not want to come to work that day and figure that they should call-in. When I ask for the doctor's excuse (after they have said that they went to the hospital--) they say the doctor won't give them one...or I go shopping and low and behold guess who I see? The person who was so deathly ill they had to go to the hospital. Then we have the people who have their mother die 8 times...it is a never ending cycle.

    I know that there are some facilities where they understaff to save a buck...this is not one such facility. I am one person--along with each member of the nurse management team and we can only fill so many open positions....

    Now, I have heard alot about what the gripes and concerns about LTC are...What I want to know are your suggestions to make it better...what are some creative ideas to help the employees be happy at work? What are things that will pull everyone together to work as a team...if anyone could give me some suggestions I would deeply appreciate it!!!!!!!
  8. by   Hellllllo Nurse
    zuchRN,

    I have some ideas of my own, but if I were you, I'd ask my staff these questions. They are in a better position to tell you than I am.
    Although, I have seen in the past where employees are reluctant to tell mgmt their suggestions and ideas. I guess they are afraid or something. Many times, I've listened to co-workers complain about things, and I've suggested "let's go to the DON w/ this." They agree, but when the time comes, I'm the only one saying anything.

    Maybe put in a suggestion box, where employees can submit their ideas for improving efficiency, staff retention, etc. Hold a meeting explaining what the box is for and how to use it. Tell employees that they can make their suggestions anonymously, or sign their names, their choice. At this same meeting, encourage them to come to you in person w/ ideas, concerns, suggestions, etc.
    If an employee's idea is chosen to be implemented, maybe give them a prize, a small cash bonus and written recognition.

    I have never called in when not ill. In fact, I have worked the floor w/ a temp of 102 (wearing a mask). I am one of those people that always shows up, out of guilt, no matter how sick I am.

    I recently moved to The Texas Panhandle. I'm surprised at the constant "no call, no shows" here. It was never a problem when I lived in AZ. If someone was on the schedule, they showed up.

    zuchRN, you sound like the kind of DON I'd like to work for. Wish I could apply at your facility!
  9. by   ChainedChaosRN
    Zuch there is not alot you can do beyond the obvious for staff morale. A lot of praise where praise is due. Management has got to be good listeners, communicators and above all else be fair in decisions, disciplinary actions etc. All the parties, treats, meetings etc is nice, but if the above is not present...it will be useless.

    It takes time and consistency to turn things around. The average length of stay for a DON in LTC is 11 months. It takes time for staff to feel comfortable with leadership. If the systems, staff and supplies are in place that's 75% of it.

    Every facility is unique despite the common bond. I've found that larger cities vs country facilities, smaller facilities vs larger facilities, have completely different dynamics going on.

    Nursing mindset has changed over the years. I'm sure I'll be corrected if any of you feel I'm wrong Twenty years ago we felt lucky to have a job where we could be nurses. We did everything in our power to help our facility be the best, we took pride in where we worked. We didn't feel our employer "owed us" better even though those 3 S's were in place. We felt we owed our employer...that's where our paycheck came from. We didn't feel because we were nurses..we were better. We were nurses.

    I think most of you can get the drift of todays mindset just from this BB. One other thread someone posted ...that if I didn't see where being a nurse was different then being a waitress, then I deserved being treated like a waitress. Hello? Any profession deserves to be treated better than another?

    I guess where I am going with this is todays society has such a mentality that we are "owed" something. So anyway Zuch, it's hard to increase morale for staff who think they are always owed something beyond a paycheck, a thank you and a smile when you've given them everything they need to do their job.

    I guess I'm wondering if the nursing shortage hasn't gone to our heads?
  10. by   FrazzledRN
    Zuch..I would work for you any day..it sounds like you do actually care and would be a supportive DON... Coming from years as charge RN..I've worked Every shift...to MDS coordinator ..I've been at my facility for 7 years...and I've seen it rise and fall...one thing that makes a huge difference is the attitudes of the DON and adminstrator..they are the trendsetters for morale sometimes...when we were at our very best was when we had a DON that LISTENED and CARED..and put her staff first..you wanted to do things well for this woman...even if you were short you knew that she did her best to help, she would be up there working short with you...if she called you out you respected her enough to know that she really needed the help and would appreciate anything that you did so you came out...when she left we all were very upset:imbar ..and now the DON we have now is much less thoughtful of her staff..and does not try very hard to help out and isn't the most appreciative woman on the earth..she is surly at times to some staff while letting others get away with anything bordering on abusive behavior... there is no fairness or disciplinary action to those in sore need of it and the good workers are frustrated that the bad continue to get away with what they do...thus the morale and the care in general has sunk to an all time low...though I know this is not 100% her fault..it has corresponded to her regime...the fustrated few hurt for our residents and shake our heads in frustration....so if I can tell you anything it is to Listen and Care, and support while at the same time be fair and do not allow insubordination to occur and for STNA's to further frustrate the nurses and try to dictate the care...you will do well...yor positive outlook is wonderful!! Good Luck!!!
  11. by   patchuli55
    this is for zuchRN I have been in long term care for over 20 years, I have pretty much seen it all...such as short staffing some due to call ins and no call no shows...or just not enough staff for the schedule....short supplies....team work that is spelt with an I or ME... and of course the ever problem of the budget, but what really upsets me more than anything is that through all of this I still enjoy LTC nursing, I do have some suggestions for you,,,, staffing why not have your nurses/CNAs make there own schedule....give them the ground rules such as everyother weekend, no OT , and pass the master around to the most senior staff first and than down the line till all shifts are filled in this offers 2 things 1 being some small kudos for longevity, 2 the choice of days on and off if staff is happy with the schdule they are more willing to show up on time and ready to work, another thing to try is , pizza party for the unit with the least amout of tariness, callins and noshows if there is a tie buy two pizzas(small price to pay for good attendence), follow-up on and disipline for tardniness and callins accross the board after 1st posting the rules by the time clock for all to see. hope I gave you a few suggestions that will work for you.
  12. by   Disablednurse
    I, too, am a prior LTC nurse of 20 Years, who is no longer working due to becoming disabled. I was "brainwashed" into thinking that I was needed there in spite of my health. I could not take off for dr. appts etc because the facility could not run without me being there. I was the MDS coordinator for a facility and was responsible for the entire building as well as for care plans, raps,etc. However, there was one small catch, I also had to work the floor when staffing was short, check charts, and forty other things and then caught hell when MDS's weren't up to par. I finally put off going to have a problem with my back checked out until I ended up with permanent nerve damage that caused me to have to file for disability. Now they have two people doing the MDS's and that is all they do. I just could not stand up for my self. We worked short staffed, and I was supposed to take call for a week every five weeks and had to work any shift not covered and then work my regular shift.
    Last edit by Disablednurse on Feb 17, '03

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