"We never did it that way" "We always did it that way"

cav5 · May 8, 2012

I hate to say this but the manager is never going to be liked-the nature of the job.

However, if you could get them to buy in a little bit and ask them for their ideas-what works and what doesn't work and why then you are going to find a lot more people know there is a problem but aren't addressing it in the group as a whole.

Even if you can't get all the staff together (which would be pretty impossible) then the senior ranking nurses, techs, aides would be fine. If you have buy in and at the end of the day they are going to feel some of the responsibility that will make it work.

I don't know if I helped any as I haven't been a manager but I have seen good ones and bad ones and those that listend were at least respected a little more even if they weren't loved (haven't found a manager in which everyone likes, even the great ones).

Just my 2 cents....

CompleteUnknown · May 8, 2012

I would give them some input into the changes. Have a meeting where you talk about the issues eg weights not getting done, monthly BPs being missed, etc and ask for their input on how to address some of the problems. You might get even get people making suggestions that are exactly the things you want to do anyway, and if it's their idea they'll be more invested in the change. If not, see if you can incorporate some of their suggestions anyway, no-one likes to be told 'things are changing around here and this is how it's going to be'.

Go slow with your changes, gain their trust, listen to them, accept some of their ideas, be willing to adjust your own expectations a little, compromise here and there, and give lots of positive reinforcement along the way would be my suggestion, especially as you say they are hard-working and caring. Change always takes far longer than you think it will but if you go about it the right way and people start to notice some positive changes, it gets easier and quicker. Good luck :)

Esme12, ASN, BSN, RN · May 8, 2012

Hello,
I am a new manager with a staff of CNAs and volunteers. Short staffing is not my issue, change is my challenge. Part of my new job is to get the facility back to where it once was which was efficient but somewhere along the line it fell short and became a free for all and it's my job to fix it.
My staff is hard-working and caring however they are resistant to change and following the daily schedule of assignments stating, "we never did it that way, we just work as a team". I'm all for teamwork however if an assignment is skipped no one is accountable, I am talking about assignments like taking monthly BPs, wts, participating with an ALZ table group activity.
I've overheard I am "implementing military style" (I find at times I take this personally and often pull back, I do not want to micro-manage) by listing daily jobs that need to be done as it is done facility wide and this is what my supervisor is requiring me to do. I have tried to explain that we are doing this for structure and organization for ourselves and the residents but they think their way works best.
I dislike red lights but imagine what driving would be like without them? Everyone seems to be running around like chickens with their heads cut off and seem to be working harder than they need to. I never know who is doing what which also takes me away from my managerial paperwork. One change that has shown improvement has gone smoothly and I use that as an example but get the rolling eyes. The volunteers are wonderful but often do tasks they should not be doing because "that's the way we always did it". I need advice as to how I should go about showing them that change can be a good thing.
Thanks for any advice,
Zoey

Healthcare workers are amongst the hardest to institute change......especially when the have been allowed to run amok. Sometimes you can explain until you are blue in the face and they may fight you tooth and nail, but you are the manager. They Will not be happy that there is a new sheriff in town but you need to politely make it clear that these are new policies and they need to be abided by.

I have always hated when managers say "my staff". As their manager I don't own them. They work for me but they're their own people. I have always said.....I manage xyz floor/unit and I have great group of people who work on the floor I manage....they are not "mine"....per se.

Tell them that this is the new policy because you need to be able to keep track of the "jobs"/tasks being done.....they can continue their "teamwork" but one individual will be held accountable for the information and for assuring/being in "charge" that this work in being done when it is due. That they are responsible adults abd that you trust them to be able to be held accountable for the work and be accountable that the work is being done from their peers.

How about a lead CNA for the day/week/month who is "in charge" of this list and of assigning these task to be done and collecting the data to be turned into you. I have always used my own money at time to gather team work/cooperation. I would reward with lottery tickets, I would reward with $20 gift cards/certificates for dinner or movies. I would go to administration and ask if they can have a special parking place for a reward (costs them nothing.) I would also tell them that if we always stuck to the way we've always done it we would be in horses and carriages and there would be no facebook or IPhone apps.

But the changes have to be made. I don't bargain the change....I tell them this needs to be done and have an in-service explaining the new procedure then explain the rewards and consequences for compliance or non compliance. For non compliance I would check with HR and my boss for progressive discipline verbal, written, final, days off/termination. I would have things like no OT when on warning. Days off no pay (all approved by HR and your "boss")

Above all treat them with respect but you are the boss and cannot be their friend. You can be friendly when appropriate but you are not their friend and as the boss you will find that they will talk about you and say negative things especially at first, it's like being a parent you can be friendly at times but you are not their friend. Firm loving limits with just ramifications for non compliance be honest be fair.

I hope this helps.

classicdame, MSN, EdD · May 8, 2012

Change theory states the individual needs to buy-in and to do that, there has to be something in it for them. How will these changes improve their lives/jobs/ANYTHING?

It is not necessary to change. Survival is not mandatory - Edward Deming

CompleteUnknown · May 8, 2012

Another thing that I often do is to make a chart or graph of how things are going and put it up in the staff room so that everyone can see where we're at. Say this month only half the weights were done when they were supposed to be done, make up your chart and put it up on the wall. Next month hopefully it'll be better, maybe 80% - add another month to your chart. Next month maybe it's 85%. I've found that this doesn't take long to do and works better than a general ranting and raving that 'these weights still aren't getting done!!'

It'd be great if you could go from 50% to 100% in one month but I think that's probably wishful thinking.

The subject of what volunteers are allowed to do is always a tricky one. On the one hand, if you have great volunteers you don't want to run them off with a million rules and regulations but on the other hand you can't have them doing things that are unsafe or potentially unsafe. We have a formal list of what tasks a volunteer is allowed/not allowed to do and competencies have to be on file for each volunteer, it's a huge job keeping all of that up to date.

zoey3270 · May 10, 2012

Thanks for all your good advice, I am so happy I found this forum. The last 2 days have been awful, I had to call in the big boss and we are set for a staff meeting. I didn't want to because being new I'm afraid she now thinks I am not capable of this job but the staff are saying one thing to her face like they understand the concept and they like the change yet to me and another they say everything I posted previous. Of course when she or I are on the floor everything runs smooth and assignments are followed, it's as soon as I go to my office it all falls apart. I have tried doing some of my paperwork out in the common area but residents keep coming up to me to talk and I have to keep turning papers over due to privacy so I really don't get anything done. I truly like this job and see a lot of potential but I'm feeling defeated and don't want to give up just yet.

sauconyrunner · May 11, 2012

I read this myself, as I am a New Infection prevention Nurse and dealing with a bunch of "why is that necessary?" (IT IS A JACHO requirement!!!!) I think you got a lot of good tips. There are definite moments that are so hard when you step into a role, and you will never be beloved. and people just dislike change.

I just wanted to chime in and say that I think I learned a lot from these tips!

catlover314 · May 15, 2012

Classicdame had a good point; what is in it for them? If duties are assigned, there is a responsible person, so "everyone" is not held responsible if "no one" does the required task. That leaves people more able to function independently when they don't have assigned tasks. Also ask them "what bugs you...what tasks do you end up doing simply because no one else does them?" Add those to the list of duties that will be spread around. This will let the staff know that you are looking for process improvement, not simply meeting some regulation (though we all know that meeting regulations keeps everyone employed!). Look at the high performers and seek their input first cause they most likely have been pulling more than their share of tasks to keep things running, and they will appreciate help in evening out jobs. Do enlist HR and hold people accountable that are not doing their assigned tasks. They will either get the message and do it, or will work themselves out the door.