What works for your facility!?

notanumber · May 28, 2017

Positive reinforcement, frequent check ins, asking how I can help if I have time, finding time to listen to venting/concerns, rewards like ordering food in or bringing coffee, etc. If people feel like they're being heard and that their effort is noticed, that goes a long way. And if someone is struggling, making sure they get access to resources like STD, mental health days, and counselling.

kfostercma · Jun 9, 2017

Yes, I agree with notanumber about positive reinforcement. Leadership 101: praise is cheap! Always say please and thank you. It is better to ask an aide to perform a task for an elder than it is to order it.

My aides often tell me I am their favorite nurse to work with. To explain that, I need to tell you a little about myself:

I made the mistake of not becoming a CNA before I became an RN. I was once a CMA but that really isn't the same thing, and not a single thing I learned as a CMA helped me transition to the professional RN role. You can imagine how lost I felt when I started working at my first nursing home!

My father raised me to believe that a supervisor (I like to consider myself a coworker of my aides, but my credential also requires me to supervise) should never ask a subordinate to perform a task that the supervisor cannot or will not do.

I have always been upfront with my aides in that I tell them that I never worked as an aide, and not knowing any better, I tell them that their job is probably harder than mine. One of my first goals was to earn the respect of my aides. Here is how I did it:

#1: If I am in a room with an elder and they need a fresh cup of water or a new brief or something, I will do it myself. I want my aides to know I am not above performing tasks that are normally delegated to them. One exception I will make is showers. I will not give showers because it is too time consuming, but I do want my aides to know that I am not above changing soiled briefs.

#2: Answer call lights, and encourage all staff (not just nursing) to do so. The aides will feel less burdened by having to handle ALL of the call lights themselves and you might be surprised how often people accidentally press the call button, or need something simple like a glass of water, or to check the time. Of course you should not expect a receptionist or a HUC to change a dirty brief, but if the call light is at least answered the elder knows that they have been heard. That goes a long way. Strive to have every call button answered in sixty seconds or less. Have you ever had to wait sixty seconds for something? That time really drags on, doesn't it? Now imagine waiting sixty seconds with a full bladder....yeah.....

#3: If an elder is complaining...at great length...about something that is beyond your control, hear them! Even if you have implemented the nursing process to the best of your ability and the elder still finds things to complain about, you can at least accept that you cannot change the behavior, but it might surprise you how far you can get with them by simply lending an ear.

You may notice that my suggestions are more focused on the elders that you care for than your staff. That is because the morale of my coworkers and I are directly linked to the happiness of the elders for whom we care. Keeping the elders and their families happy is within our best interest. I hope this helps!

CoffeeRTC, BSN, RN · Jun 14, 2017

Honestly? It is the pay that keeps me coming back. I've worked other places PRN, so I realize that it is the same type of problems in alot of the facilities. I'm starting to wonder though, lol.

ponymom · Jun 17, 2017

I think in most cases, the only true and lasting solution is going to be appropriate staffing. Everything else cascades from that.