As a former administrator I’ve witnessed, and embarrassingly partaken in, lots of finger pointing.
As a former administrator I’ve witnessed, and embarrassingly partaken in lots of finger pointing. The non-supervisory staff members think that their direct supervisors have no clue and that the leadership team lives in an ivory tower. The leaders think the staff don’t step up to the plate and are taskmasters. They cringe when it’s conveyed to them that one of their team uttered the words, “That’s not my resident,” or “That’s not my job.” Residents think they are invisible to the staff around them as they go whizzing by with a quick hello & a shallow compliment. “They obviously don’t care about me,” they reason. Family members treasure a few individual employees, but the rest don’t work as hard and they ponder why they aren’t working in another field that doesn’t require a caring heart. “They should be flipping burgers if they can’t do this work.”
And the Regulators . . .
And forget about the regulators. They have no sense of reality, and wouldn’t last a minute if they had to actually work in the field. It’s easy for them to point out what’s wrong, but what about how to fix it or, heaven forbid, pointing out what’s going well and sharing that info with others? There are lots of fingers being pointed and fault being tossed around, but who’s perspective is right?
Who’s right?
The staff? Perhaps. Leaders and managers often don’t listen to them. Their suggestions are dismissed with a less than enthusiastic, and often defensive, response. The leadership team is convinced when they read employee engagement statistics, such as only 1 in 3 employees is engaged in their work, that the author is talking about some other organization. The leaders? We all know it starts at the top. But truly, how on earth can a person who works in such a caring profession ever utter the words, “It’s not my job,” or state that a resident isn’t “theirs” so they aren’t helping? Is the leadership team responsible for every cringe worthy word that rolls off of a staff member’s tongue? The residents? They are our customers and aren’t the customers always right? I’d feel like Mr. Cellophane too if people were just hurrying around me all day long. How many times have we learned incredibly important details when it is too late, through their obituary? But realistically is there ever enough time or staff to spend the time we want? The family? Tainted by the reputation of long-term care and the weight of guilt that hangs heavy on their heart, family members are often unconsciously looking for all the things that are going wrong. As I often share in my presentations, when you look for the bad you will undoubtedly find it. At the same time, we often do a very poor job of embracing family members input and suggestions and instead tend to keep them at an arm’s length. The regulators? The closer I have gotten to regulators through my work, the more I realize they are really no different than each one of us that’s trying to make a difference. Are their good ones? Yes. Are their bad ones? Yes. But the same can be said for Administrators, CEOs, Nursing Assistants, Housekeepers and any job title in the world. Regulators have very often been exposed to horrors that you can’t begin to imagine in your organization. From that unique perspective most are on a mission to prevent such things from happening again. *Full disclosure: I’m a former administrator. I have lived through deficiency free surveys and lived through a horrific federal survey. I get it! I realize there are more pieces to the puzzle: federal regulations, state regulations, funding (or lack thereof), and aging infrastructures. The list goes on and on. But I’m particularly curious about the human side of this. What do you think? Who’s right? Denise Scott is a passionate senior living speaker, teacher and consultant who helps senior living organizations provide the highest quality of life for their residents and team members. You can read more about her on Denise’s website where you will also find lots of great resources: www.denisebscott.com
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When there is finger pointing, it means there is no teamwork and no system’s approach. Therefore it is necessary to find a scapegoat. Such systems are extremely expensive to manage and also mistakes keep reoccurring.
In healthcare it is critical to adopt and practice system’s approach and especially interperprofessionalism when the entire team takes responsibility and no single individual is left with the unreasonable task of failing.
Failures should simply indicate the system has overlooked a problem that needs to be addressed.
Dr. Ethelle Lord
Pioneer in Alzheimer’s Coaching
Thanks for that thoughtful reply! A scapegoat is exactly what people are so often looking for. I thing the team responsibility is vital; too often I hear a team member share comments such as, “Nursing got no deficiencies.” These comments just make the divide between departments even greater.
Very good points and great discussion. I have two things to add. My husband is an administrator, his mother was a state surveyor and I am a writer and I have worked marketing health care services for about thirty years. These are huge problems not easily resolved because we are dealing with humans and human behavior. First, let me share an interesting revolation. When my mother in law worked as a surveyor many years ago and the state found a problem, the surveyors stayed and worked with the home on the problem until it was fixed! Now that is teamwork, isn’t it? Next, I worked with a team for ten years. We adopted the Eden Alternative philosophy and process. It was a life altering experience and because we owned the 246 bed home, the team had more power than most teams to experiment. Our team training was all inclusive in that every employee went through “coaches corner” to learn a new common language. Although I have not published the book in that it was ahead of its time, it includes the lessons. Creating a new common language changed the reality of “silos” to a common team focused on the true plagues of aging. Like I said, the experience for everyone-elders, surveyors, associates, families, vendors, visitors, volunteers referral sources and so forth-was extremely successful.
What a great mix to have in the family Debbie! All those different perspectives must have made for some lively dinner conversation. It’s amazing how when you create a positive culture, such as Eden, it impacts everyone involved in the organization. Those silos break down not only between departments, but between family members, surveyors, volunteers, etc. Thanks for sharing that uplifting story. Now it’s time for you to publish that dang book!!
Loved the information
Thanks Yolanda!
I wish I could convey some encouraging words to staff (I’m a resident). Please know that a sourpuss or difficult resident is often “noted” and sometimes “avoided” by the other residents themselves. When they see a staff person continue to serve that sourpuss with a smile and interest, we often don’t have a good way to convey the kudos right then and there. Why? Because they don’t want their acknowledgment of the “sourpuss-ed-ness” to be noted. They want to “keep the peace.” But just know that residents’ eyes and ears are open and patience in dealing with the difficult one IS noted.
Thanks for sharing your perspective Jennifer! It’s a very valuable side for staff to be aware of.
At the root of this debate is the conflicting motivations of the involved parties. The patient wants to be cared for and feel cared about. Some of the staff are there to get through their shift and get a paycheck but many really do want to help the residents and do care about them. The leaders or those above them bearing down their back are there for profit. Often the black and white world of accounting and the real world situation of dealing with human beings do not reconcile well.
Thanks for your insightful comment Alison. I agree that many staff want to make a difference, and I would say that most do. I’ve been in fantastic for-profit and non-profit organizations that care deeply for the residents and team members. It’s all very dependent on the leadership and their vision!
Denise….what a great article. This was just passed on to the Department heads here where I work….a “Senior Independant Living Center”. Boy, do we deal with this from time to time. In the Capacity of Asst Exec Director/Dir of Operations, one of the major challenges for me is to establish and re-establish continuity between the depts as well as keep that very important link open between management and workers. Obviously, all of this while keeping the Residents in the mix…as indeed, they are the reason we are here…they are our Customers. Your readers are spot on with thier comments…there is a lot of “Finger Pointers” out there. In the military we called this “Displacement”…pointing everywhere except back at yourself. I would be remiss if I too didn’t sometimes think those in the Corporate level might be a tad out of touch with what is going in the field…where the residents are cared for. Yes indeed, there are so many pieces to this puzzle we call healthcare and basically….taking care of OUR customers. It is a constant challenge to keep our employees focused on the mission/vision while we walk that walk of the talk we talk. Some days/weeks are easier than others and some are just challenges after challenges. I always tell our folks…no matter what, remember why we are here…our focus is on the Customer…the Resident. A concept easily stated but much harder to drive home. that’s why Work is WORK.
The regulators. State surveyors live in fear of the feds coming behind them and making them look bad. The feds live in fear of what the next grandstaning politician or advocacy group will do to make them look bad. The advocacy groups must fund raise to maintain their existence. They live in fear that they will actually succeed and people will no longer need them. Politicians live in fear of the next media “expose” that will make them look bad. The media want to sell content and ads. They live in fear of lack of sensational headlines or click bait titles.
Providers. We live in fear of all the above.