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Long-Term Care Survey Alert

Staff Management:

TEACH STAFF THE SECRET TO MAINTAINING CONTROL

Published on Tue Jan 01, 2002

That old adage about counting to 10 when you're about to lose control is still good advice, but you also have to know when to start counting.

Nursing facility administrators can help keep staff from losing their professional decorum with residents, families and each other by teaching them the warning signs that they need a brief time out or supervisory assistance.

Under F226, surveyors will be looking to see, in fact, whether facilities are training staff how to recognize signs of burnout, frustration and stress that may lead to abuse.

"It's important to take the view of abuse from being an issue of judgment where 'only bad people act like this' to a much broader understanding that any one of us, given certain conditions, including enough setbacks in our lives, could act in the same way," says Beth Klitch, principal of Survey Solutions in Columbus, OH .

"Who among us hasn't gone to work occasionally with a chip on our shoulder because things aren't going well there or elsewhere in our lives?"

According to Klitch, some of the warning signs that staff can learn to recognize in themselves or others include:

  • Body tension such as clenched fists, arched back,paininneck;

  • Rapid breathing or a feeling of adrenaline coursingthroughthebody;

  • Tone of voice that becomes higher, tighter or sounds harsh;

  • A feeling of dread when approaching a difficult resident; and

  • Intentionallydelayingaresponsetoadifficult resident.

    It's not enough to just teach the warning signs. Staff should have readily available ways to switch into a safety mode when they begin to reach the boiling point. Klitch suggests the following "no questions asked"optionsforstaff:

    1. A formal "time out" program that allows staff to request 15 minutes off the floor.

    2. The automatic ability to ask for a second staff member to help without being told, "You'd better learn to do your own work."

    3. The ability to call for a supervisor at any time for any reason for help.

    Some caregivers under severe stress may need professional help for a time to help them marshal financial, social or other resources so they can continue to care for residents effectively.

    If so, "the facility might consider bringing support systems, such as employee assistance programs, into the building," suggests Washington attorney Marie Infante. "It's not going to work to contract with an entity that requires CNAs or other staff to take three buses across town."

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