A failure to communicate

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Mary Gustafson, McKnight's Staff Writer
Mary Gustafson, McKnight's Staff Writer
A former colleague of mine always impressed me with his ability to somehow get along with even the most difficult personalities. If you were taken hostage, he's the person you'd want to negotiate your release.

While he had always been able to get along with his boss, lately the boss has been nitpicky and given to bouts with the cold shoulder routine.

My friend traced his boss's chilly behavior back to when the boss attended a leadership/management conference. Upon her return, she stopped asking my old colleague about life outside of work and didn't engage in typical workplace chit-chat. She became all-business, all the time.

Inexperienced — just plain awful managers — are everywhere. And bad managers often are rewarded with promotions and raises. But some, like my friend's boss, just haven't mastered basic communication. And this can be bad news for people working in healthcare settings, particularly in nursing homes, according to a new study.

University of Rochester researchers reviewed data from over 45,000 New York nursing home residents and then measured the care rendered in these facilities based on rates of pressure ulcers and incontinence. Then, researchers, led by Helena Temkin-Greener, Ph.D., surveyed nursing home workers on their feelings about staff unity and staff cohesion. After assigning numerical values to feelings of staff cohesion, they noticed that “less than 0.25 point improvement in a nursing home's staff unity score was associated with a 4.5%- decrease in the prevalence of pressure ulcers and a 7.6%-decrease in incontinence, showing a major improvement in both these health conditions.

What this means is that those who don't feel good about their work probably aren't doing a good job handling residents. Temkin told me poor communication between caregivers during shift changes was particularly problematic. Important information, such as a sudden change in a resident's condition, can be overlooked in handoffs.

"The association with leadership and conflict resolution was also statistically significant but not as robust as with communication and coordination," Temkin explains. “While focusing on improving such work environment attributes may not be entirely cost free, it certainly remains a very cost-effective option and within reach for most managers.”

So what can managers actually do to prevent communication breakdowns and flagging morale?

“Promoting shared leadership among team members and empowering staff to take initiative have been shown effective in building teamwork. But building good communication skills is probably the most critical action they can take,” she advises.

Now, I'm neither a director of nursing nor a human resources specialist, but as a human being I do know that taking a little extra time to get to know your colleagues can go a long way towards making someone feel like a part of the team.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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