Guest Columns

A long-term care hero

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Lori J. Porter
Lori J. Porter

I'll admit it: I am a TV junkie. Modern technology has only helped to feed my habit. My DVR will record four programs at the same time. If my doctor had the scheduling software that DirecTV uses, I would never have to spend another afternoon waiting in the lobby due to double-booked appointments!

I enjoy using some of any holiday or break time leisurely catching up on television programs that I have not taken the time to watch. My list of recordings is very diverse, from documentaries to comedians, with only a few dramas mixed in, as real life provides me my own front row seat for drama.

A few weeks ago I scrolled through my recordings to find the perfect show to watch: CNN's 2013 Heroes. You know, the one where Anderson Cooper presents “everyday people changing the world.”

As I sat on my sofa, I watched stories ranging from a military veteran building and modifying homes for other wounded and disabled vets, and a a female physician who designed a solar powered “examination lamp” in a suitcase so that babies could be safely delivered in developing countries at night despite the lack of reliable electricity. There also was a grieving father who has devoted his life to transporting sick children to chemo treatments so their mothers don't have to take the bus or subway.

All of the individuals featured were very worthy of the honors bestowed, but it did make me contemplate how many heroes there are working in long-term care.

The first hero I ever met working in long-term care was Stella Parrish. The year was 1981, and I was a young nursing assistant with a bad attitude. Stella was a nursing assistant and a medication technician and probably only 50, although of course I thought she was ancient.

Stella is a hero to me for many reasons. She never missed work, was compassionate and patient, truly loved the residents and was always willing to help anyone who needed it no matter what was asked of her.

The biggest reason, though, is that she gave me an attitude adjustment that saved my career in long-term care — and this was back in the days before all the buzz words of "empowerment" and being positive. Stella schooled me well, explaining that she was tired of hearing me complain about everything. She told me the nursing home meant something to her and she would not allow me to make everyone miserable. She concluded with a request that if I could not stop complaining and inciting negativity among my co-workers that I leave. 

I did stop complaining and thanks to Stella, I became a better nursing assistant and a better person. I am certain that if Stella did this for me, she did it for many others too.

Stella was a world-changing role model. She has undoubtedly inspired a chain reaction, as I have held her service and her actions up as “the example” of a professional nursing assistant to thousands of nursing assistants, nursing directors and administrators over the last 20 years in my presentations and seminars.

I'm not Anderson Cooper, but I also know a hero when I see one, and that's what I call a hero!

Every long-term care team has a “Stella Parrish,” in one form or another. Unfortunately, sometimes we silence them out of fear.  We are afraid because of past experiences and fear of the “unknown”… the unknown responses, the unknown outcomes. We are afraid of losing control, as if we could control our external environment to begin with. 

Lose the fear. Think about some of your best nursing assistants. You know who they are — the ones who pack a clean uniform in a bag and bring to work with them when there are winter storms approaching, the ones who agree to work that one last shift you don't' have covered, those you know have your back, bringing you information you need to know but that others may be afraid to tell you.

Think about which CNAs champion your goals, are upbeat and embrace change, if for no other reason than to support and respect your leadership. These CNAs already have ownership in their workplace and that is the foundation to build upon. In the words of Stella Parrish, “This place means something to me.”

Empower those CNAs. Help them recognize the power and influence that they already have, and don't think for a minute they don't. Their power (or “control” or “influence” … however you choose to view it) lies in their ability to manage and sway attitudes, deflect negative breakroom chatter, help maintain calm during urgent situations, foster relationships and support and mentor new nursing assistants.

Consider the following with them:

  • Outline and describe your goals.  For example, if CNA turnover is an issue, work with the Stellas you have identified on your team and reinforce the negative impact of CNA turnover.
  • Create a more inclusive environment. Keep the team informed of their progress towards the goals. Share information.
  • Create opportunities for employees to shine through recognition and growth. Consider training the CNAs identified as preceptors.
  • Appeal to their sense of responsibility, that they have a personal duty to act.
  • Encourage open communication between yourself and the team.
  • Allow the “informal” leaders to speak up and challenge their peers when they see and hear things that do not support the goals, mission or quality care.
  • Ensure your “champions” that their efforts will actually make a difference and not simply be a futile exercise.

I had the privilege to work with Stella later in my career,  when I moved from Kansas City back home to southwest Missouri upon taking a licensed nursing home administrator position in 1991. knew she had my back. Despite her age and the physical toll so many years of caregiving had taken, she continued to be a dependable, loyal and compassionate CNA.

The last time I saw Stella was at NAHCA's “Key to Quality” Awards Banquet in Joplin, MO, in 1997. She helped present the Lifetime Achievement Award to a deserving CNA — the Stella Parrish Lifetime Achievement Award.

Stella died in 2003, but her legacy lives on. She continues to influence, change attitudes and save careers … which results in reduced turnover, greater ownership and accountability, happier caregivers and well cared for residents.

To me, she is a hero who will never be forgotten.

Lori Porter is a former certified nursing aide and nursing home administrator with more than 30 years' experience in long-term care. She is co-founder and CEO of the National Association of Health Care Assistants, a professional association of and for nursing assistants. A nationally sought-after speaker on frontline caregiving issues, she also is the author of the book “Everything I Learned In Life I Learned in Long Term Care.”

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