Put your gait belt where your mouth is
The idea of cross-training is great. I embraced it fully when we embarked on our culture change journey five years ago. Every team member should be cross-trained.
Initially, we believed what that should mean is every team member must be cross trained as a certified nursing assistant, including myself. At the time, I was the assistant administrator and wanted to model the way and show others it wasn't so scary to become a certified nursing assistant.
Long story short, I studied (crammed), practiced the skills and took the test. Moment of truth: How scary … what if I fail? No one else will want to take the test to be certified.
Luckily, I passed and many others followed my lead and became certified so they could be crossed-trained too and help in the neighborhoods.
Fast forward five years. Now I'm the CEO and I'm not practicing my skills as often as I should. Big-picture items take priority over the day-to-day caregiving. I trust the team we have but still feel it's important to understand, appreciate and acknowledge the most intimate work of long-term care.
We analyze staffing patterns, complain about the cost of replacing employees, show appreciation as often as we can (but is it really ever enough?) and discuss caregiver stress. But do we really have a good idea what it's like to walk in the shoes of a certified nursing assistant?
The most critical role in long-term care is one we at times take for granted. I am lucky to work on a campus with beautiful new buildings. We have a wonderful design and are lucky to now have new furnishings and neighborhoods.
Yet I'm often quoted as saying, “All of that doesn't matter if we aren't doing the right things on the inside.”
So a couple of weeks ago, I put my scrubs on, grabbed a gait belt and worked alongside daily caregivers. At the end of the day I was exhausted! Physically and emotionally.
I was humbled by the day's work and grateful for those who have found comfort and reward in doing this work every day. Throughout the course of the day, the caregivers had great influence on how each resident's day would go or not go. I felt that same influence and quickly realized I needed to step up to the plate.
I worked alongside our caregivers for a while and then started answering call lights myself, thinking I may not know exactly what to do but I'll figure it out.
So I answered “Sally's” light by myself. Being fairly comfortable in knowing her, I thought I'd be able to help her on my own. I was wrong. Sally is non-verbal but cognitively quite sharp. She knows her routine and it's obvious our caregivers know her routine as well. She didn't realize the “B Team,” (that would be me) was showing up today.
Sally likes to put her socks and shoes on first, which the caregivers told me. Easy enough, right? Wrong, those pesky socks would not line up just right so they would fit on her contracted toes perfectly. I was failing and failing miserably.
My response to her on this would define how the next 20 minutes would go. So I fell back to my old standby … smile and laugh and keep trying. She was on the brink of getting very angry and annoyed as I fumbled around with her socks, but my owning up to my inadequacy seemed to amuse her and we ended up having a great time together.
All though she didn't say it out loud, I could see in her eyes: “This lady is an idiot. She thinks she can run this community, but she can't even get my socks on the right way. I wish the A team was back in here to start my morning. But wait, maybe this will be fun. I'll just laugh at her!”
Which she did and I did too.
The rest of my shift went much the same way. Not only did the residents laugh at my attempts, but the caregivers themselves found it hilarious to watch me scramble from room to room dripping with sweat after making beds, and helping position, lift and roll residents. It was long overdue.
Of course, I appreciate what all caregivers do. But working a full shift and not holding back gave me a renewed appreciation for what goes on here. Sure, the new buildings are great but the day-to-day, minute-to-minute opportunity our caregivers have to influence the lives of those we serve is what truly creates community.
Heifetz reminds us leadership has to continue to be to be a balance of both the view from the balcony but also dancing on the dance floor with the real experts.
My time working as a certified nursing assistant was a great reminder. Balance and a deep appreciation for both helps us see things from different perspectives. As we make decisions that impact so many lives, having an intimate view of both will provide us with that much more clarity.
Julie Thorson is the president and CEO of Friendship Haven, a continuing care retirement community in Fort Dodge, IA, that earned the Governor's Award for Quality in 2014. A coach's daughter at heart, she is a former part-time nursing home social worker who quickly ascended the leadership ranks. A licensed nursing home administrator, she is a current participant in LeadingAge's Leadership Academy.