Mindset has been on my mind lately. How’s that for an opening sentence? The filter of “H-G-W” (Have to, Get to, Want to), specifically, is weighing on me as a leader.

I believe approach matters, and the words we choose to use matter, but when does the HGW filter become blurry?

I’ve been testing this filter and challenging myself the last few weeks. The results, I’m embarrassed to say, aren’t always positive. Another reminder of how leadership is about constantly learning. We are all trying to better understand ourselves, our motivations, our shortcomings, our strengths, and most importantly, how we view the world. 

The most recent way I tested this filter was when we were told “have to” in the new CMS staffing mandate. The details and the rollout aside, the “have to” requirement or mentality doesn’t seem to take into account as a field our “get to” or “want to” mindset. It is as if the administration hasn’t accounted for all of our efforts to date. 

I believe many of us in long-term care not only “want to” staff appropriately every day, but already do staff appropriately and to the needs of our communities. To place an overarching blanket across our sector without consideration for the work that is currently being done, not to mention what has been done, seems like a giant step backwards. 

It wasn’t that long ago team members in our field were referred to as heroes. With this mandate, personally, I believe the administration is saying your heroic efforts aren’t enough. For example, to not fully consider licensed practical nurses (LPNs) in the calculations for nurses is a slap in the face. We rely on LPNs to provide exceptional care for our elders and to treat them as if they are less than, is wrong. 

To assume we don’t want to recruit and retain excellent team members is also simply wrong. We talk about this daily. We are constantly trying creative, out-of-the-box solutions to recruit and retain. It has been, and is, our focus. The phrase “workforce crisis” doesn’t just get thrown around. Despite extreme challenges, we are absolutely committed to appropriate staffing levels. Thankfully, our community is blessed that we have been doing well. We have a group of dedicated, compassionate individuals committed to the residents we serve. This may not be the case for all. Simply put, it’s a supply-demand problem. 

As if recruitment to our field weren’t already difficult enough. We want people to join the honorable field of caring for seniors because they “want to” and because they “get to” experience a unique opportunity. Adding yet another requirement to our already overregulated field does not help our efforts to attract new talent to our field.   

HGW is a helpful mindset shift and can be used in multiple ways. I have to get up and go serve seniors. I get to get up and go serve seniors. I want to get up and go serve seniors. 

It’s a great filter that causes us to pause before making decisions or inspiring change. Words matter and approach matters; a mandate isn’t the answer to this problem for our field. 

“Want to” doesn’t always mean “get to,” even if “have to.”

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Julie Thorson was the 2018 recipient of the LeadingAge Dr. Herbert Shore Outstanding Mentor of the Year award. She currently facilitates LeadingAge Iowa’s Leadership Academy. She is a LeadingAge Academy fellow and former coach. The Head Coach (president and CEO) of Friendship Haven, a life plan community in Fort Dodge, IA, Thorson is a coach’s daughter at heart. A former part-time nursing home social worker, she is a licensed nursing home administrator and an alumna of LeadingAge’s Leadership Educator Program.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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