Dr. El

“God bless you,” an aide said to me the other day after I handed her a container of homemade green bean salad. She’d joined the same psychology-based weight loss program I was using and the green beans were my way of supporting her efforts.

She went on. “Some of the doctors don’t even say hello to us and here you are sharing food.”

“We’re all people working with the same goal, to help the residents,” I said. “Besides, I wouldn’t take it personally. Some of the doctors don’t say hello to me either.”

She laughed, and we each returned to our jobs. But, of course, it got me thinking. About staffing and hierarchies and silos, and about why people leave jobs and why they stay.

As McKnight’s Editorial Director John O’Connor pointed out last week in his column, “The Haddits have left the building,” increasing numbers of nursing home staff are leaving the field for reasons including low wages, other work options and feeling “like easily replaced cogs in a dysfunctional machine.”

Previously, in “The keys to reducing turnover in long-term care,” I noted factors associated with staff retention, including the ones below that involve strong relationships with coworkers and residents:

  • Motivating positive feelings between aides and residents
  • Perception of being valued by nurses and supervisors 
  • Being considered an important part of the care team
  • Working as a team
  • Positive relationships with coworkers

These research findings suggest that efforts to foster relationships in the long-term care setting can pay off in reduced staff turnover. Somewhat different approaches may be needed for recent recruits than for long-time staff members.

New hires

As facilities hire employees, consider the ways in which they’re welcomed by the organization. In my experience, new staff members often appear on the units without introduction. Coworkers, burned out on the churn of new staffers, might wait weeks to see if they “stick” before engaging with them more than superficially, thus exacerbating the churn.

To create a more welcoming environment, try integrating them into the team with these ideas:

  • Assign a work mentor, an experienced colleague who can answer questions and touch base with them regularly for the first few weeks or months of employment.
  • Introduce them to team members, either personally, through the company newsletter or intranet, or through their mentor. 
  • Facilitate connections. One organization places a box of donuts on the new employee’s desk so that they meet teammates stopping by for a treat. Imagine a bowl of fruit on the nursing station signifying a new hire and the staff member wearing an “I’m new, welcome me” badge for their first month of employment.
  • Create a welcome package containing info about the company, lunch with their mentor, encouragement to ask questions and regular check-ins from supervisors in the beginning of their employment.
  • Establish an “appreciation budget” to offer small, sustainable encouragements along the way, such as a 30-day cup of coffee and a 60-day gift certificate to the deli across the street. This could be an automated function tied to paychecks, delivered via text or email.
  • Help newbies learn the neighborhood — the best pizza joint, a great supermarket, etc. — to make working for the organization a more convenient part of their lives.

Experienced workers

While welcoming trainees can facilitate retention among new staffers, holding on to current employees is equally essential. Oldtimers have history with the organization, know how to keep things functioning smoothly and have built ties to residents, families, and coworkers. 

The ideas below can help maintain connections and sustain enthusiasm for the organization:

  • Use consistent assignments, which not only benefit resident/staff connections but also build teams.
  • Encourage managers to come onto the floors regularly and catch workers doing something good, such as a particularly kind manner with residents. While supervisors might notice behaviors that need redirection, this would be saved for later correction. The goal here is to provide positive reinforcement and improve manager/worker relationships.
  • Use the “appreciation budget” to offer small yearly rewards that acknowledge service and longevity.
  • Host staff BBQs and events where employers can show appreciation and simultaneously provide the opportunity for workers to make team-strengthening informal connections. This old standard has been sorely missed by many over the past year and a half. Smaller departmental or interdepartmental gatherings might be more realistic, for now, as we continue to grapple with the pandemic.
  • Long-term care leaders could dine in the staff cafeteria as a show of solidarity and a “worker among workers” philosophy. Chatting over a meal is a great way to model appreciation for the value of each employee — there might even be an exchange of home-cooked food.

The COVID-related exacerbation of staff shortages has highlighted the indispensability of every worker. The suggestions above are ways in which facilities can show that employees are valued, and they can increase the connection workers have to each other and to their organizations.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition andGold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements and/or content writing, visit her at EleanorFeldmanBarbera.com.

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.