As part of dealing head-on with the challenges of the pandemic, directors of nursing in long-term care need to make sure they personally come to grips with the grief and stress they have experienced, believes at least one expert.

“If we can’t name it, call it, validate our feelings around it … how can we possibly go forward?” said Linda Savage, vice president of clinical education and infection prevention at SavaSeniorCare Consulting. 

She spoke recently during a virtual session of the National Association of Directors of Nursing Administration in Long Term Care’s (NADONA’s) 33rd annual conference.

The pandemic has affected staff morale, frustration around punitive regulations and resident skin issues, among others. Once DONs acknowledge all of the disturbances that the pandemic has caused, they can move on to addressing the areas they can control.

She pointed out six in particular:
•  quality of life for staff and residents
•  emotional loss
•  the prolonged effects of residents in isolation
•  staff morale and related challenges
•  infection prevention and control practices
•  supporting resident family members

Talk is good

Savage offered strategies for tackling these areas. To deal with issues of loss, she recommended creating space to process it and developing support groups for residents and staff. Regarding quality of life for residents and staff, along with staff morale, communication is key, she said.

“The best thing we can do in our world right now is communicate and overcommunicate,” she said.

To attract staff, the postings need to be positive.

“Having your job postings reflect energy and a call to serve is so important right now,” she said.

Leadership also must take an active role in improving staff morale, she noted. “It’s more pressing than ever … that we lean into the behavior we see in our communities. We need to be the leaders demonstrating what this looks like.”

To support residents’ families, Savage recommended virtual weekly Zoom for families to speak with center leaders. She also offered creating a climate that is action-oriented. 

“Look for ways to say, ‘We can’ …’” she pointed out.

An interdisciplinary approach, involving everyone from nursing to therapy to activities and dietary staff, is effective to stay on top of residents’ clinical needs due to isolation, she added.

Infections pro

Infection prevention and control is an especially important area to focus on, she said. Such practices begin with the infection preventionist (IP), she explained. 

Beyond having a productive orientation and onboarding process, and ongoing education, they should have “an extremely close collaborative relationship with environmental services,” she said.

They should get acquainted with the chemical formulary in their center, know the cleaning process and round with the environmental services manager. They also need to connect with local, state and national infection prevention and control organizations, and local and state health departments to receive infection control updates.

Facilitating a staff and resident flu vaccination program is also the job of an IP. Because of COVID-19, vaccinating for the flu is even more of a priority this year. She encouraged the NADONA audience to consider a mandatory employee flu vaccination program. The goal, she noted, is 90% flu vaccination of residents and staff.