I just saw the results of an interesting survey published in the March print issue of Provider Magazine. The source is the My Innerview Skilled Nursing Employee Engagement Satisfactions Surveys collected in 2012 by National Research Corporation.
The question from the survey that is highlighted is “Would you recommend this facility as a place to work?” Interestingly, the CNAs and Nurses surveyed responded that they would recommend their facility less than 65% of the time. In contrast, Administration and Nursing Administration responded that they would recommend their facility about 85% of the time. I think a 20% difference between the responses from CNAs and Nurses versus Administration and Nursing Administration is significant.
What does it tell us? Maybe it tells us that the folks with the power and control think things are just great while the folks in the trenches who may be feeling disempowered aren’t so happy? My gut tells me that this is more evidence that many nursing homes still have a long way to go in moving away from the old disempowering hierarchical management model and moving toward an empowering person-directed care approach to improve staff engagement, satisfaction, and well-being. The results we’ve seen from Eden Registered Homes over the years certainly shows the many benefits to be gained by making this transition.
So, how big is the gap in your organization? More importantly, what are you doing to close the gap?
Re: my earlier reply (below)
The book I posted is an excellent resource for any nursing home, be it for-profit or not. It’s highquality reading in general. Especially the first chapter in Section 5, which is labeled as an “International Perspective,” but applies universally across geographic and professional borders.
Certainly, from what I saw when my mother lived in assisted living, a rehab center, a memory care facility, and a nursing home over 8 years, the larger the facility, the less likely it was that you’d ever catch a glimpse of the director or other top administrators out on the floor with the people who did the hands-on work. It comes as no surprise to me that administrators would have no idea what daily life is like for most residents and staff. On a related note, when I was recently interviewed about my memoir for the radio show “The Aging Boomers” in California, the host pointed out that smaller homes for elders of 6-10 residents are much more common in the West than on the East Coast. If we had smaller facilities here–real homes like The Green House Project–the underlying problems reflected in this survey would be greatly abated.
I just got my first issue of Provider this week, it’s good stuff. I’m glad this was posted, as we have been studying this exact subject for a couple of class sessions, and I feel more than prepared to at least begin to answer the question.
@ Chris listen to your gut, it’s got a good mind of it’s own. Perhaps drilling down a bit/longitudinal analysis would bear out the following: the Administrators at the homes surveyed have a vested interest/more years on the job, as compared to CNAs and Nurse staff. After all those years working as an Administrator somewhere, would you be able to say, “I don’t recommend you come to my house?” The Administrator may also feel that they know best, in that ‘all legacy nursing homes are like ours, of course you should come to mine. You don’t have much of a choice anyway.’ Denial is a powerful thing indeed. Contrast with the entry level/neophyte/Nurse who feels like they are just ‘telling it like it is,’ and who comes from a different generation where job-hopping is expected therefore they have a lessened vested interest. Add that and a bit of naiveté from these neophytes who MAY assume there are better homes via a “grass is greener on the other side of the fence,” thinking process. Until they too move from legacy nursing home to legacy nursing home and looking for something ‘better,’ and find that more of the same awaits them at the majority of such homes. It’s even possible they DO know about better homes, and are seriously recommending them instead.
On a personal level, I can say I could not and would not recommend any nursing home I worked at to anybody, at anytime for many years. We had gaps alright: poor attendance, dismal relationships with the elder’s and families that lived there, even a fire at one home. Enter ‘The Dragon,” and things just got even worse from there. (Except for the actual fire, that was put out.) So, YES… moving my career to a true culture change home and getting training that lead me to working at a Green House changed my real world outlook for the better. At the Green House, I was an Assistant Administrator/Acting Administrator (of Nursing) and I highly recommended the Green House and the home that trained me, to every elder and family member that asked. With regard to the survey I believe there would still be a ‘gap,’ with the responses you might get from the Shahbazim and nurses in that building, it’s a brand new home (<1 year old) and things are still settling out a bit. While I’d like to think I helped convey a good understanding of how empowered they and the elders were, I know a more seasoned culture change agent could have closed that gap further. (The ENCORE training provided by the Green House Project is the best training program I’ve ever seen as well.) I am gaining training on an ongoing/accelerated level at this time though.
Since leaving the Green House to go to the Erickson School’s Aging Services Program, I have already learned enough about the ‘gap,’ and how to diffuse it before it even opens. In just the firsts weeks of the program, I know I have taken more than an incremental step in positioning myself to make a real difference in long term care. The amount of truth coming at me via the Erickson School Program is so dense and powerful that I become ill to my stomach with the sudden understanding that I’ve been wallowing in the mire, when a bit of QUALITY reading could have alleviated some of my (many) shortcomings decades ago. Shortcomings that I have been cognizant of, but could not verbalize let alone comprehend; THATS the POWER of a good program.
@ all: Do you as an Administrator at a legacy nursing home have the guts to admit that your staff don’t see things like you do based on the survey results? That you have failed to communicate well enough to lead them to the promised land that is so great they could, and would, recommend family and friends come to live there.
How big is your gap and what are you doing to close it? The material is readily available, but separating the crap from the crucial is key, and there is an awful lot of less than crucial sources out there. For the administrator that is interested and can come to the Erickson School and at least visit, I say “do so.” Call now, operators are standing by. ☺ Regardless, the information to close the gap, and defeat the Dragon is out there. And the culture change movement has been providing it for decades. In this particular case, I can recommend one easily accessed, affordable ‘old,’ book on the subject: http://www.amazon.com/Culture-Change-Long-Term-Audrey-Weiner/dp/0789021110 which can be had for less than $10 used. There are more concise sources out there, but I haven’t come across them myself (yet).