Archive for May, 2012

The Tao of Teamwork

Posted by on May 29th, 2012 at 8:42 am | 2 Comments »

Helen Hanson

Working as a CNA can be extremely challenging. Whether you’re helping people in their homes or in a nursing facility, the work is basically the same. The difference is the teamwork that is part of the job in nursing homes, where you often rely on other CNAs for assistance with one of your residents.

At least, there should be teamwork in nursing homes. Remember that old saying, “Many hands make light work?” It is true. But some CNAs don’t see teamwork as part of the job.

That makes the job harder for the rest of us because it adds to the stress level. Not only the stress of dealing with difficult residents, but the stress of searching for a willing CNA to help you do a two-person transfer while a resident is patiently waiting to go to the bathroom. I find myself wondering why the CNAs who will not help a co-worker who is helping a resident got into the caregiving profession to begin with. I also find myself wondering how they are able to keep their jobs.  Continue reading »

CNA Injury Rates Linked to Low Pay, Lack of Respect

Posted by on May 22nd, 2012 at 9:01 am | 5 Comments »

A recent report from RTI press analyzed the sky-high injury rate–the highest for any occupational setting–among CNAs in nursing and residential care facilities. Lead researcher Galina Khatutsky talked to us this week about her team’s findings, including the fact that injury rates are lower among workers who are better paid and who feel respected and valued by their employers.

Galina Khatutsky

One of your most interesting findings was that CNAs who have better working conditions—those who are higher paid, feel respected and rewarded for their work, and work for facilities they perceive as valuing CNA work—are less likely to get injured on the job. How strong are those correlations and what do you think causes them?
It was a pretty big effect. We don’t know why, but we thought that maybe if CNAs perceive that their organizational cultures were welcoming that would promote a safer working environment because, for instance, it might be easier for them to collaborate and obtain additional help when they need it. We thought they might be less likely to feel that they have to rush and more likely to help each other. As for pay, we thought it may be a proxy for other CNA characteristics that we could not measure. For instance, staff who are higher paid might tend to have more motivation or to provide better care. Maybe they’re just more experienced and know what they’re doing.  Continue reading »

Open Door vs. Revolving Door: How to Retain DCWs

Posted by on May 22nd, 2012 at 9:00 am | 3 Comments »

Harry Graham and his wife Carol co-own Graham Behavioral Services, Inc., a mental health services agency with offices in Augusta and Portland, Maine. In addition, Graham presents at conferences on the topic of leadership and ethics and their effect on clinical outcomes, which is also the subject of a Doctorate in Business Administration (DBA) thesis he is currently researching. He talked to us earlier this month about what his work and his research have taught him about how investing time and money in direct care workers pays off for agency owners.

Harry Graham

What is the subject of your thesis?
The premise is mythopoetic leadership. That means establishing a culture that’s healthy for customer, vendors and staff. How do you retain the employee, the direct care workers?

It’s a matter of organizational development, structure, and how approachable the executive team is. If staff don’t feel they’re appreciated or valued, it does not work. An autocratic management model in nursing or care work does not work. The staff have to feel comfortable coming into the office. At the beginning, I don’t know how many staff said, “Gee, the CEO’s talking to me!” Well yeah, why not? That’s one of the problems, when ego gets in the way of communicating. You see that a lot. Direct care workers need to be valued. They are the service. Our service is only as good as the staff providing the service.

My door’s always open. I don’t get anything done during the morning except what they call “management by walking around.” It’s also management by objectives: Staff have to feel that they’re a part of what’s going on. I fill staff in on what’s going on and get their opinion so they can be part of the strategic plan. There are not too many agencies that do that.

We pay well. Direct care workers usually start at about $11 an hour. Then they get annual increases after that based on merit. We provide health insurance and a 401(k) if they work more than 20 hours a week.  Continue reading »

Study Finds Link Between Low Staffing, Nursing Home Deaths

Posted by on May 15th, 2012 at 9:25 am | Comments Off on Study Finds Link Between Low Staffing, Nursing Home Deaths

Plenty of studies have shown that care quality in nursing homes suffers when nursing assistants “work short,” but a new analysis of Medicare and other data reaches a startling conclusion: Nursing assistant staffing levels may literally be a matter of life and death for nursing home residents.

A group of researchers from the University of California, Davis, looked into why more people die during times of low unemployment, questioning the conventional wisdom that the cause is stress from overwork. As reported in Why Do More People Die During Economic Expansions?, they found that only 9 percent of the 6,700 additional deaths associated with a one-percent decline in unemployment in 2006 occurred among people of working age, while three-quarters occurred among elders. Women over 65 were particularly hard hit, accounting for more than half (55%) of the deaths. Continue reading »

My Friend Kevin

Posted by on May 15th, 2012 at 9:23 am | 4 Comments »

Tina and Kevin

I would like to tell you about my friend Kevin.

Kevin was born in the late 1950s with a condition we now refer to as autism. Since autism wasn’t widely known until decades later, Kevin was more than likely simply labeled as “retarded.” He came from a fairly large family and went to school until he was around ten years old.

After this, Kevin’s history is spotty at best because he was mostly hidden from the outside world. His extended family described him as the “wild boy,” left to his own devices much of the time and roaming the wooded area behind his run-down family home. When he would return home at the end of the day, many times he was locked in a bedroom, sometimes for days at a time, by a mother who was undiagnosed and untreated for schizophrenia. Surrounded by his own feces and urine, it is believed that he was given little, if any, food or water during these times. On the nights that he wasn’t locked in his bedroom, he slept in a lawn chair on an enclosed patio.

He lived this way until his situation was brought to the attention of the state when he was over 50 years old. That’s when Kevin was introduced to the woman who would prove to be his own personal guardian angel. Continue reading »

Home Care Cooperatives Spotlighted at White House Briefing

Posted by on May 7th, 2012 at 7:46 pm | 1 Comment »

Direct Care Alliance Board Chair Tracy Dudzinski was at the White House last Friday for a briefing on cooperatives.

Tracy Dudzinski at the White House

DCA: Who was there and what did you talk about?

TRACY: The National Cooperative Business Association invited leaders from 150 cooperatives across the nation to talk to the White House staff about what co-ops can do for the economy.

My agency, Cooperative Care, is a worker-owned home care cooperative, and I’m the chair of their board too. Cooperative Care was one of the featured success stories in the packet of information that NCBA made up for the White House staff. There were only eight or ten of them, so that was pretty good.

Did you get a chance to speak?

One of our allies from here in Wisconsin got the floor and talked about home care co-ops. Then she nodded at me and said I was from Cooperative Care and we were a success story, so I was able to speak a little about how we’re doing so well that we have hired 15 new people in the last year.  Continue reading »

Tracing the Link Between Low Reimbursement and High Turnover

Posted by on May 7th, 2012 at 7:43 pm | 1 Comment »

A recent article in a leading publication for nonprofits detailed the challenges faced by long-term care employers who can’t afford to pay direct care workers a living wage–and who often deal with uncomfortably high turnover as a result. In the April 29 issue of The Chronicle of Philanthropy, Nicole Wallace explained how low government reimbursement rates lead to low wages, and why well-intentioned employers often find the best they can do for their frontline employees is to help them get the food stamps and other government benefits they are entitled to. Her article is reposted below with permission of The Chronicle of Philanthropy

Service Charities Seek Ways to Help Their Lowest-Paid Employees Get By

Catholic Charities helps employees access the government benefits their low wages qualify them for.

By Nicole Wallace

As a certified nursing assistant at a nonprofit rehabilitation center in central Maine, Helen Hanson helps patients with basic activities healthy people take for granted­—eating, dressing, bathing, and going to the bathroom. Because the 46-year-old aide works second shift, she earns $10.80 an hour, a dollar more than the base pay for a nursing assistant at the center, and she often picks up extra hours on weekends when wages rise to $12 an hour.

Still, Ms. Hanson says that after she pays the bills each month, she barely has enough money left for groceries and gas, let alone to put money aside for an emergency.  Continue reading »