Wednesday, March 30, 2011

Staff Care: a New Spin on Team Building

In the care-giving professions,  employees are asked (expected even) to focus nearly all of our energy, spirit, and time solely on the needs of our clients/patients.  The expectation is that we make them our priority,  that we be empathetic and attuned to them, to be with them in their most dire time of need.  And in doing so, the expectation becomes to put our own needs aside while doing so.

While I do not disagree that clients and patients should be the central focus of our time and energy, and that they deserve that treatment, my deep concern lies in how to sustain the type of  healthy, emotionally regulated staff that will ultimately be able to provide the best care to our deserving clients.  In the agency where I work, we act under the assumption that "kids act better when they feel better." This is the premise for much of the trauma-informed care approach that is sweeping the nation in behavioral health and in working with trauma survivors. I suggest that we apply the same concept to staff- that staff will act better when they feel better.

Over the last six years I have watched the staff  who are charged with working with the sometimes very difficult  population- adolescent girls with trauma histories. I have been amazed at how far they are willing to go for our kids. They are willing to put themselves in harms way at times, to sit with children as they rage and scream and sob, to come in each day with a smile and with hope that today will be the day they will plant a seed that will make a difference in our girls' lives.

I also watch (and experience) the days where our caregivers walk in the door looking drained, exhausted from last night's crisis, on the verge of tears at times, less open to the kids, and with less patience than may be characteristic.  So I ask myself,  what is different on these days? What makes it easier to come in to work with that hope and that smile and that motivation to make an impact? What makes it more difficult to do this? What can organizations do in order to help their staff have more of those "good days"? Is there a role for administration here? Is it just a occupational hazard that is unavoidable? Or is there a better way?

The major reasoning for the change in the therapeutic approach from a more traditional, punitive to a strength-based model was that the traditional approach did not motivate the kids to do better. Why?  Because most of these kids want to do better (regardless of the amount of rewards and punishments associated with their behavior), they just don't have the skills, or the self awareness to choose a better option. I would argue that this is the same for care-giving staff. Without the proper training, self awareness, and the support, it will be more difficult for caregivers to choose the most empathetic, most attuned, and effective approach with the clients.

So what can we do to get our caregivers there?  I think there can be some simple solutions here, but one that takes commitment from the top, (and maybe even a place within the organization's strategic plan). I believe that a commitment to staff care will go a long way in helping to create and sustain the type of quality, genuine care givers that our clients so desparately need.

So what constitutes staff care? Some of it is cultural, and a lot of it is about gratitude and appreciation for each other. To create a culture of compassion and gratitude between coworkers can take time, and is mainly going to need a leader who walks that walk. But there can be simple, concrete activities, and gestures that can go a long way with staff.  One suggestion is to have a "Staff Care" day once a month or every few months. This is similar to a team building staff meeting, and has similar goals, however with a slightly different spin. (I find that when people hear that phrase they begin to feel unsafe. I here comments like, "Are we going to have to get up out of our chairs? "Are we going to have to play corny games?" "Is this going to be you guys trying force us to have fun?"  It kind of makes me laugh, but these are true fears and anxieties that are brought up for people when they hear the words "team building.")

My suggestion is this: Turn your regularly scheduled staff meeting into a kind of "Staff Appreciation Day" or "Honoring our Caregivers Day." Last week we tried this with our staff.  My goals were as follows:

- To create a sense a team while minimizing anxiety around "team building activities"

- To acknowledge and honor the difficult work that our direct care staff perform day in and day out, and to allow them time to celebrate the gains, and to grieve the losses we endure.

- To create a sense of community and compassion amongst our caregivers, and sense that "we are in this together."

So, the two hour meeting consisted of the following activities:
1. We opened with an exercise in gratitude towards each other. This was a simple activity that requires minimal prep, you simply need a piece of paper for each person with their name across the top. Post these pages around the room on the walls, and provide markers. As people stream into the meeting, amidst casual conversation staff members are asked to mingle through the room and write something they are thankful for on each staff person's page. It could be a direct thank you for something they have done, or a reminder of a strength that they bring with them to their work that you would like to acknowledge.  Leave the pages posted throughout the meeting and at the end each person takes theirs to go. This serves both as an opener and as a reflection piece for people to take with them after the meeting has ended. It also emphasizes a strength-based approach and helps with staff's self worth and sense of being an effective team member.

2. We played a slide show of the highlights of our program over the past year.  We paid tribute to the good times, laughed about the funny times, and even teared up when remembering some difficult ones.  We decided to do this over lunch, as it created an easy-going laid back atmosphere that sparked discussion when the slideshow was over.  The two hours that it took me to find and put together the pictures was well worth the result, and the staff thanked me for taking the time to honor their work and remind them of all of the good work that we have been doing.

3. We created "Self Soothing Kits"- FOR THE STAFF! "Self-Soothing Kits," also referred to as "Comfort Kits," or "Sensory Kits," is a technique we use with our kids to help them identify what types of things help them calm down, or feel soothed when they are feeling stressed.  It is about engaging all of the senses with stimulus that is soothing, calming, and grounding in the moment.  We provided an assortment of the following materials: (sample-sized) lotions, candles, shampoos, bubble bath, bubbles, candies, pieces of fabrics, inspirational quotes, scenery (cut from magazines) of gardens, beaches, and serene landscapes. We scattered these items across the table and told the staff to go at it! We instructed them to pick items that appeal to them and that would help to sooth them when they are feeling stressed.  Once the staff members realized the goodies were for them, and we weren't making these for the residents, their eyes lit up and they excitedly began to rummage through the supplies.  As we constructed our kits, we listened to my "Superwomen" playlist, where I had compiled songs that celebrate the strength of women, particularly caregivers, such as Alicia Keys, "Superwoman."  We began a discussion about what our self soothing kits at home could consist of, and recommendations for stress-relieving activities that staff already practice on their own. The vibe was relaxed and the discussion was easy-going, light, supportive, and full of glimmers of self-awareness that made me smile.

4. Our last activity was a guided imagery session based on the Dali Lama's recommendations for a daily mindfulness practice.  As I played some yoga music and dimmed the lights, I slowly took the group through an inward journey of breath and acceptance that involved focusing on observing ourselves without judgement, cherishing ourselves, cherishing others, and especially cherishing those who we may find it difficult to cherish. At the end of the five minute exercise,we raised the lights and allowed for comments and discussion. The feeling of the group was one of  peacefulness, compassion, and acceptance- even between staff members who would probably consider each other "difficult to cherish."

5. We closed by having each person pick and read out aloud one of Dr. Wayne Dyer's cards for Success and Inner Peace. The staff found it interesting who chose what cards to read, and we each reflected on what they meant to us individually and related to our work.  Before everyone got up to leave, we thanked staff for their commitment to our program and to our kids, and reminded them to take their gratitude pages with them on the way out.

The feedback over the next few days was extremely positive and grateful, and I couldn't help but notice the women on our team taking better care of each other and of our kids in the weeks to follow.  The power of gratitude, appreciation, and honoring the work that caregivers are choosing to do continues to amaze me, and I believe there is a direct relation between how well we take care of each other and how well we take care of our clients. Here's to the superwomen!

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