Leadership Definition Quote

I borrowed this quote but feel like it matches my own personal philosophy in regards to what leadership is truly about.

Leardership Quotations by Harry Selfridge

Over the last 2 years I have enjoyed watching the PBS series "Selfridges". I watched how the series showed him as a kind motivational leader. Even though he had a lot of vices he was loved by his staff. I found the following quotes that are attributed to him. I feel that these are still very modern ideas about being a manager that we can all use as we manager our facilities and staff.

"The boss drives his men; the leader coaches them."

"The boss depends upon authority, the leader on goodwill."

"The boss inspires fear; the leader inspires enthusiasm."

"The boss says 'I'; the leader, 'we'."

"The boss fixes the blame for the breakdown; the leader fixes the breakdown."

"The boss knows how it is done; the leader shows how."

"The boss says 'Go'; the leader says 'Let's go!'"

"The customer is always right."

Traveling

I know many of you will be able to understand that these type of problems are funny. Because if we didn't laugh we would cry. Well here are a few of my escapades. I have been working over 100 miles from home for a few months so there have been a couple.

I got a new travel bag and was very excited about it. I guess my life is pretty boring when I get excited over a travel bag. Well I had packed most of my stuff the night before and put some in my car. The next morning I got up and finished packing and put my bags in the car and headed to work. After I got off I went to the hotel and got my bags out of the car. I started looking for my new bag I loved so much and even rechecked the back seat and trunk. My car is a little Toyota so it was obviously not there. I had forgot my lovely new bag with all of my toiletries, underwear and shoes. At least I had cloths because they were on hangers. Thank goodness for Walmart.

I have sleep apnea and my husband gets mad at me because I won't use my CPAP machine. This is not a plea for sympathy I just think it's funny. Well after giving me a lecture he talked me into using it. I packed it the first week and he called me each night to make sure I was using it. The next week after I got to work I received a call from him and another lecture for forgetting the CPAP machine. Guess who drove it up to me that evening. I also got another lecture.

I had been staying in the same hotel for almost the entire time while working in a particular area. I usually asked my corporate contact to reserve my room for me but I forgot to do it 1 week. On Monday I called the hotel to make sure they had a room for the week and guess what? They did not have a room for the week. I contacted my corporate contact and told them they did not have a room for the week. I then received an email that I had a room in Columbus. I called another hotel which was about 25 minutes away but no traffic to deal with. They had a room. I emailed the office and asked them to change my reservation. They told me it had a 24 hour cancellation policy and could not be cancelled ( even though it had only been 15-20 minutes since the reservation was made). I bit the bullet and headed out with my GPS. The hotel was in the far north side of Columbus in Delaware right smack dab in the middle of a giant road construction site on the highway. I go in to check in and the receptionist tells me that the card the office used failed. I give him my card to use and then ask if I could cancel if I got a room somewhere else and he told me sure. I call the hotel I wanted to go to in the first place and make a reservation and after a total of 60 miles travel I reach my hotel.

National Nursing Home Week 2016

5 fun filled days to dress up and enjoy good food and games. Nursing Home Week is always special for the residents and the staff. Our staff have 5 fun days planned with:

Monday miss match

Tuesday support your favorite team

Wild West Wednesday

Tropical Thursday

Fancy Friday

National Nurses Week 2016

I put these pictures up to share how nursing has grown over the years. I included my own picture to see if any of my staff would recognize it.

Best Practices

I want to share the top 10 best practices that I feel make a successful facility. I do not take credit for these and have learned many of them through working in many settings. I feel that if you implement these into your daily practices you will be successful and have good survey results.
1. walking team rounds
      a. include nursing manager, MDS, social services, activities and dietary
      b. review nurses notes, telephone orders, 24 hour report, check MAR's/TAR's for holes errors medication availability, labs, x rays, ADL documentation
2. guardian angel program with daily rounds
3. morning meeting with all department managers
4. all hands dining
5. weekend manager program
6. monthly open door meetings
7. routine mock survey utilizing specialty service such as ABAQIS
8. stop and watch program with all staff involved to identify resident condition changes early
9. quick responses to all concerns including resident, responsible party and staff
10. an effective ongoing staff education program
   

Pinterest Ideas For Long Term Care

        Follow Mary's board Nursing Home Ideas on Pinterest.   

Being Fired

I have to admit I was not sure if I would share these stories but I feel as a leader we are always faced with the possibility that our performance does not meet or match what a company may expect from us. First I want to share my encounters with being fired. Yes I am admitting it and hope that I learned and have grown from them. I was actually terminated twice in my 40 year career. They were about 20 years apart.

The first time that I was fired I was a director of nursing in a small nursing home. I had worked there for 3 years. The company I worked for had 5 facilities. During that time I had developed a good team and had good results for surveys. This was just as OBRA was coming into play. During this time I worked for 3 different administrators. I had  what I thought was a good relationship with the owners. I was actually sent to some of their other facilities. In 1 capacity I did the CPR training for our other facilities and I also covered as  the director of nursing. Shortly after the third administrator started he came to me and said something like I have evaluated your services and we are going to let you go. He asked if he could pull my car up and got me a box for my things. Being a small facility I had to go by everyone and told one of my nurses I was leaving and wouldn't be back. She looked at me and said stop pulling my leg. I told her I wasn't and then broke down and cried. I left quickly and quietly and never looked back. I never was quite sure what happened but after a bit of searching I found work as a part time supervisor in a larger facility with a larger company. I was always honest about what had happened.

The second time I was terminated was less than 2 years ago. I had been doing independent contract work for over 1 year and loved it. Unfortunately my husband developed colon cancer and I had to find work that offered insurance. I became the administrator in a larger facility with a large corporate organization. During my time there I had a complaint survey almost monthly related to a disgruntled resident. I had 4 different regional directors. Was sent to help with yet another problem facility to help with their follow up survey. My building was census challenged therefore financially challenged. The last regional I had brought on a great regional nurse as well. I really felt like we were going to finally start seeing improvement. I had to fire several nurses for poor performance during this time but felt we had finally started to turn the corner. During the last few weeks I was employed I worked 10-12 hours per day 5-7 days per week and was starting to feel beat down a bit.

I remember the night before I was fired I felt like I got a second wind and had written up a plan and assignments to go over with my team. When I arrived that morning I asked the corporate nurse if she minded if I met with my team alone and she told me no. I guess I should have figured something was up. I then did my morning meeting and talked about goals and assignments. Again I should have figured something was up they were too quiet. I don't think they all knew but obviously some did. After the meeting I had someone to see me. The regional said they needed to talk to me and I asked if it could wait till I met with the people waiting on me and they said yes.

I met with my guests and then invited the regionals into my office. The regional vice presidents gave me a piece of paper to read. This paper said that I had basically caused the facility to loose money and  failed to improve census and clear survey issues. I was told I could sign the paper or write up my resignation. They told me if I did that they would pay me my earned vacation days. Of course I wrote a resignation.

My parting was a little bit funny to me. They asked someone to get me a box for my stuff and they brought a giant box. I had driven my little car so loading it I knew was going to be a challenge. I stuffed everything in the box. The regional said he would carry it and did. I know it was super heavy and my car was so small. He managed to get it in the car after a little bit of a struggle.
Well that is how I ended up doing what I am now as a floating administrator and director of nursing for problem buildings.

Here is the irony for those 2 situations. The first building I was fired from became one of my facilities as a regional vice president and regional nurse. The second building I was fired from was where I was working when at that time a different company sent me to school to get my administrators license and paid 100% of my tuition. If I learned anything from this it was to never burn a bridge. I never did or will speak badly of either of those facilities. Every thing happens for a reason.

Hiring Pains

I have been working in health care for 40 years with 30 of it in long term care. Yes, I know I'm too young to have worked that long, but I have. Well hiring has always been a difficult process but over the last few years it has gotten even more difficult. First of all the competition between healthcare settings is ruthless. With the reduction in our reimbursement, increase in expenses being creative and innovative in our hiring practices has become difficult.

I was recently working at a staffing challenged facility and trying to come up with ways to attract staff and get shifts covered. Well we offered a pick up a shift bonus to begin with. Next we increased it on the weekends. Then we started a referral bonus and then a sign on bonus. Before long we had STNA's making manager wages. We finally got a few STNA's hired on and about $25000.00 per pay more due to the incentives we were still running over 8% OT.

Our next attempt at improving staffing was to offer to send people to the nurse aide classes and pay their tuition. We had a lot of people interested and paid for 4 to go and at the end of the program only managed to maintain 1 at a cost of over $2000.00.

As soon as we started to feel a little better our competitor offered increased wages and a sign on bonus. Our current staff that were tired of working extra shifts were talking about jumping ship for what they felt was a better offer.

This problem is not only limited to line staff I have seen changes in how professionals and licensed staff approach the work force. I recently was looking for a DON in a facility and received 5 resumes on an online advertising program. I narrowed them down to 3 candidates. I made calls to all 3 and had to leave messages. I  received a call from 1 and set up an interview. The other 2 did not call back and the 1 I set up an interview with did not show up or call. Another position I was filling the person had accepted the job and gave notice to their company and assured me they would not stay no matter what they offered. Less than a week before they were to start they called and said their old company gave them an offer they could not refuse. I have seen DON's walk off the job which was unheard of 10 years ago.

I would like to challenge people to tell me their opinion or ideas on getting and keeping staff.