Supporting Good Interpersonal Skills in the Workplace evidence-based solutions

1. Supporting Good Interpersonal Skills in the Workplaceevidence-based solutions Case Example: Partners in Caregiving -Building bridges between families and staff in long-term care

2. Interpersonal Relations • Interpersonal problems are among the highest sources of work stress • Unmanaged stress leads to depression, burnout, physical stress-related illness • Interpersonal relations for nh staff: coworkers, supervisors, residents, families

3. Support at Work • Examples of support: tangible help with work tasks, advise, response to ideas, recognition for good work, respect for job done • Support comes from co-workers, supervisors, residents, families • Supervisor is most important source of support: gives assignments, evaluates, decides rewards/discipline • Support increases self-confidence and feelings of security

4. Reasons for CNA turnover • 3 of the most important reasons for leaving cited by CNAs: • perceived lack of respect • being left out of decision-making • not being treated as professionals • All Interpersonal Issues! • come from Supervisors and Families

5. Research on Partnerships Ecological Approach: Bronfenbrenner Cooperative Communication: Dean Elder Abuse and Families: Pillemer

6. Foundation for Partnership • Common Vision • Empathy • Mutual Respect

7. Obstacles for Family/Staff Relations in Nursing Homes • different perspectives of priority tasks • barriers to communication • time pressure on staff • family fear of retaliation • ethnicity and social class differences • negative stereotypes of the other group • lack of empathy

8. What are Families Experiencing? What have you noticed?

9. Evidence-Based Solution Partners in Caregiving: Cooperative Communication Between Families and Nursing Homes

10. Program Evaluation of PIC • Randomized, controlled intervention study in 20 nursing homes in New York state • 10 treatment units and ten control units within 10 facilities • 10 purely control facilities • Interviews with 932 family members and 655 staff

11. Findings of PIC study • Family members perceived greater empathy on the part of staff, staff viewed family members behavior toward them as more positive • Staff members in treatment improved feelings toward job and indicated less likelihood of quitting • Decreased reports of conflict among family members of residents with dementia

12. Subjective evaluations of study participants • 98% reported that they could relate training material to their own experiences • 92% rated program as excellent to good • 96% reported that they would recommend the program to their peers

13. PIC Program Design • Two parallel 6-hour workshop series (one for family/one for staff) • Joint session for families, staff, administration

14. Systematic Approach to Cooperative Communication Skills • Advanced Listening • Respectful communication • Handling Blame, Criticism, and Conflict • Techniques are general and apply to staff/staff communication as well as staff/family communication

15. Listening: Communication Helpers Door openers: Invitations to talk, letting the other decide whether or not to proceed. (“Want to talk about it?” “You look sad. Is something bothering you?”)

16. Listening: Communication Helpers (cont’d) Encouragers: (“I’d like to hear more about your family’s concerns.”)

17. Listening: Communication Helpers (cont’d) Open Questions (“What do you hope your mother will gain from her care?”)

18. Listening: Avoid Communication Blockers Blaming “Always” and “Never”   Name-calling Labeling   Giving unasked-for advice Moralizing   Giving orders or threatening   Excessive questioning Diverting or avoiding the other’s concern

19. Listening: Feedback Factual   Emotional Solution focused: focusing on resources and solutions  

20. Respectful Communication:“I message” When __________ happens, I feel __________, because __________, I would like __________ to happen.

21. Communication for difficult situations • Conflict prevention • Conflict management

22. Handling Blame, Criticism, and Conflict 1. Encourage the other person to describe the compliant fully. Use door openers, encouragers, and open questions.

23. Handling Blame, Criticism, and Conflict (cont’d) 2. Let the other person know you understand their complaint. Use the appropriate type of feedback-emotional, factual, or solution focused. Don’t defend yourself or retaliate with your own complaints.

24. Handling Blame, Criticism, and Conflict (cont’d) 3. Affirm something you admire in the person. It’s best if there is something that can help in the situation.

25. Handling Blame, Criticism, and Conflict (cont’d) 4. Look for the need behind the problem.

26. Handling Blame, Criticism, and Conflict (cont’d) 5. Together, come up with a list of possible solutions.

27. Handling Blame, Criticism, and Conflict (cont’d) 6. Together, choose one that meets both of your needs.

28. Handling Blame, Criticism, and Conflict (cont’d) 7. Agree on a specific period of time to try out the solution.

29. Handling Specific Situations:Family Expectations Awareness of family’s current reality (denial, lack of knowledge, etc.) Facilitate continuous learning Be compassionate Be aware of cultural differences

30. Handling Specific Situations:Inter-family Dynamics Remember that families are experiencing a mixture of intense and sometimes contradictory feelings.

31. Handling Specific Situations:Inter-family Dynamics (cont’d)  Families often revisit emotional issues from the past during this period.

32. Handling Specific Situations:Inter-family Dynamics (cont’d)  Stay out of family controversies. Family members may disagree and it is important to remain neutral and not take sides. Don’t get caught in the middle!

33. Related Programs • Partners in Caregiving in the Special Care Environment • PIC adapted for the Special Dementia Care Unit population • Caring Communication: Cooperative Communication at the End of Life

34. Conclusion Putting it into practice You are the co-creator of where to go from here!