Violence is any act, physical or verbal, aimed at a second party, which causes massive bodily or mental damage and/or harm. In a society aiming to uphold peace and harmony, such acts are unacceptable if not deplorable. Despite this, violence experienced in nursing homes is beyond any wild imagination. Staff members and certified nursing assistants in nursing homes have frequently yet silently been the subjects of violence for a long time. To say that it is understandable given the nature of their work is to be ignorant. The time to implement recommendations made by many researchers has surely come. Administrators, policy makers, and other stakeholders, therefore, have to use this opportunity to minimize, if not to eradicate all atrocities borne by staff members in nursing homes. Since experiences and information obtained from the Daughter of Miriams Nursing Home is reflective of the events occurring in other nursing homes nationwide, it is not wrong to assume that the suggestions put forward are revelatory. These suggestions will not only be a turning point to the Daughter of Miriams Nursing Home, but also to all other nursing homes aiming to increase staff's satisfaction and enhance its productivity.
The woes bedeviling nursing homes so far point at one crucial fall-out: working conditions of staff members of nursing homes and certified nursing assistants. Certified nursing assistants are the largest group of employees working in nursing homes. For that reason, research has demonstrated that they are a group of workers, who are most prone to abuse, both physical and verbal. Indeed, research has also demonstrated that they bear lion’s share of violence aimed at staff of nursing home. Nevertheless, violence in nursing homes is all-inclusive, and staff members together with residents are the likely victims. A number of suggestions aimed at bringing this vice under control have been made. The most outstanding and viable suggestion relates to the working environment in nursing homes. This is a broad area and it encompasses staff training, remuneration, quality and quantity of staff availed, and motivation among other factors.
Before getting approval to work in a nursing home, individuals are required to undergo training to meet job requirements at their workstations. These training demands set the basis for selection or rejection of applicants. In most instances, requirements about training level that is required for one to land a job in a nursing home are vague. If not vague, training more often than not focuses on basic skills such as feeding, bathing, and dressing residents. Training of staff should be a top priority and needs to be done comprehensively. It is a task that should be handled with sensitivity and seriousness. Apart from basic bathing, feeding, and dressing knowledge, staff members of nursing homes need to undergo extensive training that is specific to interpersonal and high quality care giving skills. Staff members need to be trained on what is otherwise known as "gentle persuasion". This involves development of exquisite skills that go a long way in equipping them with the right words and attitudes when dealing with residents. Improved interpersonal relations result in respect-dominated and harmonious coexistence not only between staff members and residents but also between the residents themselves. A resident, who feels accepted and appreciated is less likely to wreak havoc compared to one, who is ignored and abused. Improving technical know-how of the staff in care giving homes improves their productivity and productivity of the nursing home as a whole. A more productive workforce translates to satisfied and happy clientele. Clients of nursing homes are not just residents themselves, but also friends and family members of residents, who see the need of providing their loved ones with specialized and close attention.
Certified nursing assistants and the whole nursing home staff need to be trained on how to manage and cope with difficult residents. At times, staff residents can behave in a violent and aggressive manner. In their own way, they deal with internal dilemma, challenges, and moments of uncertainty. Most of them feel sorry, or even angry at themselves for not being able to perform simple tasks they earlier performed with ease. Loss of memory and inability to recall simple information does not make the situation any better for them. In a twist of events, they express this feeling of unworthiness through rage and acts and words of violence. With the knowledge of what is going through residents’ minds, staff members can regulate their reaction, taking precaution not to cause further anger bursts and episodes of violence in patients. With the increasing base of knowledge on what transpires in the minds of people with dementia, formidable training can be accorded to staff of nursing homes to keep them averse with the updates. Further, extensive research should be conducted, especially on topics such as the connection between dementia and acts of violence among patients. The research conducted can aid in shedding more light on the topics and making worthwhile discoveries, which can be significant in improving the lives of people with psychiatric disorders. With an improved knowledge base, the adequately trained staff will know what to do or not to do in case they are faced with a situation of a violent resident. This goes a long way in preventing altercation, which would subsequently degenerate to a violent episode.
Training staff members of nursing homes on conflict resolution is necessary. Even though residents commonly direct most of the violent acts and words at the staff of nursing homes it also remains true that some of the combative acts and acid words are aimed at their fellow residents. Moreover, staff members are often rude with residents. Violence in nursing homes is not always aimed at staff members, neither is it always aimed at residents. This brings to light the need to equip staff members with relevant skills on handling, managing, and quelling a potentially violent scenario before it unfolds. Staff members, more than any other party possess the ability to unlock an impasse, bearing in mind that resident’s mental condition may not always allow him or her to see the situation as logically, clearly, and concisely as staff members can. Enlightening staff members on when to stand their ground regarding an instruction given or when to lie low and avoid an argument with a resident is necessary. Staff members also need to be trained to anticipate violence and violent reactions. They have to know the best ways to avoid these situations before they occur. They need to be trained on how to control their own emotions and reactions by avoiding impulsive reactions and embracing wise, calculated moves aimed at making a deteriorating situation better.
Problem-solving skills are a key attribute, particularly in a setting where disagreements and altercations are likely to appear. This provides sufficient reason, other than for conflict resolution, why nursing home staff members need to be given comprehensive training in problem solving skills. In a way, these two factors go hand in hand. However, conflict resolution usually comes way after the problem has degenerated and culminated into something worse. Nevertheless, enlightening staff members on ways of nipping a problem in the bud before it explodes into a full-blown tragedy makes a big difference in its own way. Research has demonstrated that most cases of assault and violence occur during incidents of staff-resident contact. This interaction is inevitable and, therefore, only ways and means of limiting foreseeable problems can be devised. This can be seen by imparting skills on problem solving on staff members.
Lack of Mutual Understanding Between a Resident and a Staff Member
Research has shown that the most frequent cause of violence towards staff or by staff members in nursing homes is lack of mutual understanding between a resident and a staff member. If staff members lack adequate information on a resident, this most likely will cause friction in communication evoking resident’s irritable traits. Interpersonal association creates a different level of understanding between the resident and the staff member. It would, therefore, be beneficial for the resident, the staff member, and the nursing home as a whole if staff members were provided with in-depth and reliable information on resident’s mental condition and health status as well as on his or her likes and dislikes. For instance, it has been shown that people with dementia and Alzheimer’s disease are more predisposed to engaging in physical or verbal violence compared to other people. They are usually frustrated by their inability to perform simple tasks and to remember information they previously had on their fingertips. With this knowledge, staff members would be more careful around people with such mental problems. They can also keep such individuals in seclusion, especially after exhibiting tendencies of violence, not just to staff members but also to fellow residents.
Whenever an individual enters a nursing school, they never expect, let alone sign up for the kind of treatment that is sometimes accorded to them in nursing homes. Their objectives, goals, and expectations are usually different from the reality. Demands of the job coupled with being in a long-term care facility for a big part of their day comes with a lot of mental strain for some staff members. As a result, they are highly prone to suffering from bouts of depression and even stress. These stressful emotions may accumulate and influence the way staff members treat the residents. Unintentionally, they may experience frequent outbursts of anger and acts of violence towards the residents. In return, residents may retaliate. This creates a vicious cycle. To bring this situation under control, it is important to train staff members of nursing homes on stress reduction techniques. Their ability to efficiently and effectively manage stressful situations goes a long way not only in prevention of violence by residents, but also makes them appreciate their job more. This essentially increases job satisfaction, which is largely important for the productivity of staff members.
Screening of Staff Members
Screening of staff members is a crucial stage in hiring staff members of nursing homes. This step should neither be underestimated nor overlooked. This is so for the simple reason that staff members of nursing homes experience higher workplace violence than any worker in the nation. Sensitivity of the profession lies bare for all to see. Screening staff members before hiring assures an able, willing, and competent work force. Individuals’ history in terms of work ethics needs to be looked at carefully to ascertain that at no time in their careers did they engage in unethical or unacceptable behavior in the work place. They also need to be screened on their anger management skills, and any records of violence towards residents or any other person must be analyzed. People with previous anger management difficulties, especially in the outside world, are unlikely to be any different in a nursing home. If anything, they can only get worse. The interviewing panel also needs to find out individual’s drive for choosing the career. Only upon issuance of a convincing response should the person be shortlisted.
Based on the previous discussion, it has become apparent that people join the nursing profession for various reasons. Those who provide questionable reasons, such as monetary returns or family backing, should be filtered out. Such characters are more likely to contribute to stressful situations and even act unprofessionally in that event. Lastly, during the screening process, each person should be asked to give his or her opinion on elderly people and how they should be treated. An answer to this question may give the panel a clue about the kind of person it is dealing with. People who have a negative attitude towards the elderly are unlikely to thrive in a nursing home, bearing in mind that the elderly form a great portion of the population, if not all of it. Screening gives panelists a rough idea on the kind of person a candidate is. Even though it might not be thoroughly objective and comprehensive, it may go a long way in identifying possibly recommendable candidates. Employing staff with right attitudes and feelings goes a long way in avoiding common causes of fall-outs between administrators and staff members.
In a bid to improve working conditions of staff members, only adequate, qualified, and competent staff members should be hired. Inadequate workforce exerts a lot of pressure on the few available members of staff. This likely takes a toll on them, hindering their morale and efficiency in the process. Hiring unqualified staff can also lead to further problems. Dissatisfied customers are a frequent phenomenon. For the residents, there is a limited number of ways of expressing their dissatisfaction. One of these ways is violence. The number of cases of violence is, therefore, likely to rise dramatically. Aging and accompanying changes that come with it more often than not lead to deterioration of mental capacity of the subjects. Their actions on a number of occasions are out of control. Again, with an incompetent workforce, the staff will be more result-oriented than quality oriented. Quantitative and qualitative performance indicators include improvement of health and well-being of residents. However, with an incompetent staff, performing daily obligations is made a priority at the expense of residents’ well being.
One of the most crucial factors necessary for the progress of any institution or organization is communication. Likewise, the influence of communication is humongous in cutting down on violent acts aimed at staff members in nursing homes. Close communication between staff members and administrators as well as between staff members and residents is necessary. Staff members and administrators need to be constantly in touch to stay updated about any developments about residents. Valuable information can be exchanged through this way and later be used to improve service delivery to residents. If served well and in accordance to their expectations, it is highly unlikely that residents will act or react violently. In the same way, communication between staff members and residents is even more important. Research has shown that in their struggle to find their bearing, most residents need someone who shows a level of understanding towards them more than anything. Someone, who shows even a slight understanding of their predicament and goes the extra mile to win their hearts becomes an instant favorite. It is noteworthy that some violent residents do not just react to being placed in seclusion. It has been shown that residents will react in the same way in nursing homes as they do in the comfort of their homes. Therefore, it has little to do with vicinity and more with the treatment. Staff members in nursing homes, therefore, need to show a great level of commitment and try to find out what makes each resident tick and what does not. In this way staff members can solved a significant part of problems.
Improvement of Working Environment
Improvement of working environment should not only be done materially. Financially, staff members in nursing homes need to have their salaries raised to go hand in hand with work demands. According to research, staff members working their socks off yet earning peanuts at the end of the month are less likely to be satisfied with their job or loyal. This issue needs to be addressed immediately. In most cases, staff members, who feel that they overwork and yet are underpaid end up engaging in their own personal activities when they should be attending to residents. The frustration and lack of recognition by various authorities push them into oblivion. Repercussions are untended residents, who have few avenues of venting out their anger or letting their frustration be known. Hitting, grabbing, pinching, pulling, shoving, scratching, biting, and spitting just to name a few are their ways of making sure that their message gets home. An improved remuneration package in order to uphold wage parity will make staff members in nursing homes feel appreciated. As a result, they will embrace their jobs with a lot of zeal and zest. A fully functional team that is efficient in its undertakings is more likely to satisfy a customer, in essence reducing tantrums that would otherwise be thrown by displeased clients.
Other than giving staff member monetary incentives, they can also be offered mobility in terms of position. It is the expectation of every professional to get promoted after performing exemplary work. The case is by no means different in the case of certified nursing assistants and other staff members in nursing homes. Promoting employees shows them that their hard work has gone neither unnoticed nor unrewarded. It boosts the morale of the staff and motivates them in a pleasant way. This motivation and boost of morale result in improved performance, which in its turn results in fewer or no violent cases at all in the nursing home.
Recognition, understanding, and appreciation of difficulties that certified nursing assistants and other staff members face in nursing homes goes a long way in improving their productivity. Recognition and appreciation should be showed to them on the regular basis and may involve simple gestures such as throwing a party. These acts are simple gestures but the impression they leave on the staff is magnificent. This way, the nursing home ends up with happier and more satisfied workforce ready to go out of its way to ensure that residents are well served. As it goes, an efficiently served resident usually has few reasons to be violent.