Enhancing Employment in Long Term Care:
A Guide to Retention

Chapter Four

The Big Picture
Suggestions:

• Educate employees regarding the big picture of your organization and show how they make a difference in the big picture.
  
• Share your mission statement and your strategic plans.
  
• Provide customer service training.
  
• Explain "marketing" and the public image of your facility; discuss what is involved and the role of each employee.
  

• Allow any employee assigned to a permanent group to give input to managers.
  
• Encourage nurses to request CNA input for all care plan and MDS updates.
  
• Ask CNAs to keep the ADL care plan updated.
  
• Seek employee input for behavior management.
  
• Seek employee input for feeding problems.
  
• Invite and encourage employees to attend care conferences.
  
• Ask employees to participate in family care plan review.
  
• Utilize the knowledge of employees who are "experts" in providing specific cares.
  

• Request and accept employee input for procedure changes.
  
• Provide the format for CNAs to write the initial procedure and have the nurse fine-tune it, e.g., new bed, lift, etc.
  

• Include employees at all levels on CQI teams for issues such as retention, orientation, staffing policies, documentation tools, and shift routines.
  
• Put a suggestion box on each unit and ask employees to share their ideas and concerns prior to a scheduled meeting. These can become agenda topics for the meeting.
  
• Ask for employee assistance on a problem you need to solve.
  
• Ask employees to share the problems they encounter in providing care.
  
• Ask employees to share the problems residents bring to their attention.
  
• Ask for employee input on equipment or product purchases.
  
• Invite employees at all levels to attend monthly staff meetings.
  

• Invite employees at all levels to serve on committees that deal with topics such as quality assurance, infection control, ethics, and dining room.
  
• Provide the time employees need to attend meetings.
  
• Report committee happenings to all employees.
  
• Provide a vehicle for employee concerns to be shared at meetings.
  
• Encourage employees to participate on committees that focus on internal functions, e.g., recognition, dinner, picnics, etc.
  
• Encourage employees to report on committee functions at monthly staff meetings.
  

• Keep a running list of employee suggestions for roommate possibilities.
  
• Encourage employees to share roommate conflicts.
  
• Keep employees informed of your rationale for room changes.
  
• Teach employees all factors involved in roommate choices.
  

• Create an employee  task force to assist in goal planning for their own department.
  
• Encourage your employees to develop their own goals.
  
• Ask for employees' involvement and opinions on equipment purchases.
  
• Have the employees evaluate products or types of products.
  
• Ask employees for their input on staff allocation or assignments.
  

• Request and respond to employee concerns regarding benefits.
  
• Offer options and allow employees to select which benefits they prefer individually given available dollars.
  
• Periodically ask staff to evaluate the benefit package; make adjustments accordingly.
  
• Ask employees for their input on employment ads.
  

• Help employees develop their communication skills.
  
• Ask employees open-ended questions to encourage their sharing of ideas.
  
• Communicate directly with employees regarding care, activities, and personal needs.
  
• Give employees' ideas serious consideration and respect.
  
• When an employee asks you a question and the answer is not at hand, be sure to get back to the inquirer with an answer at a later date.
  
• Educate employees about specific resident population needs.
  
• Assign CNAs to a specific group and to a specific licensed case manager.
  

• Schedule regular meetings between the administrator and employees at all levels to discuss corporate information or to share feedback.
  
• The administrator should schedule informational luncheon meetings with departmental staff.
  
• The administrator should schedule an employee newsletter to share corporate news or plans that affect employees.
  

• Choose informal leader(s) to participate in problem-solving groups.
  
• Request, accept, and respond to employee input.
  

• Have orientation be a goal based orientation and individualize it to meet the assessed needs of the orientee.
  
• Have employees involved with the staff developer in planning in-services.
  
• Host participatory meetings with hand-on involvement -- "be creative."
  
• Conclude each orientation session with an evaluation form or interview.
  
• Ask experienced employees to serve as mentors and as personal advocates for newly hired employees.
  
• Include the mentor in the new employee evaluation process.
  
• Develop a support team for mentors. Also develop a support team for new orientees.
  
• Allow the orientee to evaluate the preceptor or mentor at the end of the orientation.
  
• Create a CQI team out of the preceptors for evaluation and on-going improvement of the orientation process.
  
• Encourage employees to share positive and negative feedback about the orientation process.
  
• Have the administrator meet informally with the employees after the orientation.
  
• Schedule weekly meetings with the orientee during the first three months to provide feedback.
  

• Encourage employees to author or co-author articles.
  
• Encourage employees to write articles regarding positive employee/long term care experiences.
  
• When you come across an article pertaining to employees, share it with your employees.
  

• Provide and nurture a vehicle for sharing information and feedback.
  
• Include sharing of employee personal accomplishments in your share-a-gram.
  
• Share employee compliments as well as resident and family compliments.
  

Preface
Chapter One: Good Wages and Working Conditions
Chapter Two: Scheduling Options
Chapter Three: Recognition
Chapter Five: Fringe Benefits and Other Incentives
Chapter Six: Growth and Opportunities
Additional Resources

WAHSA 204 South Hamilton Street Madison, WI 53703
Telephone: (608)255-7060 FAX:(608)255-7064