
Enhancing Employment in Long Term Care:
A Guide to Retention

Chapter Four
Feeling In on Things
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.
Input on Care Decisions and Care Conferences
Suggestions:
- 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.
Input on Procedures
Suggestions:
- 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.
Input on Quality Improvement
Suggestions:
- 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.
Input on Committees
Suggestions:
- 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.
Input on Room Changes
Suggestions:
- 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.
Input on Departmental Planning
Suggestions:
- 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.
Input on Benefits
Suggestions:
- 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.
Case Management -- Seek Employee Ideas to Improve Care
Suggestions:
- 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.
Regular Meetings with the Administrator
Suggestions:
- 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.
Problem-Solving Meetings
Suggestions:
- Choose informal leader(s) to participate in problem-solving groups.
- Request, accept, and respond to employee input.
Provide Opportunity for Orientation Feedback
Suggestions:
- 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 and Accept Employee Prepared Articles in the Facility's Monthly Newsletter
Suggestions:
- 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.
Share-a-Gram
Suggestions:
- 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