Early in 2020, the long term care world suddenly faced its greatest crisis ever—COVID-19. This crisis quickly changed everything about the way day-to-day activities, care, and business took place in a dramatic fashion.
In the blink of an eye, residents lost traditional group meals and activities and those critical family visits. Now they had “drive-by visits” or “outside the window” visits instead of a good-quality, face-to-face meeting, one that could begin and end with a hug. The one thing that residents now need to be able to count on is the team of caregivers watching over them.
While others were fleeing in panic at the start of the COVID crisis, these heroes got up every day, left their families, and walked into a facility to take care of residents in need. They knew the dangers, including the potential to take the virus home to their own family members. But these caregivers were dedicated, so they got up, geared up, and headed in to work.
So, how does an organization take care of those heroes who, in turn provide quality care for the residents? Here are four suggestions for leadership and team building during times of crisis.
1. Structure of the Leadership Team
Build a versatile, talented, and dedicated leadership team. Leaders are not people who can do everything. But the good ones put together a versatile team that can pretty much do everything. Start by avoiding “yes” folks—those who always agree with the leader. Especially during times of crisis, multiple thoughts are needed; having the traditional “devil’s advocate” onboard is key. Multiple ideas (and plans) must be available to survive in this ever-changing environment. A variety of talents is critical. The detailed planner—the spreadsheet guru, has a place beside the one who “can make just about anything happen in five minutes.”
Leaders all have a variety of talents; one must carefully build a team that has all the traits needed for success. So, the perfect team has the planner and the “make it up on the fly champion,” the driver and the thinker, the creator and the calculator, all making up a complete set of very necessary talents. If one is missing, see section #3 below.
Finally, but most importantly, leaders must leave all their troubles at the door. Nothing should come from a leader as she or he circles the building but positive energy. Negativity will only find its way to the staff and, ultimately, to the residents.
2. Spirit of the Leadership Team
Some organizations thrive on competition. In certain ways, under the correct circumstances, it can help drive results and be a positive motivator. But during times of crisis, it has no place.
Under the COVID crisis, regional directors have needed to cover the building needing their help the most, not ones in their traditional region. Nursing consultants need to go wherever they are needed. This means pushing a med cart on a Saturday night on the COVID hot unit in scrubs, not sitting in a conference room offering advice.
Remember those heroes? They need someone to look up to. It is easy to look up to someone who is fighting beside them to provide quality care.
Tough times do not last, but tough people do. Find those tough, hardworking leaders and promote them. During crisis, teams find out who will rise up and lead. Unfortunately, those who cannot be counted on also become apparent. The team judges what an organization values by who gets promoted. The consultant who puts a resident on a commode is a leader, the one sitting in the conference room, not so much.
3. Reinforcements for the Leadership Team
Reinforcements may be the most important point. It is certainly the one that most organizations fail to accomplish. The current crisis has taxed every health care organization. There are those leaders who worked 16-hour shifts in a hot COVID building for 10 straight days. They are exhausted, and the best of them will keep going, keep serving, until they fall over if something isn’t done. So how and where does one find the second wave of help?
In every facility there are folks wanting to be recognized, wanting to grow. To this point, fate has not presented them with an opportunity; the time for that opportunity is now. The administrator, or director of nursing (DON), or regional director find themselves out of options.
But, right in front of them is someone praying for the chance to show what they can do. Give them a piece of this problem. The results are often a pleasant surprise. It could be the nurse who always wanted the chance to run a unit, or always wanted to be an assistant DON. It could be the administrator-in-training who jumps in the car and travels to a hot COVID building to help the team survive a crisis.
Those are the moments that help teach and grow leaders better than any other experience. Certified nurse assistants (CNAs) become lead CNAs, supply clerks with a talent for organization rise up and keep day-to-day critical schedules working.
During the time of COVID, an entire group of nurses has taken on the Infection Control mantle and (where empowered) led teams through crisis. Potential DONs with one organization are found through an internal DONUT (director of nursing under training) program. This training work can include special assignments, projects, or critical leadership in a COVID-active building. All of them are leaders waiting for a chance to shine.
Another often ignored factor is cross training. In one hot COVID building the dietary manager, assistant manager, and several other team members were suddenly out of work after testing positive for COVID. Without cross training of department heads, this entire department could have been shut down. This training is not a chore to do—in fact folks enjoy learning new things. Afterward, as an additional benefit, the department heads have more understanding and respect for each other.
4. Care for the Team That Cares for the Residents
With all of this in place, it is time for the leaders to lead. It begins, as already mentioned, with positive energy. That is followed with C.A.R.E.—Communication, Appreciation, Respect, and Empowerment. During times of crisis, communication with the team (and families) is critical. Don’t wait—give information as soon as possible—that helps avoid harmful rumors.
The team needs to be appreciated: with leaders working on the front lines, a daily “thank you,” and food. With limited places to eat and the desire to keep staff in the building, providing food is important. It doesn’t all have to be facility food; outside restaurants and other companies also want to help during times of crisis, and they will often provide staff meals.
Respect is shown by providing help with stress, listening to staff members’ ideas, and giving them a chance to grow. No one is in a better position to see the best way through a problem than the folks working on the front line.
Leaders (and their family members) can also take the free, eight-hour online Temporary Nurse Aide training course offered by the American Health Care Association/National Center for Assisted Living during the COVID crisis to be in a position to really offer a helping hand.
Finally, empower the team to help the residents with their quality of life. Have every staff member be a part of resident activities. Free up every one of them for just 15 minutes a day to go do something special for a resident. Trust them (by relaxing cell phone rules) to use their phones to help a lonely resident FaceTime with a family member.
One leader alone has little chance of surviving a crisis. But a well-led, balanced team can help an organization pull through these challenging times.
Greg Dowdy is the chief operating officer for American HealthCare, which has 18 facilities in Virginia. He has been in long term care for 38 years, in which time he may have accidently learned a thing or two. He can be reached at gdowdy@ahc.cc. View Dowdy’s Provider LED Talk posted on YouTube.