| AHCA Documentary Wins Capital Emmy Award | <p style="text-align:center;"><img src="/Breaking-News/PublishingImages/2022/emmy2.jpg" class="ms-rtePosition-4" alt="" style="margin:5px;width:500px;height:240px;" /><br></p><p><br></p><p>The American Health Care Association (AHCA) documentary, <a href="https://www.youtube.com/watch?v=KtK_RIIyMpA" target="_blank">“Closed Doors, Open Hearts: Nursing Homes and COVID-19,”</a> received a National Capital Chesapeake Bay Chapter (Capital) Emmy Award Saturday evening in the <a href="https://www.capitalemmys.tv/post/capital-emmys-documentary-cultural-topical?fbclid=IwAR2tbw_erLDKnE4G89snUKO14vJ0ho9vtPjrh82J0MCvAFOpilT4A0EfVJo" target="_blank">Documentary – Cultural/Topical</a> category.  </p><p>The documentary, which was up against three other nominees, features two nursing homes on opposite sides of the country and their struggles and perseverance at the height of the COVID-19 pandemic. It highlights the heroic caregivers who continued to serve through the most challenging times. It also provides a glimpse into what has really happened inside nursing homes since early 2020 and why it is so important to continue supporting these vital providers’ ongoing efforts to keep residents safe and healthy. </p><p>The <a href="https://www.capitalemmys.tv/" target="_blank">Capital Emmy Chapter</a> is one of 19 regional chapters that make up The National Academy of Television Arts & Sciences. It is a non-profit, professional organization serving the Maryland, Virginia, and Washington, DC television and media community. The organization’s foundation is The Emmy® Award, the TV industry’s gold-standard for the recognition of television excellence. </p><p>“It is an honor merely to be nominated, but to win is truly special,” said AHCA President & CEO Mark Parkinson. “Nursing homes have been at the epicenter of the COVID-19 pandemic since the very beginning, and these providers have gone above and beyond to protect this highly vulnerable population. Thank you for allowing us to share their important story and for recognizing the hard work and passion that went into making this film. It is dedicated to everyone in long term care – staff, residents, families, and those who support them.” </p><p>The Capital Emmy is the next in a number of awards AHCA’s 26-minute film has received this year. It recently received Telly Awards in three categories: <a href="https://www.tellyawards.com/winners/2022/social-video/general-documentary/closed-doors-open-hearts-nursing-homes-and-covid-19/273696" target="_blank">Gold recognition</a> in Social Video/General Documentary, Silver <a href="https://www.tellyawards.com/winners/2022/peoples-telly/general-social-video/closed-doors-open-hearts-nursing-homes-and-covid-19/263922/" target="_blank">recognition</a> in the People’s Telly Award/General-Social Video, and Silver <a href="https://www.tellyawards.com/winners/2022/non-broadcast/general-documentary-individual/closed-doors-open-hearts-nursing-homes-and-covid-19/270584/" target="_blank">recognition</a> in General Documentary – Individual. The Telly Awards are premier awards honoring video and television across all screens. The documentary was also recognized with a Silver <a href="https://www.healthawards.com/dha/winnerss2022/dha_s2022_winners.pdf" target="_blank" title="https://www.healthawards.com/dha/winnerss2022/dha_s2022_winners.pdf">Digital Health Award</a> earlier this month.  </p> | 2022-06-27T04:00:00Z | <img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/emmy.jpg" style="BORDER:0px solid;" /> | Caregiving;Quality | AHCA Staff | Accolades continue for the Association’s short film focused on nursing homes during the COVID-19 pandemic. |
| Supporting Caregivers’ Emotional Needs to Avoid Burnout | <p>Imagine walking into a health care facility and finding there were no housekeepers, nurses, physical and occupational therapists, recreation, dietary, social workers and nutritionists onsite? Imagine if residents were left to fend for themselves in the absence of these valuable and often forgotten heroes? Despite the setbacks of the past few years, health care heroes continue to not only make themselves available to our most vulnerable population, but also strive to go above and beyond. They continue to provide optimum care even when they themselves, or their loved ones, may need this same care. </p><p>Think about the fallen heroes that died on the frontline caring for our most vulnerable population during the pandemic. Think about those that continue to put on their game faces every day to go out and give the best of themselves to the elderly, veterans, children, and anyone in need at our health care institutions. Yet who provides the caregivers with what they need to continue giving? <br></p><p>We hear about the efforts to locate staff to cover various shifts, but we seldom hear about locating services to cover the physical and emotional needs of current caregivers. Some have physically recovered from COVID, but never had the opportunity to explore resources for psychological support. Some have experienced the loss of their loved ones and didn’t have the opportunity for a traditional burial and therefore lack closure.</p><h3>When Caregivers Need Support</h3><p>Recognizing when to reach out for support is important and is often missed by caregivers as they are often the beacons of support for others. According to the National Alliance on Mental Health (NAMI), one needs to check in with themselves frequently and reach out for support if experiencing symptoms of depressed emotions and/or burnout. These symptoms include irritability or anger, anxiety, depression, loneliness, sleep deprivation, new or worsened substance abuse, fatigue, and finding it difficult to empathize with others. <br></p><p>Jeff Grzybowski, Director of Rehabilitation at Boro Park Center, a 505-bed skilled nursing facility in Brooklyn, New York, took the initiative to recognize four to five therapy staff employees during his weekly team meetings. He uses the designation “hero” when recognizing these individuals for their outstanding work. <br></p><p>“I felt that I needed to come up with ways to at least lessen, or hopefully remove, that feeling of burnout and to inject that second wind, if you will,” said Grzybowski. “As a result, several people on my team became motivated to pay it forward and made efforts to help those around them as well.”</p><p>Grzybowski’s efforts showed gratitude and awareness of staff efforts and this led to further acts of support. Staff were bringing in donuts, checking in with other therapists, and reaching out to other department employees and their supervisors to ask, “How are you doing?” and offering words of encouragement. <br></p><p>Jocelyn Nackley, Director of Rehabilitation at Onondaga Center, an 80-bed skilled nursing facility in Syracuse, New York, also praises her staff members during her internal weekly team meetings and publicly when she works alongside her team on the unit. </p><p>“Rehabilitation directors are treating this growing and common situation throughout nursing facilities,” said Nackley. “My team particularly enjoys it when I bring in their favorite foods from local lunch and coffee chains. It brightens their day and helps them go the extra mile. They love their patients but we’re no use for them if we cannot get past that burned out feeling.”</p><h3>Going Further</h3><p>Bringing in food and expressing gratitude is a start in the right direction, but it’s certainly not the entire answer. It shows that leadership is paying attention. It is a focus on helping ourselves so that we can better treat the residents and their loved ones.</p><p>Several free services are available to assist caregivers including <a href="https://www.covidmentalhealthsupport.org/" target="_blank">COVID Mental Health Support</a> from the Pandemic Crisis Services Response Coalition. The <a href="https://emotionalppe.org/" target="_blank">Emotional PPE Project</a> is another support service that connects heath care professionals with licensed mental health professionals who can help. This service is free and does not require insurance. NAMI can also be contacted directly to access confidential professional support. In addition to these, there are other numerous support services available for health care professionals with both local and nationwide access.</p><h3>Self-Care Suggestions</h3><p>In addition to professional support, leadership should encourage caregivers to use self-care as another strategy to combat burnout. Ideas for self-care include:<br></p><ul><li>Humor can be used to cope. Seek out the things that make you laugh. Laughter is the best medicine.</li><li>Recognize you are vital and are critically important in the fight against the pandemic. You are doing the best you can with what’s available.</li><li>Sleep is important and one of the best ways to rejuvenate. Try to get at least 7 hours of sleep daily.</li><li>Eat to provide fuel to your body. Ensure you eat as balance of a diet as possible. Adequate hydration is essential as well.</li><li>Meditate to relax, reduce anxiety, and manage stress. There are online classes and apps available.</li><li>Exercise is hugely beneficial. Walking increases circulation and endurance and can be a great way to escape from the everyday. Simple muscle stretching and coordinated breathing techniques add to the benefits of exercise. You don’t have to join a gym to get going as many activities are available free of charge. </li><li>Reach out to family, friends, and coworkers for support. Don’t go at it alone—talk to others for support. Many facilities also offer more formal support programs that can be helpful. </li><li>Stay positive. Healing improves when the mind is relaxed and in a positive state. Try to see the positive in others and yourself. Provide positive reinforcements to others every chance you get. </li><li>Connect with your spirituality. Ask yourself how you are feeling each day. Ensure you listen to the voice within and act in ways to support it. Calming environments and music may aid this journey. Learn to appreciate what you have and be thankful to yourself and others that helped along the way</li><li>Take a trip. Travel to a place you want to explore. This can be anywhere from the new restaurant down the street to another state or even international travel. This helps you to focus and reflect as you explore other worlds outside your own.</li><li>Love yourself and others. Find ways to remember the good you’ve done and show compassion to others.</li></ul><p>The pandemic stressed health care providers to their limits. Now it is time for leaders to provide additional support to these caregivers in order to avoid burnout. <br><br><em>Dexter Vickerie, RN-BC, MSN, RAC-CT, is Corporate Director of Quality/Clinical Compliance and Risk Management at Centers Health Care.</em></p> | 2022-06-01T04:00:00Z | <img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/DexterVickerie.jpg" style="BORDER:0px solid;" /> | Caregiving | Dexter Vickerie, RN-BC | health care heroes continue to not only make themselves available to our most vulnerable population, but also strive to go above and beyond. |
| Retaining the Newly Licensed Nurse | <p>While skilled nursing facilities (SNFs) have confronted a nursing shortage for many years, record attrition during the COVID-19 pandemic has intensified the problem. One solution has been to hire newly licensed nurses and quickly assign them responsibility for patient care. However, to retain these nurses, it’s important that SNFs understand reasons newly licensed nurses might hesitate about a career in geriatrics, address the struggles they face as new nurses in a SNF setting, and implement tactics to meet their unique needs.</p><h3>Attrition of Newly Graduated Nurses from SNFs</h3><p>The transition from student nurse to newly licensed nurse is a vulnerable time. A study Kovner and colleagues conducted found that more than 17 percent of newly licensed registered nurses (RNs) leave their first nursing job within one year, and 33 percent leave within two years. Furthermore, Press Ganey reports that newly licensed nurses are at highest risk of attrition. <br></p><p>One reason newly licensed nurses are so vulnerable to attrition in the SNF setting is the accelerated transition from student nurse to one who is expected to provide care for multiple residents—and to do so with significant autonomy. In acute care, a newly licensed nurse works closely beside other nurses and often has a dedicated mentor. In the SNF setting, newly licensed RNs might be the only one working at that time of day, or LPNs might find that peers are working in other areas of the SNF and not easily accessible to them. <br></p><p>This sudden shift in expectations, with limited access to experienced nurses, does not provide the support their level of practice necessitates and can reinforce feelings of insecurity and uncertainty. Newly licensed nurses have some clinical knowledge but need guidance to prioritize care effectively and understand what assessment findings mean in relation to potential impact on the resident. Whitmore and colleagues found that when newly licensed nurses feel isolated and struggle to meet the expectations placed on them, a sense of disappointment in self, the SNF, and even in the profession can erase enthusiasm and passion, eventually leading to the decision to quit or to leave nursing altogether.<br></p><p>Furthermore, newly licensed nurses who experience stigma for working in a SNF may second-guess their career choice and seek employment in another setting where they believe they will be perceived more favorably. Manchha and colleagues identified three overarching themes influencing the stigma against nurses and other caregivers specializing in geriatrics:<br></p><ul><li><strong>Unfavorable characterization of geriatric nurses.</strong> Unfounded beliefs posit that geriatric nurses lack the ability to work in other health care settings and that unethical behavior is a common trait (e.g., geriatric nurses are lazy or aren’t smart enough to work in the hospital). <br></li></ul><ul><li><strong>Elder care is of lower societal value</strong>. Because society does not value care as highly as a cure and does not believe caring for the geriatric population requires a high level of skill, those engaged in providing care are perceived to have lower professional status (i.e., because geriatric nurses don’t provide a service that results in a cure or other highly valued outcome, their work is perceived as less important). In addition to the faulty assumption that care doesn’t require skill to provide, there is also the belief that the work itself is dirty, with frequent references made to the provision of incontinence care. <br></li></ul><ul><li><strong>Negative emotional connotations associated with elder care.</strong> Society negatively perceives that the care environment for elderly people is sad, depressing, and boring.<br></li></ul><p>Stigmas against geriatric nurses are perpetuated not only by society in general, but also by other health care professionals who may lack respect for geriatric nursing and undermine the choice to work in a SNF. Newly licensed nurses are often advised to avoid employment in a SNF so they don’t lose skills or to seek employment where they can make a difference and learn more technical nursing skills. This can create serious reservations about continuing SNF employment, especially if they feel insecure or disappointed in their abilities. Other opportunities may entice them if they believe their service will be perceived as important and if they will receive more support to develop their skills. <br></p><p>People typically become nurses because they want to serve others. Some even describe caring for others as a higher calling. A deeply felt drive and passion to help others and provide excellent care is a tremendous motivating factor for a nurse. However, the SNF workload often requires completion of a high volume of tasks in addition to managing certified nurse aides. Because newly licensed nurses are learning how to prioritize care and develop their clinical skills, they may struggle with the demands of the workload, with providing the level of care they want to, and with successfully managing others. Whitmore and colleagues found that when newly licensed nurses perceived misalignment in what they hoped to accomplish and what they spent time doing, discouragement replaced feelings of optimism about making a difference, leading to the decision to quit. </p><h3>Three Tactics to Retain the Newly Licensed Nurse</h3><p>To combat these challenges and retain newly licensed nurses, SNFs should implement the following tactics. <br></p><p><strong>1.</strong> <strong>Implement a formalized orientation and mentorship program tailored to newly licensed nurses and further customized to individuals’ needs and goals</strong>. To address needs unique to newly licensed nurses, the program should utilize expert nurses who can help new nurses transition into their roles and expand their abilities as they do so. <br></p><p>The program should include a professional development plan that reflects the importance of a geriatrics specialization. Geriatric nursing is a specialty, just like pediatrics or emergency nursing, and requires a tremendous skillset to care for very vulnerable and medically complex people. A plan that reinforces the specialized geriatric skills the newly licensed nurse will gain, and how the SNF will provide opportunities to develop those skills, combats the stigma that geriatric nursing doesn’t require a high skill level and communicates that SNF leaders value their employees and will invest in their ongoing development.<br></p><p><strong>2. Facilitate collegial relationships between newly licensed and other nurses, encouraging camaraderie but also facilitating knowledge-sharing.</strong><strong> </strong>This helps newly licensed nurses feel connected to a team, curbs feelings of isolation, and helps them learn from others. It also combats negative perceptions because they are part of a group that has a shared passion for geriatric nursing. <br></p><p><strong>3. Have a plan of support in anticipation that newly licensed nurses will feel overwhelmed and possibly discouraged.</strong> Given the shortage, SNF leaders must explore how to best utilize nurses, but when possible, reduce the workload for newly licensed nurses by limiting or assisting with certain tasks. Frequent check-ins to ascertain how new employees are doing and what they need is critical to communicating support and enables management to detect and intervene if the intention to quit emerges. <br><br><em>Alexis Roam, MSN, RN-BC, DNS-CT, QCP, is a curriculum development specialist for the American Association of Post-Acute Care Nursing (AAPACN). Roam can be reached at <a href="mailto:aroam@aapacn.org" target="_blank">aroam@aapacn.org</a>.</em></p> | 2022-06-01T04:00:00Z | <img alt="" src="/Monthly-Issue/2022/JuneJuly/PublishingImages/060722_caregiving.jpg" style="BORDER:0px solid;" /> | Caregiving;Workforce | Alexis Roam, RN-BC | While SNFs have confronted a nursing shortage for many years, record attrition during the COVID-19 pandemic has intensified the problem. |
| A View from the Field | <p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/MatthewBarrett.jpg" alt="Matthew Barrett" class="ms-rtePosition-1" style="margin:5px;width:125px;height:143px;" /><span class="ms-rteThemeForeColor-5-4">“COVID-19 relief dollars provided by both federal and state government have been nothing short of a lifeline for our Connecticut nursing homes hit hard by the pandemic and now on a pathway toward recovery, but a longer bridge or recovery period of support to the other side of the pandemic is needed beyond what was initially forecasted. Occupancy recovery is now the main issue in the elongated pandemic, and how staffing shortages are hindering occupancy recovery is the same issue at both the federal and state level.”</span><br><span class="ms-rteFontSize-1">—Matthew V. Barrett, J.D., M.P.A., President and CEO, Connecticut Association of Health Care Facilities and Connecticut Center for Assisted Living</span></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/RobertVandeMerwe.jpg" class="ms-rtePosition-2" alt="Robert Vande Merwe" style="margin:5px;width:125px;height:125px;" /><span class="ms-rteThemeForeColor-9-4">“I believe the greatest challenge both in Idaho and nationally is the workforce crisis. We always knew that there would not be enough workers to support the Baby Boomers after 2030, but the pandemic has brought that crisis eight years earlier as millions have left the workforce.”</span><span class="ms-rteFontSize-1"><br></span></p><p style="text-align:right;"><span class="ms-rteFontSize-1">—Robert Vande Merwe, Executive Director, Idaho Health Care Association</span></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/BrendanWilliams.jpg" alt="Brendan Williams" class="ms-rtePosition-1" style="margin:5px;width:125px;height:143px;" /><span class="ms-rteThemeForeColor-7-4">“The predations of national staffing agencies threaten to destroy long term care in New Hampshire and nationally. Having a staffing agency in your building is like inviting in a vampire.”</span><br></p><p><span class="ms-rteFontSize-1"> —Brendan W. Williams, M.A., J.D., President and CEO, New Hampshire Health Care Association</span></p><p><br></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/CherylHeiks.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:125px;height:125px;" /><span class="ms-rteThemeForeColor-10-3">“The pandemic represents the greatest threat to the industry in its history. But with every threat, there exists the chance for opportunities. The crisis should be the clarion call to stakeholders beyond the industry who were already painfully aware of staffing shortages. The lack of supply of health care professionals in the country because of increased competition, the aging of the existing workforce, and traditionally lower wages and health benefits in the long term care industry will add to the challenge.”</span></p><p style="text-align:right;"><span class="ms-rteFontSize-1">—Cheryl Heiks, Executive Director, Delaware Health Care Facilities Association</span></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/KevinWarren.jpg" alt="Kevin Warren" class="ms-rtePosition-1" style="margin:5px;width:125px;height:143px;" /><span class="ms-rteForeColor-6">“I believe nationally, the greatest issue facing long term care is a true lack of understanding of the economic and societal role the nursing home profession serves in communities (urban and rural) across the country. They are the support for a disappearing safety net as the population over 65 grows faster and the availability of family caregivers declines. In communities across the country, nursing homes are among the top employers, nationally generating billions of dollars in labor income, state and local tax revenues.</span><br class="ms-rteForeColor-6"></p><p><span class="ms-rteForeColor-6">“The biggest short-term issue facing long term care in Texas is the inevitable expiration of the federal public health emergency and the end of Medicaid add-on in place that has served as a lifeline for long term care. Long term, the biggest issue in Texas is the lack of a predictable Medicaid policy that pays for actual costs of care, adjusts to the growing acuity needs, and ensures the availability of resources to provide the highest quality of care our residents/</span><br class="ms-rteForeColor-6"><span class="ms-rteForeColor-6">patients deserve.”</span><br></p><p><span class="ms-rteFontSize-1">—Kevin Warren, President and CEO, Texas Health Care Association<br></span></p><p><br><span class="ms-rteFontSize-1"></span></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/PattiCullen2.jpg" alt="Patti Cullen" class="ms-rtePosition-2" style="margin:5px;width:125px;height:143px;" /><span class="ms-rteForeColor-1">“Workforce availability is the biggest issue—it has always been a small concern, but current labor market competition, suppressed wages, and a decreasing number of eligible workers have created a workforce crisis that is not easily resolved. Simply legislating or regulating workforce standards does not solve this problem; rather, significantly increasing wages and benefits to entice workers to join and stay in the long term care profession as a valued career is essential to avoid collapse of this sector.”</span><br></p><p style="text-align:right;"><span class="ms-rteFontSize-1">—Patti Cullen, CAE, President and CEO, Care Providers of Minnesota</span></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/RachelBunch.jpg" alt="Rachel Bunch" class="ms-rtePosition-1" style="margin:5px;width:125px;height:125px;" /><span class="ms-rteForeColor-9">“The biggest issue facing our sector nationally is funding, which affects all areas of a quality delivery service, especially access to care in rural America. The biggest issue facing our state is workforce, in particular the shortage of nurses.”</span><br></p><p><span class="ms-rteFontSize-1">—Rachel Bunch, Executive Director, Arkansas Health Care Association and Arkansas Assisted Living Association</span></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/RickAbrams.jpg" alt="Rick Abrams" class="ms-rtePosition-2" style="margin:5px;width:125px;height:143px;" /><span style="color:#ff9900;">“No question that in Wisconsin and nationally the biggest issue is workforce. Our members are continually challenged to maintain adequate staff coverage in all operational areas so that they can continue to deliver the high quality care that our seniors and folks living with disabilities expect and, indeed, deserve.” </span><br></p><p style="text-align:right;"><span class="ms-rteFontSize-1">—Rick Abrams, CEO, Wisconsin Health Care Association/Wisconsin Center for Assisted Living</span></p><p><br></p><p><img src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/ZachShamberg.jpg" class="ms-rtePosition-1" alt="Zach Shamberg" style="margin:5px;width:125px;height:143px;" /><span style="color:#0099ff;">“At both the state and federal level, the biggest issue facing the long term and post-acute care sector will be securing a seat at the table for policy, regulatory, and legislative discussions. As we continue to see new reform after new reform introduced by CMS and state legislatures throughout the country, we’ll need to ensure long term care providers can share their expertise and experience to help shape policy. Otherwise, the future of our industry will be dictated by those who never spent a single day on the front lines of the COVID-19 pandemic and who couldn’t possibly understand the challenges we face.”</span><br></p><p><span class="ms-rteFontSize-1">—Zach Shamberg, President and CEO, Pennsylvania Health Care Association</span><br></p> | 2022-06-01T04:00:00Z | <img alt="" src="/Topics/Special-Features/PublishingImages/2022/State%20Execs/RobertVandeMerwe.jpg" style="BORDER:0px solid;" /> | Caregiving;Management | | AHCA/NCAL State Executives and leaders weigh in on what they see as the sector’s biggest challenges and what issues they are facing head-on in their local communities. |