Maureen Sheahan

Cean Eppelheimer

As important as it is to emphasize person-directed care for elders and people living with disabilities, it’s also crucial to acknowledge that we live through relationship with others. In substantial ways, the quality of these relationships creates the quality of our lives. While research of individuals at a variety of ages rank relationship as critical in giving meaning to life, elders rate it higher than any other age group.¹

At an older city-center nursing home that had seen better days, we were struck by the warmth of the staff, the happiness of the elders, and the incredible sense of community across diverse nationalities. As staff discussed the home’s challenges, one aide announced, “We’re not pretty, but we’re good! We care about everyone who works and lives here!” That’s a relationship-centered culture – one in which respectful caring for elders and clients is seamlessly woven into caring across all layers and functions of staff, as well as with families and the larger community.

Yet we have all experienced how challenging it can be to maintain positive approaches as differences in points of view and styles create tension among colleagues. Pressing demands also strain our interactions—significant workloads lead to a focus on tasks. We can become so absorbed in completing these tasks that we forget to communicate with each other along the way.

Practical Skills

To improve relationships—among staff and between staff, the people we care for and their families — we all need to learn concrete, practical skills to make it easier to listen and speak across our differences.

As one participant said to the instructor at a recent Coaching Approach to Communications class, “Don’t you think just everyone needs to learn this?!” We do. The skills PHI offers enable us to build the great relationships that foster the best quality long-term care, supports and services. They include:

• Active and open listening, using body language, paraphrasing, and open questions to hear others’ points of view more fully
• Gaining the ability to manage our own reactions, judgments, assumptions and emotions as we enhance our self-awareness
• Speaking clearly and directly, without blame and judgment, while expressing belief in the other person’s ability to resolve issues with us
• Jointly solving problems and making decisions with others

See the PHI Training & Organizational Development Team’s website for more information.

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¹ Burbank, P.M. (1992) “An Exploratory Study: Assessing the Meaning of Life Among Older Adult Clients,” Journal of Gerontological Nursing, 18(9).

Panels and presentations on “Living the Possibility of a Coaching Culture” and “The PHI Coaching Approach^SM to Leading Change,” were offered along with hands-on, skill-building workshops, covering topics such as using coaching skills to manage difficult conversations, creating and leading self-managed teams, and empowering staff at all levels to engage in problem-solving.

At the final plenary on “Creating and Sustaining a Coaching Culture,” PHI President Steven Dawson explained, “What we hoped would happen [in developing CCSL] is that these essential skills of listening, problem-solving, and communication would fundamentally change the way staff relate to each other and to their clients. CCSL has allowed us to bring together people committed to doing that work.”

Pat Ramsey, president of Edgewood Center in New Hampshire, told the summit’s participants, “It’s clear to me today that without coaching supervision, we would not be where we’re at in terms of facilitating culture change… And we’ve seen very real changes in terms of family satisfaction, resident satisfaction, and quality of care.” For the past three years Edgewood Center has been a recipient of the Quality of Life Award from the Quality of Life Council, which recognizes nursing home initiatives and improvements in several areas including: resident empowerment, resident care and choice, home environment, and community involvement.

Different settings; Shared commitment

The Edgewood Center was one of several sites in attendance who have been engaged in PHI’s Northern New England LEADS project for the past several years. Many other conference attendees had been part of PHI’s CCSL project, which is made up of a diverse group of nursing homes and home care agencies.

While the scale and location of these 21 home care agencies and nursing homes varied, they all shared an excitement about coaching and a commitment to sustaining it in their organizations. Those that had been on the journey for a little longer talked about how the coaching skills and approach affected so much more than supervision, that it was really the underpinning of their organizational transformation. CEOs, Nurse leaders, HR Directors and other executives told stories of how their organizations implemented the coaching approach, how they worked through obstacles, and what they see in terms of new behaviors from managers and frontline staff in their organizations. Breakout sessions explored these themes further and allowed leaders at different organizations but in similar roles, to share successes, work together through challenges, and learn from each other.

Participants shared ideas about how to sustain the momentum after training, and how structures such as cross-functional teams and coaching booster sessions can support ongoing learning. For many participants, networking and meeting other leaders was a highlight of the summit and they left feeling recommitted to the work that they have been doing. “In this tough economic climate,” one CEO said, “we have to make really hard choices, but we WILL find a way to hold onto the coaching work, because it is the foundation for everything else we’re doing to promote culture change.”

Learn more about Coaching Supervision

The programs are designed to help home- and facility-based providers manage change and create dynamic relationship-centered organizations that better serve elders, people with disabilities, and their families.

“We are delighted that registered nurses are now eligible to receive ANCC contact hours when they continue their nursing education through PHI training programs,” said Susan Misiorski, BSN, PHI Director of Organizational Culture Change Initiatives.

The PHI Coaching Approach^SM, PHI’s suite of training programs, builds the skills to create a supportive workplace culture and fosters respectful relationships throughout an organization. Five of these programs have been accredited by ANCC for contact hours:

• PHI Coaching Approach to Supervision (11.7 contact hours)
• PHI Coaching Approach to Leadership (5.5 contact hours)
• PHI Coaching Approach to Communication (3.45/5.5 contact hours)
• PHI Coaching Approach to Peer Mentoring (Train the Trainer) (34.7 contact hours)
• Person-Centered Care – Getting Back to the Heart of Nursing (2.75 contact hours)

“We have seen improvements in job satisfaction — both with the aides and staff,” said Marki Flannery, president of Partners in Care, Visiting Nurse Service of New York, whose staff has trained with PHI. “We also are seeing improvements in retention, because when people are happy, they tend to stay where they are,”

The American Nurses Credentialing Center is the largest and most prominent nurse credentialing organization in the United States and is a subsidiary of the American Nurses Association (ANA).

“ANCC accreditation of PHI courses is important to nurses who are required to show evidence of continuing education to maintain an active nursing license, as well as to maintain professional certification within the nurses’ chosen nursing specialties,” said Misiorski.

For more information on PHI Training and Organizational Development Services, visit www.PHInational.org/training. To contact PHI to learn more about PHI’s accredited training programs, click here.