THIS ISSUE Feb 18, 2004

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Featured Article:
Violence in the Workplace.

One out of every four Americans workers will be attacked, threatened or harassed at work in their lifetime by another human being. That is a staggering number!

I remember all to vividly the horror of watching my Dietary Supervisor being wheeled out on a stretcher. She had been attacked (this tiny 5-foot woman) by our (over 6-foot tall) cook, during a disciplinary meeting with the HR director. The cook was placed in a chair next to a wall. They were in a tiny office. The HR director was sitting in front of the cook with a desk between the HR director and the Cook. Sitting next to the cook was the Supervisor. Weather they realized it or not, they had completely blocked the cook in the office. Not only did they place the cook in a confrontational situation, they had placed themselves in harms way. Once the disciplinary meeting began, the cook jumped on the Dietary Supervisor, pinned her to the ground and began pummeling her. The tiny office door was closed and blocked by her body, which was now on the floor. The HR Director also could not escape the blocked doorway. It was a tragic event. But with every tragic event, it gave us an opportunity to learn, the managers an opportunity to explore what went wrong in the disciplinary meeting and take steps to insure that this never happened again.

OSHA requires that all healthcare facilities have a Violence Program in place. They state, “all hospitals and nursing homes must have security and safety plans in place, find and correct things that lead to violence, do things to prevent violence and give training on safety, security and ways to prevent violence and give training on safety, security and ways to keep ourselves / patients safe”. Many facilities do have Safety / Risk Management Programs or Committees. If, you do not have a program, they offer for free the entire training program that can be downloaded. It is already in overhead format and is easy to follow and use as a training tool. Additionally, OSHA states, “that their training program is not copy righted and they want the long-term care industry to use the training materials.” www.osha.gov

Work place violence is any physical assault, threatening behavior or verbal abuse occurring in the work setting to employees or clients. This can be the building, surrounding perimeter, parking lots, client’s homes and traveling to and from assignments. This includes assault, criminal mischief, disorderly conduct, harassment, larceny, menacing reckless endangerment, robbery, and sex offense. These offenses can range from beatings, stabbings, robbery, rapes, intimidation, verbal threats, bodily harm and territories activity. There are many new catch phases that we hear, “Desk Rage, Terrorist Activity and one of them is “going postal” which Sienfield coined.

Violence can be by strangers, customers, clients, and co-workers and by personal relationships, such as an estranged boyfriend. Social workers and nurse’s aides are assaulted more often and in greater numbers. OSHA requires employers to maintain a safe work place.

Your facility / employee is at risk if you have one or more of these factors?
Working alone at night and during early morning hours
Performing public safety functions in the community
Working with patients, clients known or suspected of having a history of violence.
Employees with a history of assaults who have exhibited belligerent, intimidating or threatening behavior to him/her or staff.
You are an authority figure

Additionally, you need to look to see if you a “toxic work place culture.” The Nursing Assistants Web site list some common sense things to look for:
High turnover and absenteeism
High amount of agency staff use
Uptight staff
Gossip Groups
No Team Work
Hostilities between shifts

If your work place is toxic, what is the management doing to address these issues? Because it cannot be allowed to fester, knowing full well that it is a bomb waiting to go off in your building. It is a myth that “people suddenly snap.” He may have just snapped but if you look back there were warning signs. All the staff saw the signs but maybe the culture of the building is not to report things. It is another myth that situations will resolve themselves and just have a cooling off period will resolve it and the problem will go away. If there is a situation, address it head on.

If you wish to begin a violence prevention program there are many components that should be included and these are:
*Clear policies about violence and prevention. The policy needs to be clearly spelled out to your employees, visitors and residents. The policy should clearly state that you have a “zero tolerance for violence.”
*Ensure that employees who report incidents that they do not experience reprisals.
*Clear Documentation Forms that not only has space to document incidents, assess risks but also can measure progress.
*Develop a liaison with law enforcement and others who can identify ways to prevent violence.
*Provide resources to carry out training.
*Affirm management commitment to a worker supportive environment that places the importance on a safe work environment.
*Let your staff know that you are starting this program and what it will involve, which includes preserving employee safety, supporting those employees that have experienced violence and recovery.

Finally, the 5 components of a violence prevention program are
1.Management Commitment and Employees Involvement
2. Work Site Analysis
3. Hazard Prevention and control/ responding
4. Health and Safety Training
5. Record Keeping.

As a final note, all management teams should receive extensive training in hiring, firing and disciplining. There are many signs to look for in a violent employee and these are traits that the supervisors should be trained to recognize and handle. If you are a non-profit facility, please visit the OSHA web site where they provide grants for safety and health training.

Obviously this is a huge topic but we hope we have touched upon some key elements that should be addressed in your violence protection programs.

References: www.osha.gov

Volunteer Recognition

Now is the time to order promotional materials for the Volunteer Recognition Week. You can order from The Points of Light Foundation infro@pointsoflight.org The theme for this year is “Volunteers Inspire by Example” You can download a tool kit free of charge from www.pointsoflight.org/nvw or call 202 729 8118 Points of Light Foundation.

There is a great resource manual at www.activitytherapy.com, Volunteer Management Essentials for The Long Term Care Setting. Now is a good time to look at your volunteer management program. If you need to develop policies, orientation packets, applications, sign in sheets, awards, job descriptions, recognition events, certificates, this manual is loaded with resources, quotes, poems and information. Another great resource to order promotional items is Positive Promotions, and their number is 1800 635 2666 or www.positivepromotions.com.

When planning your volunteer program, remember to include your seasonal volunteers such as the dance troop that volunteers once a year, the volunteers who help your religious services and your resident volunteers, like the President of the Resident Council or the Friendly Visitor. You may wish to keep an ongoing list through out the year, so that you don’t forget someone who has provided a service. The volunteer recognition, party, diner or luncheon is extremely important and you should put some planning and thought into this event. All managers and administration should attend this program. Awards and certificates should be handed out and additionally; pins should be awarded for years of service. Please allow the volunteer to bring one guest, as this is important event for them. Plan a special meal and you may need to caterer it. It is a festive time, so book entertainment early.

The administrator should make a speech about the important contributions this individual or group has made to the residents lives. Type up a few prepared sentences about each volunteer that can be read as they come forward. In the state of New Jersey, The New Jersey Activity Professional Association asked the members to submit nominations regarding a volunteer who should be selected as volunteer of the Year. What an honor and thrill for that person! Take the time to make this event something special. The one thing I can tell you for certain, that if you neglect this area of your volunteer program and don’t plan a special event, than that might be one clear indicator as to why you have so few volunteers. A thank you goes along way!

Once a year, you should provide an evaluation to your volunteers. It’s an opportunity for them to have “face time” with the supervisor and it provides an opportunity to give feedback on how they are doing. Evaluations should be a positive and an important part of your program. You could plan the evaluations around the volunteer week.

Volunteer Week is a great opportunity to let the public know about your volunteer program, so why not take photographs of your volunteers or the volunteer recognition event and submit to the paper. Make a banner and place in your facility. Additionally, take pictures of the volunteers and place on a bulletin board with their names and what they do.

We would love to hear from about the recognition events you have planned or have conducted, so feel free to email us at activitytherapy@aol.com. If you are supervising volunteers you may wish to explore certification through the Association of Volunteer Administration at www.avaintl.org.

National Council of Certified Dementia Practitioners

If you have completed Alzheimer’s and Dementia Training through the Alzheimer’s Association, or another training program, you are eligible for CDP certification.

If you are a trainer, or an in-service coordinator, you may wish to apply to become an approved instructor with the NCCDP.

For a list of instructors for your area who are approved by the National Council of Certified Dementia Practitioners to teach a comprehensive course in dementia, please go to www.nccdp.org

New Products

Calendar Dates to remember: This is an extremely comprehensive list of dates to remember when planning events for the year. Many marketing directors also use this list in planning their marketing plans for the year.

Adult Day Care Calendars
We now offer Adult Day Care Calendars. If you are finding it increasing difficult to plan a calendar to serve the diverse needs of your population, why not purchase a subscription. The calendars are planned 30 days in advance and you may download and change the calendar to fit the needs of your building.

Adult Day Care Menus: We will be offering a six-week cycle of menus. Please email us for further information.

Adult Day Care forms, policy and procedures, in-services and Q/a will be loaded shortly.

Resident Council / Client Council Forms:
Many people have wrote to us requesting help and suggestions for forms. We are now offering these forms and how they should be filled out. Also suggestions given about running a resident council/ client council meeting.

Spirituality Assessment Forms:
Many facilities are implementing Spiritual Assessment forms. If you have not been able to locate a form, we have developed forms for you. These forms will help you in planning a residents spiritual needs.

Alzheimer’s & Dementia Unit Development

The number one question we are asked is what we see as the future in Design for Alzheimer’s Units. Besides the obvious of a home like setting, the trend that we see is a “smart home’ or a “smart facility”. That means sensors. You know the kind we mean. Sinks that turn on and off when the hand is placed in the water, toilets that flush automatically, rooms that adjust to the body temperature and lights that come on when you enter the room and turn off when you leave. The other areas are in the environmental department (house keeping). One of the smartest things we are seeing is the of wet vacs that dry as they go. This eliminates the need for “wet signs” and makes so much sense for a dementia unit. Many facilities are placing armoires in the hallways and getting rid of the clean linen carts that always seem to be lining the hallways. Additionally, some buildings are placing the dirty linen in an armoire rather than having a “dirty linen” cart in the hallway. It’s unsightly and usually adds an odor to the hallway.

We are lucky that we travel across the country implementing dementia units and are able to see first hand some of the innovative things that are being done. This week we were very privileged to tour Cedar Crest Village, which is an Erickson property. Cedar Crest Village in NJ is a CCRC with plans to open the nursing home in 2004 or early 2005. They have some of the most innovative designs that I have ever seen. If you have the opportunity to visit New Jersey, stop by and visit Cedar Crest and ask for Mr. Gary Hibbs. You will be blown away.