The Other Side of the Family’s Journey
This article was written by a woman who is an outstanding example of what a good Director of Care should be. Good care flows from the people at the top—a great administrator and Director of Care (Nursing) are instrumental in making a great organization. So how do you know if care is going to be good—figure out the people at the top!
A Nursing Director Speaks
What is it like to be a Director of Care? This is the question that a Social Worker friend asked me recently. The first things I thought of were about the professional qualities that I have had to have. Long hours, many more than are called for in my job description, have meant I needed a strong work ethic. The always growing knowledge in the field of aging has meant I am always looking for new methods and models. I have had to have a mind set to always improve on what I am doing and an openness to what is changing, to name a few.
My work in nursing homes is always guided by many factors, including the things I have to be aware of because I work in an organization: the home’s goals and objectives, mission, vision and value statements, policies of the board of directors, resident rights and legislated policy. Some of these help, some of these mean we have to jump through hoops, and that we have more than one master.
Is there a lot on my plate? Yes. Is it rewarding? Absolutely. I think of my role as using a mixture of knowledge and requirements that help me organize care based on best practice. This helps me create a circle by then allowing me to influence goals and objectives, mission, vision and values of the home. For me, though, more than the rules and knowledge, and whatever is written, what is important is to have a love and appreciation for the population that we care for. I think about these people who shaped our world, working, volunteering and contributing in their own unique way. I think that, while they are in our care homes, they deserve to be cared for in a manner that respects their contributions, their uniqueness and individual needs. When I see people who are out of sorts, or “difficult,” I remind myself that it may be due to their diseases, dementia, or it may be pain or loneliness that is behind the mood and behaviour. The remedy is not drugs or policies, but giving care as we would if we were looking after our mother, fathers, grandmothers or grandfathers.
The “care “ part of my job as Director of Care focuses in three directions. Towards my residents, their families, and also towards the staff. I look at the care aides and nurses, the recreation workers, and others; their needs in the context of the workplace are important. Providing them with education that helps them in their roles at work is mandatory, as far as I am concerned. The bonus is that education is useful in their personal lives, and I know they appreciate it. After all, most of us like to learn something that pertains to us as a person. When I am organizing and planning for my staff’s ongoing education and development. I am also helping to build a stronger, better home.
My caring role extends to the family of resident who are in our home (or maybe, in whose home I am working). It is important to understand and figure out how to meet the needs of family members, and to support them from the admission period up to and including the end stage of the life of their loved one. Providing family with ongoing education throughout the process of living and dying is a major part of my role. It helps them cope with their own feelings and also with the person in care. My job is also to make sure that my staff have this same understanding, and learn the skills to do provide this kind of care.
The challenges of the Director of Care’s position are complex. They come from within the home and from the outside. Sometimes I have no control over those challenges . Like I said above, it is as though we have (at least) two masters. I have worked in the field of geriatrics for many years and have worked with two different systems as they were going through “regionalization.”
I have had to learn some simple coping strategies. Simple, but not easy when it impacted on my residents and staff. I had to learn the necessity of an attitude of changing with the times, of adapting to the ever-changing tides – like the “ship on the ocean,” and of moving with the flow of the currents.
The challenge to change in response to government and financial changes was to be able to maintain my professional principles and stand firm on what was ethical and right for the residents and staff. In my experience when I feel passionately about what I am doing, it gives me the strength to use my knowledge and experience to explain my point of view and look for ways to compromise which takes into account the needs of the system, residents, and staff. If I do that effectively, the “powers that be” most often respond with respect…
The “home” that I work in now is considered small by comparison to others. We are able to feel very close to the residents and staff. The values of our caring are based on respect for individuals, teamwork, spirituality, and excellence and are given in a homelike environment. The interdisciplinary team that I work with is excellent and I feel very privileged to be part of that team. Providing good care is always a challenge, no matter what the size of the home, When I am able to do that, when I accomplish my personal and professional goals, it is extremely satisfying.