Proficiency in the meeting - a professional approach

This article is written from a Swedish perspective. Hopefully, it can inspire those interested from other countries.

Everything has to move so fast. Unfortunately, this culture can also spread to the nursing home. In our professional role at the nursing home, we meet the residents in different situations. We then need to be able to converse in a relaxed manner. It's important to be both professional and personal. If one crosses the line and becomes too private, one risks undermining the trust in professional competence. It's easy to succumb to pressure and as healthcare staff, we should always be "the adult in the room". This is a professional approach and treatment.

Foto: Mostphotos

The Stressed Business

Nursing assistants, licensed personnel, and managers rush around to fix various problems. It becomes more important to do than to be. For those who are dependent on others' help, it may mean that they do not ask for what they would like. Professionalism means not letting stress affect the encounter with the individual.

In a radio program, a woman told about the doctor who came to confirm the death when her mother had died. The doctor walked into the room at the nursing home in snowy boots and with her coat on, took out a mirror that she held over her mouth and confirmed that the mother was dead, then she left the room. She made no effort to make contact with the relatives and left behind dirty wet footprints. For me as a professional, it sounds strange as confirmation of death requires a thorough examination, but this was the relative's experience of the visit.

It happens that nurses and nursing assistants in home health care do not take the time to take off their outerwear during home visits. Staff at nursing homes do not wear outerwear, but can still convey haste in body language and attitude. We perceive a person who chooses to stand up and talk while we sit down or who does not take the time to take off their clothes or looks as if they are rushed. The resident may then think, "Dare I ask that difficult question if she is in a hurry?" or "Do I have time to get help with toilet visits?" For someone who suffers from aphasia or has difficulty communicating for other reasons, such signals can create insecurity and depression.

Being Professional

Put conversations about communication on the agenda for staff meetings. There is never any excuse for poor treatment. We have a shared responsibility to stop every negative tendency and develop a professional approach. Supervision, conversations about values and treatment, knowledge about lex Sarah, reflection on events and reviews in the staff group are some ways to prevent.

On a few occasions in my professional life, I have come across employees who have lost their spirit and who no longer have the ability to see the person or feel their situation. Employees who have had to change employers several times due to procurement and have not received either encouragement or further training for several years can lose commitment and drive.

People who work in caring professions need recurring supervision and further education to be able to handle different situations that arise. Supervision is a necessity especially in situations where staff are emotionally affected. It can then be difficult not to act based on one's own feeling. To be able to benefit from supervision, it must be regularly recurring.

The supervision can contain many different perspectives for example to learn to treat others with dignity even though you yourself do not get respect. People with dementia can behave irrationally and sometimes aggressively. The caregiver must use herself as a tool to reach out. Learning from colleagues and better understanding the individual provides tools in the encounter. Supervision and further education can be support for a changed working method.

Reflection is a good method that leads to reduced stress and helps staff come up with good solutions and positions in ethical dilemmas. To maintain the ability to help others, we must learn to handle the feelings that difficult encounters arouse in us. Therefore, the opportunity for supervision and reflection is so important. Caring for employees must be more important than caring for cars.

According to Wikipedia, a professional approach is a constant strive to be guided by what - in the short and long term - benefits the person seeking help, not by one's own needs, feelings and impulses. This means showing respect, interest, warmth, humanity, empathy, and personal treatment.

Being professional

There is a difference between being personal and being private. The resident must be able to confide in the caregiver. Concerns about the family, thoughts of betrayal, grief over the dead or dreams that were never realized come up. The resident must be able to feel that the person he is talking to is also present in his mind. The resident must also be able to feel that the listener is not putting prejudice or personal beliefs as a filter over what is being said.
During working hours, employees meet colleagues and residents in their professional role. The residents have the right to feel safe to have opinions that differ from those of the employees without it affecting the treatment or care they receive. Being professional is being able to explain how we work and why. This also includes being able to respond to criticism objectively.
Likewise, being able to justify one's position, explain, be responsive, listen to what others say and show the ability to see things from different perspectives.
In order to give the care staff support in dealing with the difficult questions they face, the manager and certified employees must be available. It can be difficult to carry out recurring supervision when everyone is on schedule and many work part-time. Support can be provided by the business setting aside time for reflection each week. Walking around and exchanging a few words with everyone working is another way. A five-minute daily reconciliation where either the manager or certified staff is present can be a valuable support.
Being a professional means a responsibility to develop in one's professional role and as a person through commitment. One aspect of professionalism in care is friendship. When someone cares for a person for a long time, they get to know the person on a deeper level. It gets to know morning mood, humor, taste in music, relatives and different sides of the personality. It can be deepened even more for the person who is the contact person for the person.

What is a relationship

Relationships are built on trust, and trust is built on dialogue. In a nursing home, employees need to be able to be professional and personal without crossing the line into the private. Telling them that they are going on holiday, about leisure interests and a little about everyday life can create a good basis for conversation. It may also be needed to be able to talk about memories from life. Humor can sometimes be used to build relationships with residents and relatives.

There are occasional people who talk without sensing the interlocutor's interest. A conversation is precisely several people speaking. When a person talks on without listening in, it's usually called a monologue, and it has nothing to do with building relationships.

Getting too private

However, an employee must not become private by talking about, for example, miscarriage, divorce, abuse or infidelity. Illnesses in the family are also of a private nature.
Similarly, employees must not divulge their colleagues and their private concerns. Many develop a sense of security over the years, while others seem to have a need to make themselves more interesting by telling intimate events in their lives.
The employee must be able to distinguish between what is personal and what is private. Personally, it's what you can imagine writing on a postcard. Private is what you would write in your diary or talk about with a close friend.
Some instead become rigid and impersonal in their quest to be professional. There is no contradiction between being professional and personal. However, staff lose their professional role if they go in and become private. In the professional role is to treat everyone fairly and equally. This is a balancing act, where you use yourself as an instrument.

Reflection - dignity in the encounter
Care staff:
• What do you do to remind each other not to let stress affect the encounter with the resident?
• Is there anyone who feels embarrassed in connection with toilet visits, etc. where you show extra consideration?
• Do we give temporary visitors to the nursing home conditions for a good meeting?
• Have you or have you had colleagues who become too private in the encounter with others?

Manager, nurse, occupational therapist and physiotherapist:
• Do you have a common policy for what you do when you enter someone's apartment?
• What do you do to create a professional culture?
• How are you as a professional towards the residents and other employees?

Residents and relatives:
• Do all representatives of the business take the time to stop and listen when you or your relative want to say something or ask a question?
• Do you experience the employees as professional?

Erland Olsson
Specialist nurse
Quality in elderly care

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