Often as nurses, we find ourselves completely focused on the task at hand, especially when our ever-growing to-do list is longer than the number of hours left in our shift. When we focus on what needs to be done, we sometimes end up diminishing the contributions of our unregulated co-workers in the overall care of patients and residents. We don’t do this on purpose, it just happens as an unintended consequence of the evolving role of the RPN in different settings. As time goes on, the result is the erosion of the bonds of a well-functioning team, especially in long-term care.
Recently, I had the unexpected opportunity to work on a new unit. During the morning report, we learned that a resident, who had been experiencing declining physical functioning, had fallen just before we arrived. Later, I overheard a PSW explain to another colleague how she had hurt herself while assisting that resident during a transfer. After connecting the injured PSW to health and safety support, another PSW and I reviewed the details of the incident as well as the availability of equipment to transfer the resident safely, without causing undue harm to either the resident or staff. My PSW colleague asked me if they could go ahead and start using a sit-to-stand lift. When I agreed, she also asked me if I would update the care plan and the staff communication board so that other staff would know about the changes. I readily agreed and added that we should also refer the resident to physio for an assessment of their transfer abilities.
My willingness to immediately act on the safety issue that affected both residents and staff came as a surprise to the PSW, who had 10-years of experience working on that unit. She recounted how in the past when she would bring a concern to the attention of a nurse and ask for action that could help prevent future care issues, she felt her concerns were minimized, brushed off, or completely dismissed. This left her feeling increasingly disenfranchised and marginalized. Sadly, this PSW explained that in her many years of experience in her role, she had never had a nurse stop what they were doing, listen to her, and immediately act on her concerns.
The role of the nurse has become increasingly task-focused, usually in the face of both peer and workplace pressure. Nurses need and want to get as many things done as possible in order to avoid explaining to the incoming shift why something wasn’t done. Through the rush of the shift, the time spent with the residents and patients and unregulated staff alike are reduced to impersonal encounters, even though much can be learned from slowing down and being attentive to both. The relationship between a nurse and an unregulated care provider has far-reaching effects – perhaps even beyond the workplace. It should be the goal of every nurse to encourage the participation of all staff, maximizing input and involvement at every opportunity, regardless of role in the home. Perspective matters when it comes to the quality of life of the staff as well as patients and residents.
About Mary Furlan
Mary Furlan, RPN received her PN diploma as a mature student in 2006. She has practiced in community care, pediatric complex care, and while working in long-term care, gained experience in a variety of roles from staff nurse to management. Mary completed the IDEAS Advanced Learning Program in 2015 and developed a strong interest in culture change through quality improvement. In September 2019, Mary started the PN to BScN Collaborative Bridging program at the University of Windsor/Lambton College. You can find her on Twitter, advocating for better living conditions for LTC residents @MarysxcntrcCan