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8 Best Practice Tips to Create a Culture of Caring – Part 2

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Culture of CaringIf you’ve worked in healthcare for any length of time, you are quite familiar with the pervasive ways so called “professionals” torture each other. The old eat their young; nurses get thrown under the bus in front of important people (sometimes patients); the day shift battles with the night shift; and, employees come to work only to find they have been pulled to another unit (where they’ll be tortured). These experiences certainly don’t convey the culture of caring so many of us expect to find in healthcare.

In Part 1 of this article, we shared our research that shows that disruptive behaviors show up in four common ways:

  1. Yelling, criticizing, gossiping, and arguing in patient care areas
  2. Treating float nurses, travelers, and agency nurses in an unsupportive, disrespectful manner
  3. Wars between the day shift and the night shift
  4. Eating our young

The good news is that with a few simple strategies, you can shift your culture from one of cruelty to a culture of caring! Here are 4 additional best practice tips based on our Cultivating a Culture of Caring, Initiatives (we have more):

If you haven’t read our first 4 best practice tips, click here.

Set the Next Shift Up for Success to Establish a Culture of Caring

Each shift seems to believe that they do more and work harder than the other shift and that somehow the opposite shift has it easier. They forget that care happens over a 24-hour period. Although differences exist in the structures of the shifts, patients still get admitted; unexpected crises occur; and medication administration, assessments, and documentation occur day and night.

Employees of one shift fight with those of the other—not overtly. No. Their weapons are subtle but still lethal. Here are how some of the weapons work:

They “dump”, withhold information, nitpick each other to death during shift report, and spend precious time and energy bad-mouthing each other.

Best Practice Tip #5 – Anticipate any supplies they might need and put them in the room

The worst thing to happen is to start doing a dressing change, thinking that the supplies are all there, and find out you’re missing a few critical pieces. Now, I know you should check before you start, but how wonderful would it be to KNOW and TRUST that the previous shift completely stocked your room or cart with everything you needed?

Best Practice Tip #6 – Give pain med ahead of next shift if due

One of the most frustrating things is when you finish getting report and 3 out of 5 of your patients are on the call bell asking for pain medications! If your patient CAN have pain medication, please administer prior to giving report.

To change your unit’s culture from engaging in shift wars to setting each other up for success, gather the employees from your unit. Ask this question: How can we set the next shift up for success? Ask all employees for their input on what the previous shift could do to make it easier for the next shift to take the baton and run!

Mother Bear New Employees

Mother bears are the quintessential role models for loving and protecting their offspring. When a mother bear detects a threat to her cubs, she attacks! A mother bear will sacrifice her life to save her cubs.

Research conducted through the Vermont Nursing Partnerships resulted in a rich body of knowledge related to the integration of new nurses through their relationships with their preceptor and colleagues. The preceptor assumes many roles in helping to transition a new graduate nurse into professional practice and foster a culture of caring. Roles such as protector, educator, socializer, evaluator, and role model provide a framework in which the preceptor can coach a new nurse. Preceptors, regardless of their gender, therefore, need to become the primary, but not the only, mother bears for new employees.

Best Practice Tip #7Call new employees BEFORE they start

Calling your new employees about a week prior to their start date is a HUGE de-stressor. Welcome them to the unit and let them know you’re excited to be their preceptor (if you’re their preceptor). Ask if they have any questions and if there is anything you can do to support them.

Best Practice Tip #8 – Celebrate their first day on the unit

Studies show that how a person feels on their first day sets the tone for the rest of their time there! A good way to welcome them is to make sure EVERYBODY knows they are starting that day, smile, welcome them with a sign or card signed by the staff, and FEED THEM. Seriously, food is a HUGE satisfier.

Welcoming new employees to your department shouldn’t feel like a burden. It should feel like a joyous occasion, filled with hope, excitement, and optimism, just like any parent feels when bringing their child into the world. Celebrate your new people—don’t eat them! Don’t let anyone else eat them either!

It would be wonderful if we could simply establish a culture of caring where bullying and incivility were not tolerated. As a leader, you have the opportunity to do even more! You can build a culture of caring with the initiatives described in this article. Begin by getting your team to designate sacred spaces, roll out the red carpet, set the next shift up for success, and act as mother bear to new employees. When they are busy doing these things, no one will be lining up at your office door to tell you their complaints. They will be using that time and energy to support each other and deliver exceptional care.


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The Healthy Workforce Institute is the global leader in addressing disruptive behavior in healthcare. Through our cadre of services, we provide the strategies, skills, and solutions to address any incidences of disruptive behaviors that show up in healthcare.

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