Culture Change—It’s about Relationships

A couple of months ago a colleague sent an email asking the team what “relationship” meant to us. I spend considerable time educating on the importance of relationships, so, I was surprised when I hesitated before shooting back a quick and easy explanation. I really gave thought to her question. What does it mean to have a true relationship? What are the basic needs of a relationship? What clicks between people who are close? I’m not talking about romantic relationships here, but, those deeply satisfying personal connections that are so important to our over-all well being. Let me share a portion of the email in which I responded to her inquiry.

“When I open up and give of myself, it means the other person has earned my trust. If I develop a relationship with someone, I believe that sharing ‘me’ is safe. Conversely, I want to make sure the other person trusts and feels safe with me and that I never do anything to destroy their trust and feeling of safety.

That said, part of trust and safety involves compassionate honesty. When a true relationship has been formed, neither party is put off by compassionate honesty because they know their best interest, their personal growth, their professional growth and/or spiritual growth can only happen with that feedback.

I believe we respond and reveal ourselves in varying degrees depending on the type of relationship we are involved in. There are pieces of ourselves that we give depending on the type of relationship. A person only opens completely and shows their true and real self if they sense trust and safety (on both sides).”

Person-Centered Care requires a willingness to lay aside old ideas and beliefs. One of the first things we change is the way we interact with each other in the work place. Traditionally, we have intermingled with each other based on “position” or “level” within the organization and we interacted with residents from a stand-point of authority. Neither did much to advance trust and safety!

In the past, relationships were the last thing a company wanted because it was viewed as wasted employee time and led to unrest among the “troops.” I remember going through Leadership Training as a young Director of Nursing. We were told never be friendly with staff and NEVER socialize with them. The rationale was that discipline was a large part of the position and it was impossible to provide necessary and needed discipline if we were friendly. The belief at that time was that staff must be disciplined frequently and harshly.

I remember also that the instructor spent significant time explaining why a nurse should never have a relationship with a patient. We were taught never to address a patient by their first name even if they ask us to, not to discuss personal affairs with them and never to ask them a question personal in nature. The rationale? A nurse needed to be objective and with personal relationships, objectivity was lost.

Today we know that quality of care and quality of life for elders and job satisfaction for the team is all about relationships. It’s time to lay aside these old beliefs and build productive and satisfying relationships among elders and within the team. How do we begin to do this? 1) Get to know each person 2) Build an environment that is based in trust and safety 3) Embrace diversity and individuality 4) Allow people to contribute and become involved. When we view staff and residents as complete individuals it is impossible to interact with them in the same old non-relational way.

--Teresa McCann, Senior Consultant & Director of Development