Culture Change One Step at a Time
Submitted by Sonia Harden, quality improvement specialist, Quality Improvement & Information Management
Listening. Acceptance. Courage. Generosity. Spontaneity. Gratitude. These were some of the words and characteristics permeating the atmosphere at Brock Fahrni last week as the team embarked on the first piece of the Megamorphosis pre-work around compassion. The first exercise was to identify how compassion manifests itself in us and what traits we wanted to grow. When staff recognized those traits being demonstrated in their colleagues, they acknowledged their achievement with a simple sticker on a card that they wore. Hundreds of stickers were given out as staff showed their appreciation for one another.
The next exercise gave staff the chance to experience shift report through the eyes of residents who may have some physical challenges. Some staff wore goggles to simulate macular degeneration, almost complete blindness or loss of peripheral vision. Others wore gloves on their hands to mimic people who have lost their fine motor skills and some experienced hearing loss with the use of ear plugs. Great conversations were had about how it must feel for the residents, and how frustrating residents must feel not being able to see what they need and not having the choice to remove goggles from their eyes.
A third exercise opened up a dialogue about caring for people whose senses have diminished and whose perceptions may be clouded by their dementia. Chocolate pudding was used to open the exercise. Staff described knowing it was chocolate pudding because of the smell, sight and texture. Some powerful stories were shared around experiences of finding residents who have had a bowel movement, reached for it with their hands and used their senses to understand what this “brown matter” is, perhaps also wiping it on the walls when they realize it is not pleasant. Staff shared their approaches to preserving the dignity of the resident, rather than reacting and shouting “NO”.
Friday ended the week with a lunch hour experience where residents had the chance to feed pureed foods to staff. Lots of laughs were had as residents were heard telling staff to “open up” and staff, in their “shirt protectors”, took deep breaths before leaning in for a bite of the mystery puree (which we later found out were vegetables). Staff were appreciative of the care and attention that residents took to make sure the food was not too hot and the conversations that they shared while being fed.
This week, staff have been focused on thinking about the language that we use and how labels such as “challenging” and “difficult” can be hurtful. Staff chose positive words to describe themselves and received stickers from their peers when they demonstrated those words. On Tuesday, the group discussed the difference between saying “no” versus “yes.” Staff were asked to respond no to a series of questions. When asked, they said it was awkward and uncomfortable because “no” is a powerful word. The group talked about how it is easy to not engage with people as they may have a request that we feel we don’t have time to fulfill. The session ended with everyone getting “Yes” buttons to wear and an awareness about starting with yes instead of no.
This week ends with two more exercises: one around “seeing people” and the other around the importance of names. The last week of Megamorphosis pre-work exercises focus on understanding the pain experience in the people we serve and each other. Stay tuned for the results of these exercises next week.
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