By Claire Lucas
Workforce challenges have become the norm for most health care providers. Low unemployment, increased competition and workforce shortages all contribute to the problem. Not only is it difficult to hire employees, but retention is also a serious issue. These challenges unfortunately will only continue to get worse. It is predicted that the number of open positions will steeply increase in the next few years.
So as a health care provider, you might ask “what can I do?”
The Green House Project has had great success utilizing Sages, volunteers who act as a coach and advisor for the Shahbazim, a specially trained versatile worker, who has core training as a certified nursing assistant (C.N.A.). The Sage is typically a volunteer from the community who has demonstrated wisdom. They serve as a mentor, advisor, facilitator, counselor, coach and role model to the Shahbazim.
At The Green House Project we believe that by empowering staff, you not only motivate employees to perform at the optimal level, but you promote higher job satisfaction, which supports higher retention. Empowering staff takes an intentional effort from leadership. It is an ongoing process of providing staff the tools, training, resources, encouragement and motivation they need to be successful. Sages can work in tandem with leadership to provide the extra support and mentoring that is often so vital for success.
The Sage creates a valued relationship with the Shahbazim, becoming a trusted person whom the Shabazim feels comfortable seeking counsel and assistance with problem solving. They can also act as a liaison between the staff, the elders and the organization’s administrative staff. The Sage visits the homes on a regular basis and participates in team meetings. They are part of the team.
The Green House Project believes in Self-Managed Work Teams (SMWT), grooming Shahbazim to manage household matters, such as ordering supplies, budgeting, cooking, laundry, etc. The Sage can be instrumental in coaching the team as they encounter the challenges of creating an effective working group.
This year at the Pioneer Network Conference we will be offering an educational session The Wisdom of the Sage (D11), which features the Sages from Mirasol, a Green House community in Loveland, Colorado. Come learn more about the duties and responsibilities of the Sage, where to find sages and leadership’s role in supporting the Sages. We feel this model of using volunteers to support staff, transcends the Green House model and can be utilized successfully in any health care organization.
We invite you to join in the conversation and share your thoughts and ideas … what innovations are you seeing? What would you like to see?
What a wonderful article by Claire Lucas! I love the way the role of the Sage honors and values both elders and workers, and that this idea is accessible both inside and outside Green House Homes. I’m also appreciative of the discussion points raised by Donna and Cathy as well! There is no doubt that wages and benefits are a contributing factor to challenges with recruitment and retention. There are also other contributing factors, including but not limited to employees having meaningful participation in decisions affecting their daily work, having genuinely supportive and respectful supervision, and opportunities to learn and grow to name a few. Yes–we have made progress–particularly in the Pioneer community–and yes–we continue to have a ways to go! I’d like to invite all individuals with a desire to explore the workforce issue more deeply to sign up for PHIs “60 issues campaign” if you haven’t already–PHI is publishing issues at least every two weeks that feature solutions to the workforce crisis, and advocating for improved wages and benefits is a part of that campaign. This is a complex topic, and it will take all of us working together to creating a tipping point!
PHI is doing some great work – if you haven’t checked out their” 60 Issues Campaign”, you definitely should! And you have a chance to meet Sue and her colleague, Anna Ortigara, at this year’s Pioneering a New Culture of Aging conference in Denver this August. Recognizing the importance of workforce issues to those working to create a new culture of aging, PHI is partnering with Pioneer Network and sponsoring a Workforce Track. Sue and Anna will be presenting a concurrent session, (B1, Giving and Receiving Feedback: A Foundation for an Empowered Workforce) and a 1/2 day Intensive, )#6, Pioneering Solutions to the Workforce.) I know I always learn something when I have an opportunity to network with Sue and Anna!
I’m still waiting for groups like Pioneer Network to talk about two things that would really boost employee satisfaction and retention rates: better wages (in addition to ‘sages’) and better staffing. I’ve asked Green House Shahbazim, and some still work two jobs to make ends meet. Wages are better in Green House homes but are still not a living wage. Until this issue is faced square-on, how will things improve? Even staffing ratios, which seem and may even be better in Green House communities at the outset, may not be as ideal when you begin to factor in the additional household responsibilities of Shahbazim and residents’ increasing care needs over time.
It’s wonderful to take the counsel of elders and sages. Why not do the same with respect to CNAs who work in your communities? If I’m a broken record on these issues it’s because I still don’t hear credible responses from senior care leaders, even those who have been culture change pioneers. The answer is “We’re doing better than we used to,” and “We can’t afford to pay more or hire more people.” In that case, “Show us the money.” Be transparent about where the money goes, and include your Shahbazim in this transparency.
I’m sorry to sound cynical, if I do, or unappreciative of efforts made. But I think at this point we’re spinning our wheels. Coming up with more great ideas and models and training programs, coming up with everything but money to raise wages and increase staffing in the long-term care communities our loved ones live in.
Donna – thanks for sharing your passion. Though it may be hard to hear, you make valid points. The solution is not a simple one and I don’t think anyone would dispute that the need for better wages is a part of the issue. But as we have heard so many times, we can’t continue to do the same thing the same way and expect different outcomes…workforce redesign has to be a part of the solution, and we applaud the many communities and organizations who are working hard to find new and innovative ways to support elders and care partners through workforce redesign.
The Green House Project reinvents care and empowers lives. This reinvention encompasses the elders who are living in the homes and the individuals who are working in them. Establishing better jobs is imperative to accomplish everyone’s goals. Those who are working closest to the elder in Green House homes, have an expanded role and are elevated to a new level of respect. Along with this added responsibility and esteem, The Green House project advocates for a higher wage and flexible, empowered workflow patterns. Improving the retention and recruiting of a talented workforce is not a simple ‘fix’, it involves an intentional focus to create and sustain a high trust and high belief work environment. The future success of our field hinges on creating a world where employees are seen as unique individuals who have incredible value, worth and potential.