Nursing Home Workplace Culture


Definition: The predominating attitudes and behavior that characterize the functioning of a group or organization.

Maybe you have heard a lot about workplace culture lately. It has been a buzzword for the past few years and much of it is geared towards the corporate world rather than the nursing home setting. However, every place of employment DOES have its own culture and within the LTC setting a bad culture is devastating to staff and residents.

Signs of a “BAD” Culture include:

  • High turnover and absenteeism
  • High amount of agency staff use
  • Uptight unsmiling staff
  • Grouchy residents
  • Backstabbing, gossipy groups
  • No teamwork
  • Hostilities between shifts
  • Too many cliques

Causes of a bad culture include the actions, or lack of action from management, charge nurses and YOU the CNA. You have a huge impact on the culture of the unit you work on. Your attitudes and ability to be positive all have a large role in whether the place you work is seen as a good employer.

Everyone has a set of personal values they go by; also, everyone has morals. Knowing these can be a first step towards changing your attitude and therefore becoming more upbeat.

Many of the reasons/causes of an unhealthy culture are not the fault of the CNA, and these areas must be addressed by the Administrator and DON. Some tips for them would include:

  • Hold regular staff meetings with ALL staff
  • At these meetings seek input and advice from staff, and ACT on items that can be acted upon. Explain why others cannot be followed through.
  • Break up negative cliques and do not allow little gossip groupings
  • Examine reasons for shift wars and implement methods to stop them
  • Have a mission and SHARE it with all staff better yet have all staff help with developing the mission statement
  • Maintain a positive attitude and make all decisions based up the mission statement.
  • Catch staff doing things the right way and give them credit for doing so (Gone with the mindset that “They should be doing it this way in the first place”)
  • Hold staff accountable for policies and procedures breaches (attendance)

Many things are within the control of you the CNA, when it comes to creating a positive culture. You have to look at things differently though, and this can be hard work for old timers not used to change. Having the mindset that people are lazy and will take advantage of others, for example, will get you nowhere. You will always been seen as a negative force.

Your attitude might be why you are so unhappy at work. No one likes to be around someone who always finds fault with others with their work, their uniforms, and their lifestyle.

Negative people drain energy from others. It is hard work to remain negative it amazes me to see how some CNA’s can be so miserable for so many years. It does seem that these miserable aides end up having more health problems as they get older, they LOOK so much older than they are, and they are just as unhappy at home as they are at work. The old saying “Misery likes company” may have some truth, but what I think really occurs is “Misery infests others”.

Things You Can DO, Right Now:

  • Try not to get involved with gossip; stay away from groups of staff who tend to share stories about others. If you are approached with a statement like “Did you hear” say NO and say “I DON’T WANT TO KNOW”. Walk away.
  • Don’t be a part of the “Call in Queen Club”. Show up for work, on time. And have a smile on your face.
  • Have a personal mission statement/vision if management cannot pen their own. A simple motto will work something to the effect “I will give the best care I can and I will be a good coworker to my peers.” Live by this. You will quickly become known as someone everyone likes to be around.
  • Don’t keep old baggage on your back. Forgive others for past mistakes and issues. Move on. Talk with them; tell them they have another chance with you. Stand up taller, take the higher road. You will feel so much better, like a burden has been lifted.
  • Use your manners. Saying PLEASE, THANK YOU, EXCUSE ME and I’M SORRY go so much further in the culture you create, then saying things like Nope, I can’t, or doing things like rolling your eyes, sighing heavily, murmuring under your breath.
  • Instead of having that “Us vs. Them” mindset, why not have “Its US”? All of “us” shifts, including housekeepers, cooks, nurses, residents, etc. We are working together, not against one another.
  • When you are training new staff, be kind and gentle to them. Just because they are CNA’s doesn’t mean they should be treated poorly. And don’t expect them to know everything no one knows the little tricks with residents until they get the training you can give. Model decent behaviors and talk about being positive. This will make a lasting impression.
  • When agency staff are utilized, don’t be rude to them. It’s not their fault they are there. More than likely it’s partly the facilities’ and YOUR fault! It all rolls back to culture if a place is full of negative people who refuse to help one another, who call out frequently and where there is management that condones these practices. Folks are not going to work there. People will quit or call out. Face it– a vicious cycle can occur here.

When you treat agency staff poorly, they talk. They tell their bosses and they tell other aides in other facilities we have all heard about HELL HOLE nursing home its hell because of the staff usually. I have heard some stories about agency staff being treated so badly by aides at certain nursing homes I would NEVER consider working at. And that is bad for you: Aides who might consider getting a job where YOU work, so you are not working short all the time won’t even give your employer a chance. And you might wonder WHY you don’t have enough staff.

The same cycle occurs when we mistreat new staff who quickly quit on us. They find employment somewhere else, and talk to others about their experience at your facility. The facility has reputation that has bad culture and is terrible to work at.

Help the culture at your work. Do your part: Smile, stay positive, help coworkers, train new staff well and ask Management to help create a workplace culture that helps with retention, and then in turn, recruitment.

Hopefully management can assist with this because it will take some enforcement on their part to make this work.

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