Reflection:
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I completed my Honors Practicum working as a Certified Nursing Assistant (CNA) in an Assisted Living facility that specialized in memory care called Birchwood Cottages. We had beds for a maximum of 34 residents and required that each one had a dependent level of cognitive decline due to either dementia, Alzheimer’s, or a traumatic brain injury. The residents living in our facility required a range of assistance from simply just needing help via verbal cues to being fully dependent on care staff. As a CNA, I am responsible for assisting the residents with activities of daily living at the level indicated on their care plans. Working so closely with the residents makes me responsible for reporting any changes and advocating for their wellbeing. After a short time of employment, I was promoted to Lead CNA for the evening shift. This title indicated duties such as organizing staff and our shift duties, training new members, and speaking as a representative for my shift as a whole. This role came with clear responsibilities and required dependability. This position allowed me to practice my leadership skills among my care team and observe the leadership dynamics of other shift groups. In my role, I rewrote the job description/duty sheet for the evening shift. By doing this I reworked our schedule to be most efficient in the way we got tasks done that coordinated with the need for teamwork and paired/group tasks. For example, we would have specific independent tasks to complete such as cleaning the dining room, fixing laundry, and toileting some residents while we cycled through staff breaks to reserve time to do partner tasks efficiently and safely together afterward. This reorganization also reworked the workload to ensure that each staff member was putting in the same amount of work. This schedule favored partner tasks so that staff was splitting tasks to make them easier and share the load. From my experience, it was always easier doing care tasks with a coworker whether or not the care plan stated the resident was a one or two-person assist because it makes the work easier, safer, faster, and simply more enjoyable. No one really likes to work alone for an entire shift. By encouraging staff to work together more, the team environment grew substantially, and communication became much more open. We learned that this job required us to have each other’s backs, and everyone worked toward mutual team respect.
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To embrace this team dynamic, at the beginning of our shifts, we started having team meetings. During this time, I assigned employees to a specific half of the building to work for the evening, discussed our plan with showers, meds, and how we would split two-person tasks. By establishing this at the beginning of our shift, there was no question later about what to do next or whom to ask for help. Obviously, things did not always go according to plan, so as issues came up, they would be reported back to me so that one decision was made about what to do next and how to readjust. Now a lot of the time, these adjustments required me to collaborate with the care team, and I think this was important because each member could add input and we would make decisions together, so everyone felt heard, and that their opinions were valued. Prior to my promotion, I spent a lot of time just observing the dynamics of all shifts and how efficiently they ran. It appeared that the morning shift has a very loud lead who came off as a dictator. Everyone was a little scared of her and did not feel like their voice was valued. The evening shift at the time completely lacked organization and communication. Staff members seemed to almost be afraid to talk to each other or ask for help. The night shift had a very good lead dynamic where everyone was heard and respected. Their tasks were split evenly, and the members seemed to enjoy their shifts. This setting of leadership makes it difficult to have roles for all members, but it was clearly beneficial to have one common voice to go to for questions, to advocate through, and see the bigger picture.
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The shift leads at Birchwood are by no means any more superior to the rest of the CNAs and can be better described as just speaking a little louder and being able to envision efficient practices. I actually advocated for myself to be promoted because I saw the lack of leadership on my shift. I had ideas about organization and teamwork that would benefit my shift substantially. I saw the opportunity to implement my leadership values within this group and see them grow. I think that so far, I have effectively balanced our workload within an established team environment, introduced better communication and reliability, and effectively spoke up for my group. I have brought team issues to my boss and relayed information back to them. I feel like my peers can rely on me and feel comfortable sharing/talking with me. I think my leadership skills can still be improved in ways that better implement new staff into our routine and team community. I want my new staff to understand the flow of the shift and feel like a valued members of the team almost immediately. My ideas for improving this include a longer training period and some sort of team bonding experience.
Although I have noted a few things I would like to improve on, this role has allowed me to grow in my leadership tremendously. I found a style that I like and feels comfortable to me and created a dynamic that made sure my peers felt valued. I believe my efficient leadership philosophy utilizes teamwork with strong and open communication, there is a single leader for everyone’s reference, and we follow a basic plan that allows team function to be efficient as well as flexible. I have noticed that in my leadership I am even more devoted to my residents and am not afraid to speak up and advocate for their wellbeing. This experience has allowed me to fulfill competency for Leadership Values and Teams levels three and four.
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