Page 44 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
DEEP ORGANIZATIONAL CHANGE
people and everyday events at Lenawee by becoming a neighborhood coordinator and receiving CNA training. Her main concern: Building relationships with residents, family members and other staff. ‘My first love and training is as a clinical dietitian, so to be asked to supervise the kitchen or coordinate an activities person or housekeeper, those kinds of requests are way outside the box,’ she explains.
Three Weeks After Move-In: So Far, So Good
‘So far, so good’, agrees Hiltner. Elders’ food intake has increased, and ‘we’re getting a lot of positive comments from families and residents.’ Her dual role as Clinical Dietitian and Neighborhood Coordinator is working out as co-workers pitch in. The dietetic managers have lighted her clinical duties by taking over some (parts) of the nutritional assessments, and the neighborhood nurse leader is helping her stay on top of her coordinator responsibilities. Frequent meetings and learning circles are enabling her to build relationships with staff, residents and family members.’
Three Years After Move-In: We Are Households
‘Professionally it’s a challenge for me...that’s the way you want any job to be. You don’t want the same old experience. You want something that’s going to make a difference in somebody else’s life. That’s why anybody chooses this type of profession, you want to make a difference.’ On her dual role as Clinical Dietitian and Household Coordinator - Hiltner recalls her pre-move jitters about becoming a neighborhood (now household) coordinator, and how often over the last three years she felt her leadership role distracted from her chosen profession as Clinical Dietitian. Though stress is still part of her job, experience and personal growth have cut it down to size. ‘I worked into it a bit better... delegating more to the dietary managers and getting them involved in some of the hands-on supervision,’ she explains. As for sacrificing some of her dietitian duties to household coordinating, ‘I think it’s a decision each individual has to make about what they’re comfortable with and how they want to balance their jobs,’ she says. Hiltner sees a bigger picture with more options and shades of grey. ‘It’s not the black and white, straightforward, do this, put the food out, count our numbers, meet the regs. It’s definitely more people oriented now,’ she says. (Schaeffer, 2008, p 10-18)
DEEP ORGANIZATIONAL CHANGE – FROM A STAFF AND FAMILY PERSPECTIVE
Northern Pines Communities embraced deep culture change and experienced actual outcomes that far exceeded expectations. Karla Nieman, CDM and Community Coordinator, notes, “We’ve had miracle after miracle. Residents walking who were not before, elders wearing new dentures who had refused to even go to the dentist because they just didn’t care anymore...it just doesn’t stop.”
In Better Than We Ever Dreamed, Linda Bump explains: “The central role that food plays in caring, comfort and family, and the central role that the kitchen plays in family and community in all of our lives was confirmed as consistent staffing allowed caring staff to respond meal by meal to residents intake with tempting meals of personal choice, illustrating that when residents can eat what they want, when they want, prepared and served with fellowship, weight loss can be ‘avoidable’ in long term care...”
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