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CHAPTER 11
FUTURE PULL Understanding the Culture in Culture Change by LaVrene Norton
other’s perspective they also become more aware of the darker realities they have previously walked past and ignored. It is this initial wake-up that must take place, as surely as an alcoholic must acknowledge the addic- tion. A powerful visceral experience is often needed to assist in this awakening.
A simple exercise Action Pact uses is to give learn- ing circle participants questions on a form and send them off to spend 15 minutes sitting with a resident of their choosing and ask what they miss most about their earlier life. Another tool is a powerful slide show that compares homeless people with nursing home residents. These exercises often are the wake-up call needed to confirm staff’s hidden fears: that many if not most nursing home residents feel lonely, powerless, and even homeless. These and other techniques can shake otherwise loving staff members from the lethargies of providing care to rather than in cooperation with older adults. Once they begin to see the gaps between the myths and realities, they also begin to understand what they can do to bridge them.
THE INFLUENCES PEOPLE HAVE ON
EACH OTHER WITHIN THE ORGANIZATION
To know your organization’s true culture is also to understand the influence certain people have on it. For example, the organization’s overall climate may be pes- simistic, but how about those folks in Hallway B? They are always smiling and joking with the residents; you can feel the positive energy just by entering their sec- tion.
Often the source of stark differences from one part of the organization to the next is an individual or small group of people whose enthusiasm and good cheer are enough to buck the overall trend and light up those around them. Or conversely, a negative personality can put a whole department on life support while the rest of the organization seems fine. Thus, individual influ- ences make for a continuously shifting culture within the larger organization.
One of the strengths of an organization is that its identity, presentation, practices, and reputa- tion exists independently of any individual or small group within it, including any of its leaders or the
board’s stated purpose. However, that is also part of the danger: It becomes its own thing, for better or worse, as there are underlying assumptions that di- rect the actions of its individual members. Also, there are values that have been defined or repudiated that are not necessarily known or adhered to by all.
And there are daily procedures, schedules, and practices that are often not properly integrated into a thoughtful and compatible blend. For example, con- sider how a nursing home operating 24 hours a day, 7 days a week is guided by many forces from many directions (e.g., doctor, pharmacy, dietitian, state regu- lators, director of nursing, environmental services, risk management). These are some of the challenges to un- derstanding and changing culture.
THE ARTICULATED AND THE FUNCTIONAL VISIONS OF THE ORGANIZATION
Akin to the differences between the myths and realities coexisting in the organization is the gap be- tween its articulated and functional visions. The nurs- ing home web site may say residents have choice here, but in practice the choices are superficial, such as selecting the color of sweater you want to wear to- day or whether you want oatmeal or eggs for break- fast. Meaningful choices such as when to get up and how to spend your day do not exist.
Or the board’s strategic plan and annual report speak of creating a more homey environment for residents. There may be fresh paint and new residen- tial-style decor in the lounge, but out on the floor the old institutionalized regimens prevail. Residents sit stiffly in the nice new reclining chair or avoid it altogether, afraid to muss the furniture.
As Action Pact assesses and begins to understand our clients’ organizational culture, we compare the ar- ticulated concepts presented on its web site, in its lit- erature, and by its executive leaders and middle man- agers with what is happening in the home. Often, the two are opposites; the cheerful facade shown to the public hides a more sobering reality.
As with myths versus realities, the bigger the gap between the articulated and the functional, the more troubled the culture, and formal leaders may become numb to the realities and regard the facade as real if
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