Do you find it easy to fall into the trap of the “if only” Blame Game? By the “if only” Blame Game, I mean you find yourself thinking “poor me.” “If only the CNAs would transport residents and give residents the activities left in their rooms.” Or you find yourself thinking, “If only the therapy, medication, and shower schedules could be arranged to accommodate residents attendance in activities.” I find usually “if only” statements accompanied by a “poor me” attitude by the activity professional lead rather quickly to blaming, because you are starting to take the actions of others personally.

Taking things personally can mean blaming others or expecting to be blamed by others. I’ve noticed a subtle dynamic regarding taking responsibility in some facilities. One staff member will maneuver the other staff member to make a decision that would more appropriately be a joint agreement. Why? Because then the uninvolved staff member can say, “It’s your fault, I didn’t create this plan for Culture Change implementation.” The key to avoiding this is, as mentioned in the four steps in Section 2 above, is to suggest a plan to facilitate implementation of Culture Change. For example, organizing names of residents to be transported based upon the organizational system of the CNAs workload. So rather than allowing your DON to give you lip service by saying, “Yes, residents will be transported tomorrow to the Sing-a-Long,” but then the “busy and short” excuse is given, be invested in proposing a specific plan to your DON.

If you take lack of support personally, as yourself, are you using the ultimate gem of , “How can you do this to me?” This is the trademark of a staff member with a martyr mentality. The “How can you do this to me?” martyr mentality seemingly attempts to instill both guilt and blame upon the transgressing staff member. Think about your self talk regarding transporting, schedules, and activities by all staff. Do you repeat rhetorical questions to yourself like “How can you do this to me?” or “How can you do this to poor Helen, who enjoys Sing-A-Long so much?” Do you accompany these thoughts or verbalizations with a great sigh? It can make knots in your stomach and have devastating long-term effects.

Asking for Culture Change to be Implemented
The reason why I am helping you focus on blaming others is that rejection of other staff’s behavior perhaps becomes full-blown when it comes to your getting up enough courage to find the words to ask for something you want or need. What if the Speech Therapist tells you, “No, I cannot change Helen’s speech schedule.”? Can you tolerate the “no,” or do you feel embarrassed and apprehensive for even asking? Do you have a habit of overgeneralizing and
A. Blaming yourself by telling yourself you are worthless and not respected in the facility? Or…
B. Do you tell yourself that this department head doesn’t care about you or your Activity Program or CMS Culture Change compliance?

However, here’s the problem with blaming yourself or the speech therapist : who or whatever your are blaming has happened in the irrevocable or unchangeable past. Oftentimes, if you are like me, you end up thinking, “Ain’t it awful that thus and so happened.” So you end up awfulizing or catastrophizing, and feeling stressed about Culture Change. The solution… change your mental filter. Here’s how.

Blaming Others: List something that happened or did not happen in the irrevocable or unchangeable past in which Culture Change was not implemented due to lack of support from another staff member.
[For example, Ella was taken out of Exercise Group for her shower. Robert slept through Bingo because his medication schedule was not changed. Effie has a three-piece puzzle in an Activity Bag taped to her night stand, and once again this was not given to her after lunch.]

Empathize: Since blaming another does not change anything, change your mental filter. Don’t take the staff member’s lack of follow-through personally. To stop yourself from personalizing the staff member’s actions, empathetically hypothesize a reason for that specific staff member’s lack of support or follow-through. Below list a possible reason for Culture Change not taking place in your example above. [For example, perhaps the Director of Nursing has not told the Charge Nurse that Ella’s shower schedule was to be changed to accommodate her attendance in the Exercise Group. Perhaps the speech therapist’s hours have been cut at your facility. She likes to group residents with similar speech problems together. Thus she feels she cannot accommodate your request.]

Action Plan: Using the four steps proposed in Section 2 above, make a plan.

Step One: Describe the non-compliant behavior in observable, non-blaming terms.

Step Two: Describe how you felt about the behavior.

Step Three: Describe how you explained the non-compliant staff member’s behavior to yourself.

Step Four: Describe what you would like to have happen the next time.

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