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Section 22
Effective Strategies for Replying to Blaming and Verbal Abuse

Table of Contents | NCCAP/NCTRC CE Booklet

Four  "Blaming" Diversions

When you tell your Sue about failure to follow through with the agreed upon plan to reschedule the resident’s PT time, she might look for someone to blame her lack of follow through on. Here are four blaming diversions regarding various Culture Change requests.

1. Blaming you for Culture Change
She may try to excuse or rationalize her lack of follow through, and try to make you feel guilty.  Sue unconsciously may change your request for Harry and Mary’s schedule change into the question, “Why are you changing things from the way they have been?” As a result, she may blame you by stating, "Why are you saying I should change their schedule when I have never had to do this in the past to accommodate Activity attendance?   You are making things so difficult."  You could deal with her blaming accusation briefly, by repeating your "Broken Record" script.  Or if you feel a separate meeting needs to be scheduled, do so.

2. Blaming you for their lack of follow-through
Imagine how you might reply in a friendly, professional manner that encourages support when the other staff member blames you.   He or she might state,  “What is your problem?  You’ve been Activity Director here for a year now and all of a sudden you are asking us to do things we have never done before.  Why are you making things so difficult for me?” 

Staff can be very ingenious at blaming you for their own shortcomings regarding Culture Change.  So how do you respond?  Basically…
A. Keep attention focused on the specific Culture Change area your script is about. (transporting, scheduling, and/or Activity involvement)
B. Don’t get sidetracked into new problems of apportioning blame by focusing on past transgressions or lack of follow through.
C. Keep repeating your "Broken Record" script developed in the previous sections regarding their doing something to take action on their area of non-compliance (changing his/her behavior). 

3. I told you so
If you suggest a plan for Culture Change compliance that does not work, the other staff member may respond with, "I told you so."  For example in care plan conference you may suggest Hester do yarn winding in her room once it has been provided by a CNA.  The other Department Head states,  “Suzie is a new CAN and has a lot to remember and will probably forget to give the yarn winding to Hester.”  Since you had just left Hester in her room prior to Care Plan Conference doing yarn winding, you state you’d still like to give it a try and arrange for giving a 2-3 minute Inservice to Suzie concerning initiating yarn winding with Hester.   Now, as these things sometimes go,  Suzie in fact is not giving Hester the yarn winding, even after you have Inserviced her.  When you bring to the attention of  the other Department Head, she blames the current lack of follow-through on your not following with her advice by stating, “I told you so.  I told you Suzie would not remember to give Hester the yarn winding.”  

Here’s the challenge for you… Though this parent-like “I told you so” attitude stings, I feel you need to resist a counterattack by not taking the staff member’s “I told you so,” parent-like comment personally. Keep in mind, the issue is Suzie’s current behavior, which you find unacceptable regarding Culture Change and want changed. You could answer an “I told you so” by using a simple deflection.  Here it is:
A. “That may be true, but my point or concern is... (agree . . . but) I know our CMS Survey is coming up in a few months and I want to be prepared,” or ;
B.  “That may be true, but my point is... (persist with your Broken Record script) the facility needs an activity program that is in compliance.”   These replies keep your conversation focused on the area of support you are requesting. They keep you from digressing into a position of defending your actions.

4. Blaming the actions of others
A fourth way a staff member can blame others and thereby justify his or her unsupportive behavior is by appealing to group norms or standards.  By appealing to group norms or standards, I mean the other staff member states, “No one else is giving residents activities after they return from breakfast.” You simply indicate that you don’t share these standards of behavior by stating, “That may be, but the facility needs to comply with CMS Culture Change.  For this reasons, I really need your ideas as to how Suzy might be reminded to provide Hester with yarn winding after she returns from breakfast.”

In general, when the department head or staff member replies with one of the above forms of blaming, do not respond to their attempts to excuse their lack of follow through by their creating a diversion composed of blaming you. Above all, don’t blame back!  Focus on the future and create a specific, practical plan to help them support you.  Ask “Is there something I can do to make is easier for Suzie to give Hester the yarn winding?  Would it be possible for me to give Suzie another Inservice in Hester’s room showing Suzie how I get Hester to do the yarn winding?”

Staff Member:

What blaming statement was made?

What is your reply to get her/him back on track?

 

The “Verbal-Abuse” Diversion

Verbal abuse in­cludes insults, disapproval, “cussing out,” sarcastic remarks, and other forms of put-downs.  Of course reactions of verbal-abuse to your requests for staff support are rare and can be very subtle.   The types of verbal abuse you can imagine are almost unlimited in kind and quality. However, generally, the verbal abuser can criticize
--your views  “Who cares about Culture Change.  They didn’t focus on it in the last survey!”
--belittle you “Getting too big for your boots aren’t you?”
--downgrade your ability “I noticed in Care Plan Conference you had not interviewed all the new admissions!”
--or personal characteristics. “And when will you learn to spell?”

However, a horror story you may tell yourself is that the unsupportive department head or staff member will assault you verbally when you bring their area of lack of support to his or her attention. Despite all efforts to eliminate inflammatory words from your scripted developed in the previous Sections, the other staff member may still interpret your requests as critical and challenging. Thus, his or her reaction to your scripts may be to criticize or attack you.  For example, by saying the following when you request a schedule change from the Speech Therapist to enable a resident to attend an Activity:
--“Oh, the Activity Director is running Speech Therapy now!”

To dispel your perhaps unfounded fear of a verbal attack like the one above, I find it best to plan for the worst case scenario.  Thus, by planning for the worst, you can put your fears to the side knowing you have planned for the worst case scenario, even though it may be an unrealistic fear.

Verbal-Abuse:  Strategy #1 Ignore
My experience in consulting is that in facilities where staff feel stressed they use verbal abuse as a sort of escape bubble to release tension caused by circumstances probably unrelated to your program.  Most such verbally abusive statement should simply be ignored as you continue with your script.  Why ignore the insults or sarcastic remarks?  Well… why reward the other staff member for the abuse by letting it sidetrack you?  In the examples below, notice that the replies concentrate on staying on track to solve the staff support issue. Of course you avoid counterattacks, since counterattacks are likely to increase verbal abuse by the other staff member.

Verbal-Abuse:  Strategy #2 Acknowledge
You can acknowledge someone’s anger or abuse, by saying something like, “I can see this makes you angry (upset/anxious/concerned, etc.).” 

Verbal-Abuse:  Strategy #3 Reschedule
“This is important to me (the facility/my department/Mr. Jones etc.).” If she continues some form of abuse continue calmly and state, “It’s important that we talk about this, but I can’t hear you when you are talking this way. 
Would this afternoon be a better time to talk?” Or, “Let’s talk when you have had a chance to calm down.” Or,
“Why don’t we talk later?”

Try to defuse the anger by changing your Broken Record script.
If the other staff member insults or swears at you, you can ignore it or perhaps REDEFINE what it means in less emotional terms.   By “redefine” I mean try out several Broken Record scripts.  What works with one staff member may not work as well with another.
1.You might start with, “The problem is I am unable the check  Effie’s attendance record now.” 
2. You might change your Broken Record script to “I need to be prepared for Survey.” 
3. If that doesn’t work, try “Mr. Jones is concerned about activity department compliance with Culture Change.”   Get the idea of changing your script to find which one defuses their anger.

Be Big… not Small!
Remember don’t take their verbal abuse personally.  They just are venting built up frustration, anxiety, or fear etc. from  many different areas that their job demands.  Your request for staff support happens to be the straw that broke the camels back, so to speak, on this particular day at this particular time.  So be the bigger person, take the high road, develop a thick skin and  “Don’t Take It Personally” or remember the acronym DTIP.

Staff Member:

What “verbally abusive” diversionary statement was made?

What is your reply to take the high road and get her/him back on track?

 



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