Do you have a staff member that uses joking as a diversion or detour from making a change you are requesting? Remember, as mentioned previously, do not fall into the trap of viewing this staff member as bad, cruel, or somehow defective. Merely view him or her as employing a familiar communication tool to create a diversion to possibly lower their stress level on the job. In short, objectify and separate. Don’t make the mistake of personalizing by getting your feelings hurt. Also, don’t make the mistake many Activity Directors, with whom I have consulted have made, the mistake of using the other staff members’ mere diversionary remarks as a measure of your or your Department’s self-worth.

Here’s how I have observed the “joking” diversion used. The other staff member may respond to your requests for support by
--making a joke about your request “Oh sure like Hester could really wind yarn!”,
--poking fun at you, “Change the medication schedule! Who died and made you Medical Director?”
--or exaggerating your claim in a ridiculous manner. “Oh! So you are saying CNA’s have never transported a single resident ever to any activity!”
--or exaggerating your request in a ridiculous manner. “Oh, right! Now CNA’s are suppose to do arts and crafts! Who is going to get residents dressed… the Activities Staff?”

To deal with the ridiculing and/or joking, you could ignore the humor and simply persist with your Broken Record script. Nothing extinguishes a jokester’s humor as fast as a deadpan unresponsive recipient. Below write an example of joking distraction and how you might reply to them.

Staff Member:

To prepare yourself, write down a joke or humorous retort the other staff member might make to the lines of your scripts.

As you may have noticed, sarcastic humor is a popular form of put-down in our society. So you may want to prepare some one-line replies for occasions when you need them. How would you reply? The best reply is to repeat your Broken Record in a neutral non-defensive tone. “I need to be prepared for Survey.” Etc. Considering the Department Head’s or staff member’s brand of humor, write the lines of your script that are most likely to produce a humorous (or contemptuous) reaction from the other staff member?

Write your reply.

Next role play with another activity staff member or significant other at home your script as a response to a Joke diversion given by an unsupportive staff member. We’ll talk more about practicing your script at the end of this Manual.

If you express negative feelings about a staff member’s lack of follow though, she may answer, not with a joke, but by reinterpreting the “meaning” of his or her lack of follow through, by saying that she intended to do what you requested. For example, a staff member may state, “I intended to tell Erica the Medicine Nurse that the medication for Herbert was to be given after rather than before the Men’s Discussion Group, to enable him to stay awake during the group.” In short, by saying they “intended to” do something is not equal to, or let’s them off-the-hook from, actually giving Herbert his medication after, rather than before, the Men’s Discussion Group.
1. Recognize “I intended” as a Valid Statement
Step One, or the initial way to respond when the other staff member reinterprets her or his behavior in the favorable light of “good intentions” is to of course give them another chance. Sincerely and genuinely state, “Oh good I am glad you remembered about Herbert’s med schedule change that we discussed last week.” However, next week if Erica states, “I intended to change Herbert’s med schedule and forgot again,” and the next week and the next week; clearly Erica has her own broken record script of “I intended” she is using with you.

2. Create a Plan to Facilitate Compliance
Step two regarding the continual user of “I intended to” is to point out her behavior, “Erica I noticed the last three weeks you have stated you intended to change Herbert’s med schedule, what’s the next step? Is there some way I can help to remind you to make the change? Would a post-it note or an e-mail help? If so, where is the best place for the Post-It Note or what is the best time to send you the email?”

3. Escalate
Step three, if the med schedule still is not changed after repeated validations and plans, you can escalate by talking with whomever is above her in your facility hierarchy. You might mention this escalation to Erica, of course as a last resort. Put it in the frame of “I don’t know what else to do. My department needs to comply. Herbert’s mental ability would benefit from the Discussion Group. I don’t know what else to do but talk to the XX (Charge Nurse/Inservice Nurse/Care Plan Nurse/DON/Administrator). Do you have any suggestions?” You fill in the name and/or title of the appropriate person. Of course, the danger of this is that your words might come across as a threat. Use your judgment as to whether you will inform the staff member of this escalation or not.

Staff Member:

Situation to which they responded “I intended to…”
What will you say to:
1. Recognize “I intended” as a Valid Statement

2. Create a Plan to Facilitate Compliance

3. Escalate, as a last resort, if needed

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