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Healthcare Training Institute - Quality Education since 1979

Section 11
Track #11: Obstacles to Gaining Staff Support

Table of Contents | NCCAP/NCTRC CE Booklet

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Note-Taking Exercise

What are the two main pay-offs for not being assertive?
1.

2.

What are the pay offs or rewards if you act non-assertively and do nothing if the resident is not transported?
1.

2.

3.

What possible reason do you have for rocking the boat in your facility?

What is catastrophic thinking?

What is the worst thing that could happen when you request a change in your facility?

What forms of catastrophic thinking can you recognize in your thought habits?

Transcript of Track 11

What stands in the way of your gaining staff support and cooperation?   Let's examine where we have come from.  On the last track we discussed the three risk levels to consider when approaching an obstinate staff member.

I feel it is time to look at four self-talk messages you may be having at this point in listening to this CD set that are, in essence, causing you to say to yourself at some level, "I could never rock the boat that way!"
 
On this track, we will examine two obstacles to gaining staff support and cooperation and the consequences of each. These obstacles are: (1) payoffs for acting non-assertively; and (2) catastrophic thinking.

#1 Overcoming the Pay-Offs for Inaction
Along with fear of conflict, discussed on track 3, the second obstacle is the Pay-offs received for not dealing with problems.  By this, I mean the personal benefit or pay-off for NOT taking action may outweigh the pay-offs for taking action.  Agree?  (pause)

Clearly there are some apparent pay-offs to non-assertion, none of which will help you regarding compliance, or the quality of life for your residents in the long run. The two main pay-offs for not being assertive are, of course, safety and praise.  Non-assertion, or not taking action, may seem safer.  Non-assertion can also be seen as polite and easy going, leading to praise from others.  Not that there’s anything wrong with being polite and easy-going,  However, letting things “go,” all the time leads to that sickening feeling in the pit of your stomach that your requests are being ignored, you are being taken advantage of, and not being treated with respect. 

When you turn the CD player off, ask yourself, “What are the pay offs or rewards if I act non-assertively and do nothing if the resident is not transported?” 

It's easier to do nothing, keep the status quo, and not rock the boat.  Now, When you turn the CD player off, ask yourself, “What possible reason do I have for rocking the boat in my facility?”  I am hoping the answer will be a commitment to improve the quality of life for your residents. 

#2 catastrophic thinking
Now that you are thinking about how to overcome the huge pay offs for inaction, lets look at the next obstacle: irrational thinking. In addition to overcoming the payoffs for inaction, possibly the second largest of all obstacles to gaining staff support and cooperation is your catastrophic thinking. 
What do I mean by catastrophic thinking?  As I describe these, see how many, if any, apply to you when you think about making waves when residents aren't transported, for example.

catastrophic thinking occurs when you work yourself up to thinking a situation is much worse than it is.  When you catastrophize, you are always asking yourself “What if…?”, and scaring yourself with irrational, worst-case-scenario answers.  What if Julie resents me when I give her the reason why Ella needs to be transported?  What if she tells the other CNAs, and no residents are transported?  When you turn the CD player off, imagine the worst thing that could happen.  Let your imagination go wild. 

When you did this catastrophic thinking exercise, did you start to think in absolutes?  By absolutes, I mean did you only remember negative situations or actions of others, and likewise view the future negatively, using words like always or never?  For example, "Julie never transports residents!" conveniently forgetting about the one time in ten she did transport.  Did you add in a touch of must-have thinking?  Must-have thinking restricts your idea of what is acceptable.  Must-have thinking causes you to believe you must-have everything you want, all CNAs transporting every resident you request all the time.  If you don't have perfect support and cooperation, you have nothing.  Or perhaps you become involved with rationalizing.  Rationalizing occurs when you go to great lengths in your mind to justify an unacceptable action or situation so you don’t have to deal with it. 

When you turn the CD player off, rethink which catastrophic thought patterns you practice.  I'll repeat them. 
1. Catastrophic, or fear of what-if. 
2. Thinking in absolutes, using words like always or never and not recalling any positives.   
3. Must-have thinking, regarding you must-have what you want 100% of the time.
4. Rationalizing your lack of assertiveness by excuse making or justifying.
Now, recall which of these catastrophic thought patterns apply to you.

To overcome the pay off for inaction, you may need to overcome your catastrophic thinking regarding:
1. Fear of what-if. 
2. Thinking in absolutes, using words like always or never and not recalling any positives.   
3. Must-have thinking, regarding you must-have what you want 100% of the time
4. Rationalizing your lack of assertiveness by excuse making or justifying

On this track, we discussed obstacles to gaining staff support and cooperation.

On the next track, we will examine Positions of Powerlessness.