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Healthcare Training Institute - Quality Education since 1979

Section 23
Recognition and Non-recognition

Table of Contents | NCCAP/NCTRC CE Booklet

a. Recognition: Is It Perceived as Being Fair?
Recognition is a double edged sword.  The reason recognition is a doubled edged sword as a motivator is because residents have to see the system of recognition as being fair.  Agree?  Here's an analysis of the story from the DVD.
1. Awards:  You might consider having an activity's Resident Volunteer Tea where you recognize your Resident Volunteers. 
2. Decide on Criteria:  Let’s say you decide that Helen is going to receive the award for being the "Resident Volunteer Gardener of the Year."  Helen is a real worker.  She’s out in the garden all the time and you make a big ribbon to give to Helen and at the Resident Volunteer Tea you say “…and the Gardener of the Year is Helen!” 
3. The Non-Worker:  Now, Laura is a complainer.  Laura says, “I’m a gardener!” But Laura is a sidewalk superintendent.  She would tell Helen, “You missed a weed!  Why’d you plant the corn there?  It’s going to shade all the other flowers.”  Of course, you’ve said to Laura, “Laura would you like to help Helen?”  Laura stated, “For the amount of money I’m paying to stay here!  Me work?” 
4. Award Given: Now it comes time for the Resident Volunteer Tea, Laura is sitting next to Helen.  Helen gets the nice big ribbon.  She gets the big award.  What does the complainer Laura say to Helen?  “Oh, how wonderful?  You did such a great job?"  No.  She says, “What? Why didn’t I get one?!” 
5. Unfair: She doesn’t only complain to activities and social services, but she complains to everybody! – nursing, families, and on and on.   Right?  The idea here related to the Recognition Dilemma is the fact that whenever you recognize anybody related to anything, whether it’s at a Resident Volunteer Tea or maybe the special person who gets to hand out the songbooks, people have to perceive the system of selection as being fair.
6. Solution:  Create an awards committee that establishes the criteria for the award.  This criteria is made clear to Laura prior to the Resident Volunteer Tea.  In addition to Laura you also explain the criteria or the Gardener Award established by the Awards Committee to staff, family, volunteers and any others that Laura might complain to.

Two key points regarding rewards:  1. The system need to be perceived as being fair.  Reward can act as a big de-motivator if they are perceived as not been awarded fairly. 2. Notify all ahead of time regarding the criteria for giving a reward.

Residents to motivate by the use of "Recognition"

Culture Change CNA Inservice:  Brainstorm about residents CNAs feel that “Recognition” could become a motivator to encourage involvement.

b. Non-Recognition, A Success Story
Here's a success story regarding the use of Non-Recognition as a motivational tool.  As you hear this story, be thinking of your Henry for whom non-recognition may be a motivator to become involved in an activity.

When I was an Activity Director, I conducted a Men’s Discussion group.   About three or four male residents would sit around in a circle and talk.  There was a new admission, Henry, who was an alert male resident.  I thought to myself, “Oh wow! Another person to add to my Men’s Discussion Group.”  Henry had his left leg amputated due to diabetes.  He was in a wheelchair.  I brought him into the Group and he seemed to enjoy the meeting.  The men sat around in a circle and they would talk.  So the next week I went to Henry’s room, and I asked, “Henry, would you like to go to the Men’s Discussion Group again this week?”  I was sure he would want to go because he laughed and joked with some of the men, and he seemed to enjoy the group.  However, he said, “No, I don’t think so.”  And the following week I also got a “No." By the third week when I got another “No,” I knew that he wouldn’t be coming back to the Group.  I am sure you have probably experienced the same thing.  A resident attends an activity one time and everything seems to go well.  However, they won’t come back.

"Embarrassment" was the key:  The behavior that I observed about Henry when he would look at me during a conversation, there were times when he would break eye contact and look down to where his leg had been.  Henry then would look away in what I interpreted as embarrassment.  Remember I told you I had the men sitting around in a circle. None of them had any visible deformities like Henry, who had an amputated leg.  So you tell me how I changed the format of the group.  I had the men sit around a table, so that Henry’s leg was hidden.  Now regarding interdisciplinary communication, I stated, “I think this fellow is embarrassed about his leg, so what could nursing do when they get him into his wheelchair?”  “Put a lap robe on his lap.”  Sure, put a lap robe on him.  Now I believe nursing is going to have an easier time getting him out of his room and when he is being taken down into the dining room if they put a lap robe on his lap.  So pass along this information regarding non- recognition and hiding Henry's leg to nursing to facilitate their motivational attempts to get Henry to leave his room. 

Here's another example of non-recognition.  Let's say you have a resident who has to go to the bathroom frequently.  You might say, “Mabel would you like to come out to the Current Events discussion?”  She replies, “Well, I don’t think so.”  You might say with the idea of Non-Recognition in mind, “Well, you know, we’ll have you sit in the back of the room so that if you have to go the bathroom you won’t have to get up in front of others.”  The embarrassed resident may not bring their fears, insecurities, and concerns to your attention.  So be sure to tell the Mabel’s CNA about her insecurities when he or she is getting Mabel ready to go to Current Events.  Tell her, “She will sit in the back of the room.”  Can you think of resident’s for whom you have forgotten about this Non-Recognition technique of telling them they will sit in the back of the room?

Below write the names of your residents who may be motivated by non-recognition.  Also write what serves as a means to avoid drawing attention to your Henry's or Mabel's area of concern.

Residents to motivate by using "Non-Recognition"

Culture Change CNA Inservice:  Brainstorm about residents CNAs feel that they could motivate by the use of  “non-recognition.”