Shortcomings in treatment

On a few occasions in my professional life, I have encountered employees who have lost their spirit and no longer have the ability to see the person or empathize with the resident's situation. In some cases, these are employees who have had to change employers several times due to procurement and have not received any encouragement or further training for several years.

You have probably read about Lex Sarah cases where healthcare workers have failed in their treatment of residents. It is extremely rare for healthcare workers to be genuinely bad. Often, mistakes are due to frustration stemming from a lack of knowledge.

Poor treatment in healthcare

Poor treatment in healthcare is a serious problem that can negatively affect residents' physical and mental health. It is about a lack of respect, empathy, and professionalism from the health care staff towards the residents. Examples of what residents may perceive as poor treatment include:
1. Lack of communication: Poor treatment can manifest itself in a lack of communication between healthcare staff and patients. This could be not listening to the patient's worries or questions, being inaccessible to provide information, or using medical jargon that the resident or relative does not understand.
2. Lack of compassion: Compassion is a central part of good care. Poor treatment often means that healthcare staff do not show enough empathy towards the resident's pain, fear or emotions. This can make the resident feel ignored or that the healthcare staff is talking over their head.
3. Long waiting times: Long waiting times to receive care are a common source of frustration and poor treatment. The resident may feel ignored or as if their time is not valuable. Likewise, it can be distressing and embarrassing if, for example, the need to go to the toilet is not met.
4. Discrimination: Poor treatment can also include discrimination based on gender, age, gender identity, ethnicity or other factors. This is unacceptable and can have serious consequences.
5. Insufficient information: Residents and relatives have the right to clear and correct information about the care. Poor treatment can mean that the residents do not receive sufficient information about treatment options.
6. Lack of cooperation: Cooperation between different healthcare personnel is crucial in healthcare. Poor treatment can manifest itself in a lack of cooperation, poor communication between different professions, or a lack of coordination in care plans.

Poor treatment is not only uncomfortable for the resident and their relatives, it can also lead to them not reporting care needs and not following treatment advice. It can also create a negative working environment for healthcare staff and affect their well-being. It is important that healthcare works actively to improve treatment, including training staff in communication and empathy, and creating structures to follow up and handle complaints about poor treatment.

Supervision and further training

People who work in caring professions need recurring supervision and further training to be able to handle various situations that arise. Supervision is a necessity especially in situations when staff are emotionally affected. It can be difficult not to act based on one's own feeling. In order to benefit from supervision, it needs to be regularly recurring.

The supervision may need to contain many different perspectives. Firstly, it is about treating people with dignity even though you yourself are not respected. People with dementia can behave irrationally and sometimes aggressively. The healthcare worker must use themselves as a tool to get through. Learning from colleagues and better understanding the individual provides tools in the meeting. Supervision is also further training when it comes to new and changed work tasks. Interaction between colleagues in a team that works closely together and who depend on each other to do their job is not always easy. Cultural issues, non-verbal communication and values are other issues that may need to be discussed.

The values are reflected in the treatment

Ethics means reflecting on moral issues. What is right and wrong, good or bad. It's about suffering, respect for self-determination and integrity. Reflection is a good method that leads to reduced stress and helps staff come up with good solutions and decisions in ethical dilemmas. In order to remain good at helping others, we need help dealing with the feelings that difficult encounters evoke within us. Therefore, the opportunity for supervision and reflection is so important. Sometimes I feel that people care more about the business's cars than the employee.

It can be difficult to get recurring supervision in nursing homes where everyone works on a schedule and many work part-time. Having short feedback sessions every day where the manager and qualified staff regularly stop by and take part in what is happening, can be a start. To set aside time for reflection every week. Plan regular meetings where the contact person can follow up on the care efforts for their resident together with the nurse, occupational therapist and physiotherapist. In these meetings, discussions can be held about how the staff in the operation can best support the resident and their relatives. My experience is that it is important to have a clear structure so that everyone knows when and in what forms meetings take place. A work team is no stronger than its weakest link. If a colleague falters in their treatment, it creates an insecure situation for the residents.

Care staff:
- What do you do in the team to each other when difficult things happen?
- For example, how do you handle a situation when it's difficult to find a good approach to a confused resident?
- How do you notice when a colleague is run down or has difficulty finding a good approach to one of the residents?

Manager, nurse, occupational therapist and nurse:
- What do you do to create a learning organization?
- How do you create a structure where there is time for reflection and knowledge exchange around the residents so that the team together can offer the best possible care?

Residents and relatives:
- Are you invited to contribute with knowledge when it comes to the care of your relative?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day