i) Managers

Managers of workers working with people with ABI need to understand a key to working with a person with an ABI is building a relationship with them. Working with people with acquired brain injury can be difficult.

• It can be hard to get to know them.
• It can take time to get to know them.
• Behaviours can be difficult to deal with.

The difficulties create stress for workers and the stress needs to be managed so it doesn't lead to disillusionment.

Rules of thumb

1. Be clear on what good management and supervision of staff entails

2. Be aware of the disillusionment process

3. Take steps to prevent stress for workers so the disillusionment process does not set in.

4. Understand what pushes your buttons and develop strategies for dealing with this.

 

One manager said:

I think that the challenge is the unpredictability. Because you can work with one person one day and the next day it can be a totally different scenario and that's due to their injury, the nature of their injuries. So it can be the littlest thing that has changed for them that has totally upset them. So from day to day you don't quite know what you are walking into and how you can best support your client.

 

ii) Managing staff   

Good staff management and supervision includes:

How to get the right person for the job

• Recognise the value of the recruitment process
• Identify important criteria in selecting staff to work with people with ABI.

Developing and retaining staff

• identify key strategies to retain and develop staff working with people with ABI.
– orientation
– training and education
– performance management

Good management practice

• Identify key issues in working with clients with a brain injury
• Identify strategies and good practices for effective supervision and support of staff working with people with ABI
• Identify good management practices
• Explore basic concepts in the provision of client services
• Identify the value of policies and procedures
• Recognise the stressors that often exist for staff due to the nature of brain injury
• Identify management strategies in response to staff stress.

The role of the manager

• Identify essential skills and responsibilities for managers
• Link recruitment with a Management Framework.

Good management practices

• consistent approach to client management
• good communication, written and verbal,
• clinical and critical pathways
• develop and foster a team approach
• hold regular meetings to review and monitor and evaluate plan
• provide in service education and training to staff
• provide crisis management, intervention and debriefing
• rotate staff to prevent burnout and stress
• OH&S issues for staff – safe workplace
• accessible and user-friendly policies and procedures
• recognise staff stress – disillusionment process and stress.
  

(c) Copyright - See: Module 7. Case management - www.TBIStaffTraining.info

 

iii) The disillusionment process   

Staff working with people with ABI can experience a disillusionment process - especially when staff management practices are not working

The disillusionment process moves through the following phases:

Enthusiasm

• Unrealistic expectations for the client
• Inadequate skills
• Over identification with the client - not professional relationship
• Over investment of self - personally involved.

Stagnation

• Lose enthusiasm with client due to unrealistic expectations
• Other needs assume greater importance
• Sense of unfulfilled expectations - feeling of non-achievement

Frustration

• Questions effectiveness - feels client is not achieving
• What's the point
• Staff member loses respect for the client
• Hostility towards colleagues and superiors

Apathy

• Staff member does the minimum
• Disinterested
• Its only a job
• Emotional detachment

Staff members leave with negative experience.

Strategies for preventing the disillusionment process

Some of the strategies for preventing the disillusionment process from setting in are:

• Realistic expectations for the client
• Staff understanding of ABI generally
• Staff understanding each clients ABI - injury - effects - behaviour
• Staff training with the skills to manage the behaviours for each of the clients they work with.
  

(c) Copyright - See: Module 7. Case management - www.TBIStaffTraining.info

iv) Preventing stress  

Good management processes will prevent stress and the disillusionment process from occurring. Understanding the causes, symptoms and prevention strategies for staff stress enables the manager to act early. Positive staff management practices within an organisation maintain enthusiasm and involvement of staff with the client and the organisation. It is the key to retaining staff:

Symptoms of staff stress

• absenteeism and poor time keeping
• regular extended breaks
• high Staff turnover
• tiredness, apathy, depression, avoidance of clients and colleagues
• extreme cynicism
• no team work
• negativity
• loss of professionalism.

Causes of staff stress

• working in isolation without support
• long periods of intensive work with little relief
• aspects of work tasks which assault personal dignity, individual differences coping with stress
• exposure to pressure when least able to cope
• lack of training
• no crisis intervention or debriefing from Managers
• lack of communication, direction and responsibility from Managers
• no plan or goals to work toward
• lack of understanding & acceptance of capabilities & limitations of other.

Stress prevention

• provide relevant training and orientation
• remove staff from the stressful situation, encourage them to leave their work at work
• provide crisis intervention, support and counselling
• have clear OH&S policies and procedures
• expand on the staff member's individual skills
• approve leave and roster changes
• provide opportunities for peer support and working with a more skilled colleague
• involve staff in decision making, to contribute ideas and problem solving
• hold regular meetings where grievances can be aired constructively and support refocused
• communicate realistic expectations, from the perspective of staff
• assume responsibility for and deal with organisational matters that create stress
• communicate clear organisational aims and have written policies and procedures
• set up a method of evaluation and review related to client goals and aims.

(c) Copyright - See: Module 7. Case management - www.TBIStaffTraining.info

v) Questions