The primary goal of all long-term care facilities is (or should be) to provide a "caring community" for those who reside therein. Public opinion and legislation, in addition to professional and lay groups, seek to ensure that the needs of the older adult are met expeditiously and competently.
The director of nursing services in this setting is crucial to the achievement of this goal. Upon her shoulders rests a iarge portion of the responsibility for the enhancement of the quality of life for the residents. In recent years, however, the need for extending the concept of the "caring community" to include the staff members has become increasingly more acute.
Within the past few weeks, the following events have occurred in the lives of the primary caregivers within one facility:
* One nurse filed for divorce
* Another nurse filed for divorce, the husband committed suicide, and the house was robbed while everyone was at the funeral
* While a nurses daughter was hospitalized for surgery, her son-in-law and grandson died in a fire
* A nurse's daughter died when her mobile home caught fire
* A nurse was arrested for DWI and is now in a treatment center
* Another nurse was hospitalized with multiple fractures and injuries sustained in an accident on the way to work
* One nurse suffered a myocardial infarction
* Another developed myocarditis
* Still another received a diagnosis of diabetes
* A nurse's husband died
* One nurse had a hysterectomy
* Several nurses have had influenza
* One nurse must have special scheduling to accommodate counseling sessions
* A nurse's niece was crushed to death under a piano
There are undoubtedly many other problems which were never brought to light, but the above incidences are of such magnitude that they affect not only the staff member, but the peer group as well as the resident population.
The need for nurturing when such trauma occurs is imperative, demanding immediate attention and an ongoing commitment to support, comfort, and strengthen the individual throughout the crisis. How fortunate is the worker who finds that the "caring community" extends to his/her individuai situation when personal tragedies strike.
In times of stress, many persons feel inadequate, wishing to be helpful but unsure of appropriate words or actions. It is with relief that a minister or social worker is notified and cards or flowers are sent. How much more confidently and skillfully a supportive network could be provided for both residents and peers if counseling skills were a part of each nurse's armamentarium.
Although technical skills must always be a top priority equal emphasis must be placed on interpersonal relationships so that the learner/student will develop a heightened sensitivity to the feelings and needs of others. To be able to relate to others in a positive, effective way builds bridges of communication and develops a trusting relationship that will provide a warm, safe harbor when life crises occur.
How and when to incorporate counseling skills Into curriculum are questions which deserve serious and immediate consideration. Unless or until this becomes a reality within the educational system, we who are practitioners must be committed to the development o/ these skills individually and to providing similar opportunities for other nurses.