Using Games to Implement Recovery Language

Tuesday, 31 October 2017: 9:00 AM

Kathleen Lehmann, EdD(c), EdS
Department of Nursing / Department of Mental Health, Boston Veterans Healthcare System (VHA), Hull, MA, USA

Many organizations now encourage the use of clear, unambiguous, plain language in health care and client teaching. Nursing is challenged to move beyond more traditional habits of using medical jargon and language that is concise and succinct – at the expense of the client. This non-client-centered language has been used historically and is abrupt and to the point. However, this language pattern also carries with it the price of being judgmental and often disrespectful. Language that is not client-centric maintains the power imbalance between the medically trained staff and those they are caring for. Recovery principles are undermined when the language used in nurse-client interactions reflects traditional power-based, non-recovery-based relationships. A multi-tiered game was developed and successfully implemented to change the culture inside a long-term psychiatric inpatient unit. Staff first completed the basic eight and one half hour American Psychiatric Nurse Association (APNA) Recovery to Practice (RTP) program, developed in conjunction with Substance Abuse Mental Health Services Administration (SAMHSA). Lists of desired goal language were identified and posted creatively throughout the ward milieu. The first level focus was to learn and recognize the desired language. Once this was achieved, all staff were encouraged and monitored in their ability to implement this language into their speech – particularly in verbal reports. Staff were recognized appropriately using recovery-based language in individual interventions and in group report sessions. Staff then were challenged to incorporate this language into their written reports and daily notes. Ultimately dozens of templates were developed to incorporate this language, to emphasize that even others who read this language will benefit from exposure to this type of practice. Prizes were awarded for individual, team, and then shift collaboration. Ultimately the long-term residents were integrated into the game to practice the language, monitor their peers and staff, and to compete for prizes. Clients continue to participate in a regular Recovery Language group – no longer with prizes awarded. Staff members continue to develop new and creative gaming activities to maintain interest, excitement, and motivation for all.