Addressing the Needs of Direct Care Staff When Affected By Natural Disasters Globally

Background

A competent workforce committed to providing patient-centered care is vital since retention and turnover rates of direct care staff in skilled nursing facilities are directly related to quality of patient care (Austrom et al, 2015). Turnover and retention rates can become extremely challenged when a workforce is in crisis.  Following the 2010 devastating earthquake in Haiti, 31 skilled nursing facilities in Florida and Georgia actively engaged in providing support to Haitian employees and their families both in USA and Haiti. Administrators, leaders and line staff participated in the support and relief efforts to acknowledge their staff’s grieving period over their native country’s devastation. This was effective when other employees experienced natural disasters affecting them and their families, 2012 Hurricane Sandy in New Jersey, 2013 Tsunami “Yolanda” in Philippines and 2014 Ebola crisis affecting staff working in the Texas facility.

 

Theoretical framework

There are four concepts underpinning person-centered nursing a) being in relation; c) being in a social world; c) being in place and d) being with self. The articulation of these concepts raises the recurring themes of knowing the person, the centrality of values, biography, relationships, seeing beyond the immediate needs and authenticity (McCormack, 2004).

Method

HCR ManorCare collaborated with the Haitian American Nurses Association (HANA) of Florida, Inc. to respond to crisis, demonstrating an engaged, caring and employee focused response to this crisis. Workforce turnover rates at HCR ManorCare were monitored during and after the Haiti earthquake whereby 20% of HCR ManorCare workforce were impacted by the Haitian crisis. 

Results

The earthquake in Haiti occurred on January 12^th 2010. After year one of this intensive crisis intervention, HCR ManorCare retention rate 2011 was 81% compared to the overall industry retention rate of 71% -demonstrating that HCR ManorCare results were stronger by 10%. Furthermore, in 2011 HCR ManorCare turnover rate was at 30.4% vs the industry average at 44% demonstrating 13.6% stronger results than the industry average.  Measuring the same results for year 2012, retention rates for HCR ManorCare were 79% with the industry retention  running at 68.9% - demonstrating that HCR ManorCare was stronger by 10.1%. Turnover rates 2012 for HCR ManorCare were running 30.1% with the industry turnover at 50% demonstrating substantially stronger results of 19.9% by HCR ManorCare.  Finally, HCR ManorCare in 2016 measured the retention rate of all employees impacted by 2010 earthquake and 6 years post-earthquake, the company has retained 52%of the original 2010 Haitian team.

Discussion

This program demonstrated that when proactive and engaged management teams collaborate with community resources during workforce crises they can effectively maintain or improve on retention or lower turnover rates.  Post-earthquake, HCR  did the following: (a) provided employees with calling cards for Haiti to allow for multiple communications between loved ones; (b) gave “HUG” fund grants to employees with losses; many Haitians needed money to send to Haiti; (c) HCR & HANA brought supplies, tents, clothing and money to employees’ families in Haiti; (d) HCR provided $15,000  for transportation in/out of Haiti; (e) HCR received a waiver to donate returned unopened unexpired medication to HANA for medical missions which included employee family members in Haiti. (f) HCR/HANA raised funds to put 55+ Haitian children in formal education programs; (g) provided computers to schools in Haiti;  (h) provided a $50,000 grant for HANA to place nursing instructors in FSIL, Leogone, Haiti nursing school  (i) provided EAP for employees with losses and conducted memorial services.

Conclusion

A responsive management team during employee crisis increases retention rates of employees and decreased turnover rates.  HCR Manor Care and HANA worked together to ensure that employees felt supported and engaged during this severe crisis.  The company could have lost 20% of its workforce if the employees were not effectively engaged and supported – this could have had a devastating impact on quality of care.  Although managers are often engaged in celebrating positive events with their employees (birthdays, holidays, marriages, pregnancies etc) it is imperative that leaders and organizations understand the importance of being ever present during a crisis.  When leaders demonstrate support during a crisis, the workforce are able to continue their jobs and are less likely to leave the organization.