If you are fed up with incivility in your healthcare workplace, watch this:
We get lots of questions about workplace incivility, and we’d like to share them with you! While each problem is specific to the individual who sends it,
most people will be able to relate and make use of the information.
If you have something you’d like to ask our workplace incivility experts, click here and send us your anonymous question. We will never publish real names or workplaces in this column.
Dear Civility STAT!
I work in a nursing home in Tennessee. Our employer does not provide a private break area away from resident’s and their families. We have to share the snack machines, fridge, and microwave. Our time clock and other personal items are in there. We are not paid for a 30 minute break, and we have no where to get away from resident care. Is this legal?
~ fed up in tn
Dear Fed-up in TN,
Thank you for submitting your question. It’s a good one!
First, regarding the unpaid lunch:Federal law does not mandate any specific meal or rest breaks. It does, however, give guidance as to whether or not an employee should be paid during these times. Short breaks (usually 20 minutes or less) should be counted as hours worked. True “meal periods” are usually 30 minutes or more, and do not need to be paid as work time.
But, here’s the catch: During an unpaid meal break, a worker must be completely free of his or her work duties. If the employee is still required to do any duties (even minor duties such as answering a phone), it can’t be considered a meal or lunch period and must be paid. So, if patients or families are coming in and engaging employees in patient-related discussions or making requests, it would seem that that could not be considered a break.
And, here is some OSHA stuff that addresses the problem with the public break room:
“OSHA’s bloodborne pathogens standard prohibits the consumption of food and drink in areas in which work involving exposure or potential exposure to blood or other potentially infectious material takes place, or where the potential for contamination of work surfaces exists [29 CFR 1910.1030(d)(2)(ix)]. Also, under 29 CFR 1910.141(g)(2), employees shall not be allowed to consume food or beverages in any area where occupational exposure through the contamination of food and beverages is likely.
From what I can tell, OSHA inspectors evaluate each facility on a case by case basis. If your break room has the public in and out frequently, and you are expected to share the same fridge and microwave with potentially infected residents, then OSHA might object.
Then, there’s the HIPAA issue. Mixing staff, residents and families in a space intended for staff to relax is a HIPAA violation just waiting to happen. Staff members talk. They have to. It’s part of the debriefing process. It’s how we process and deal with all the stuff that happens on a typical shift. Residents and family members will, sooner or later come upon a discussion in that public break room and a hipaa violation will be tremendously costly the facility.
And finally, it’s a morale issue. A private break room would create a space for your team to unwind. Nobody can stay “plugged-in” all day long. Your body and mind will become drained. Drained staff members are more likely to experience decreased morale, a drop in sharpness (leading to more medical errors) and loss of productivity. A private break room would give you and your co-workers a place to go to get away for a while and mentally recharge so you can return to your residents rested and re-energized.
You could present all these angles to your employer. But, if you also want to present a solution, ask yourself these questions:
If you need more specific information about the laws in your state, call The TN Division of Labor Standards at 615-741-2858 (option 3) or toll-free at 1-866-588-6814.
Hope this helps. Please keep us posted. We love to hear your success stories!
If you have something you’d like to ask our workplace incivility experts,
click here and send us your anonymous question.
Workplace incivility is a hot topic these days. But “civility” and “civility training” are more than just the latest buzz words. Want proof? Consider the new study published in the Journal of Health Services Research. Conducted at the University of Rochester Medical Center, the study found that nursing home residents have less chance of developing pressure ulcers and/or incontinence if the employees in their facility feel united and work as a cohesive team.
Researchers looked at the incidence of incontinence and pressure ulcers for more than 45,000 nursing home residents living in 162 facilities throughout the state of New York. In addition, they measured what they termed the “staff cohesion” of nearly 7500 nursing home employees. The staff answered questions on a survey about common goals, values, responsibility for care delivery and group identity.
When the two aspects of the study were compared, the authors found that even a small upturn in how employees got along led to a significant decrease in the incidence of pressure ulcers and incontinence. “We know from other fields of medicine that teamwork—the relationship between coworkers that facilitates decision making and care coordination—plays an important role in the quality of care,” said lead author of the study, Helena Temkin-Greener, Ph.D. “Our body of work in this area demonstrates that, while many nursing home managers may contend that they have teams in place to coordinate care, it is only when staff perceives that they are part of a cohesive unit that the quality of care is improved.”
Without staff cohesion, employees work in an environment hampered by poor communication (between employees and between shifts) and ineffective coordination of care. Preventable patient outcomes—like pressure ulcers—are more likely when the staff fails to communicate monitoring procedures, repositioning guidelines and other resident-specific information.
“This study empirically demonstrates that better work relationships between staff, as measured by staff cohesion, are associated with better outcomes for nursing home residents,” said Temkin-Greener. “Nursing home managers have the tools to encourage good patient care but they have to work at it and encourage practices that promote better cohesion, communication, and teamwork in their facilities. If they do this, the quality of care will improve.”
It’s undeniable that many healthcare workplaces are infected with incivility. And where incivility reigns, staff unity suffers. The good news is that even a slight improvement in the workplace environment can raise the level of patient care. When that happens, everybody wins. Employees are more satisfied, patients are healthier and healthcare organizations stop wasting time and money on preventable nosocomial conditions. That makes civility training a sound investment for every healthcare organization.