Working in aged care is not easy. The work can be emotionally and physically demanding, the remuneration is poor, and society does not give you much thanks for it.
And if that is not enough, at HelloCare we also often hear of a difficult culture in aged care workplaces, bullying and uncaring colleagues who don’t look out for those they work with. We also see experienced staff unwilling to pass their knowledge on to new recruits and complaining when their work is not up to scratch.
Of course, not every aged care workplace is this way – and there are plenty of toxic workplaces in other industries too, but at HelloCare we hear about it all too often.
So, we set out to try to understand why toxic cultures arise in aged care so regularly, what aged care workers can do if they find themselves in an unsupportive environment, and some tips to help them deal with difficult people at work.
Ryan Ng is a psychologist and the founder of TalentIdentify, a psychological profiling tool that matches people with roles, and he has worked extensively in the aged care sector.
Mr Ng told HelloCare he has seen comments about bullying in the aged care surveys he conducts, and he puts a lot of it down to aged care staff being overworked and burnt out.
“If you are caring for someone, you’re giving a lot of yourself, and that is the nature of the job. When carers are burnt out, there’s little support or resources [to help them],” he said.
People who are burnt out can become irritable, apathetic, they lose empathy, experience depression, and they can start treating people more harshly, Mr Ng explained.
“It’s all captured under the behaviours we talk about when we speak of toxic culture, or bullying or rude behaviour or harsh behaviour,” he said.
The fact that most carers are highly empathic can also be a factor, because it can be difficult for them to have confrontational conversations. When they avoid these difficult conversations, tensions can build, and issues are not communicated or resolved.
Hierarchical structure can also contribute to toxic cultures because workers don’t have a sense of autonomy, leading to stress and staff feeling demotivated, Mr Ng said.
Interpersonal conflict or dealing with a toxic culture at work can affect every aspect of life.
“It affects the whole person, your mental health and cognitively as well,” Mr Ng said.
“A toxic culture is a threatening one. Our body responds to threat by putting us into a fight or flight state, and if you’re in a fight or flight state we’re not going to be able perform well.”
He added that it’s harder to perform or engage when you feel threatened because you can’t focus on the work, while all your energy is spent on looking out for and dealing with the threat, leading to fatigue, burnout and exhaustion.
“Engagement and creativity require you to be feeling safe [but they are] just not going to happen,” he said.
Mr Ng suggests a two-pronged approach to dealing with difficult people at work.
“The first step is the importance of checking in with themselves and asking if this person is really being intentionally difficult, are they struggling with something, or are they just as stressed as I am and we’re all in the same boat together,” he said.
“So, check in with yourself and have a little bit of understanding [of the person].”
Then, if you decide it’s necessary and you are dealing with a “more difficult” person, Mr Ng recommends talking to them, remaining calm, maintaining a slow, deliberate talking speed, and not letting yourself get worked up.
The aim is to avoid the possibility of conflict escalating, he said.
“When you’re emotional you can start to speak really fast and things just come out, so deliberately pace how fast you talk,” Mr Ng advised.
“Listening is the number one step. At the end of the day, everyone wants to feel heard and things can’t progress until the person feels acknowledged.”
The language you use is important and can prevent situations from escalating into an emotional rollercoaster.
Use ‘I’ statements. For example, say “I feel sad when you talk to me like that” or “I feel hurt when someone shouts at me like that”.
Focusing on the ‘I’ makes you articulate your needs without using the word ‘you’. The other party feels less offended and it makes you focus on what you need. “It protects both sides,” Mr Ng explained.
Don’t use labels, and stick to describing the behaviour, not the person, suggested Mr Ng.
For example, you could say, “I notice you’ve been a bit quieter than usual, I just wanted to check in to make sure everything was alright. Do you want to talk about things?”
When we are emotional we tend to use words that are more categorical, like ‘always’ and ‘never’. Avoid these words because those claims could upset the other person.
If it looks like the situation could escalate, take some time out.
“Take deep breaths. Going for a walk creates that space. You can think, ‘Let’s pause this’ and go for a walk. You can come and talk about it later,” Mr Ng said.
When dealing with difficult people it can also be useful to get the perspective of others to see if they have experienced similar issues.
Of course, serious cases of harassment or bullying should be reported to human resources, who should have a framework to address the problem.
The self control required to deal with these challenges can be exhausting, so self care is really important.
“It helps you to recharge your batteries,” Mr Ng said.
He wondered if carers sometimes care for others to the point they neglect their own needs.
“If you don’t love yourself, you can’t love others. You can’t pour from an empty cup.”
To ensure your values fit with a potential new employer’s culture, you can ask pointed questions that reveal the true nature of an organisation’s culture, such as:
Simply asking, ‘What is the culture like in this organisation’ will no doubt be met with the usual platitudes about flexibility, collaboration, and good work-life balance.
“What you really want to know is, realistically, on a day-to-day basis, what is it going to be like?” Mr Ng said.
A functional culture ensures workers feel empowered, while toxic cultures tend to disempower staff.
Empowering workers means having autonomy, being able to have a voice, being able to feel like what you say is taken seriously, that you’re being valued for your opinion and your contribution, and you feel valued as a human.
As much as the work of aged care staff is often very structured, workers must be free to follow the processes rather than be micromanaged through them, he said.
In the end, Mr Ng turned to a quote from the bible. “Treat others as you would like to be treated,” he said.
If everyone checked in with themselves and asked this simple question, many of these problems would be solved. But there will always be difficult people in the world, and as frustrating as it may be, how we deal with them is up to us.
HR in Aged Care here…nurses eat their young.
The old adage that Ng mentions of “Treat others as you would like to be treated” seems to be forgotten & nurses work on the “treat the juniors the way I was treated when I was a junior”. We are working on changing the culture here with tool box talks, mental health programs & an open door policy & so far it seems to be working, with new hires reporting that they are feeling supported & included by most staff, but there are still one or two of the “old guard” who need to catch up.
Hit the nail on the head with this article.
This article is to true. There are so much burnout and stress due to understaffing and staff leaving in mass due to being pushed to do doubles and more.
I am now treated differently at work almost shunned due to having to take time off to look after a loved one. Yet there times I did 9 days straight and 3 double shifts.
I returned to work and was ignored by other staff members and the managers.
The threatening intimidating bully behaviour is a code of practice set and encouraged by many aged care providers.
They are on massive salaries pillaged from resident funding at each facility.
This is theft from resident care budgets.
Aged care has senior level staff (EG HO positions) who are not from a nursing or care related background.
They are driven by the bottom line and will slash burn bully for personal KPI recognition.
Nurses are accountable for their behaviour and this includes code of conduct.
Any Registered Nurse of any rank who breaches the Code of conduct and causes pain and suffering to another colleague should be reported to the appropriate registration board.
AHPRA and HCCC are then responsible to investigate the issues.
Going to HR is fruitless and toothless
Senior bullies are rarely held accountable.
The next line is to take WHS action based on breaches of policy and code of conduct and have the organisation held responsible.
Final step. Go legal.