Five hints for nurses on how to make change happen in dementia care

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The areas of concern about people with dementia have not changed since I was a student nurse.  In the last century we were talking about improving dementia care. Nurses today are aware of the needs for people with dementia.  Some seem institutionalized and not wanting to change.  However, this is often the result of working in systems that dehumanize them and their patients. 

Although nurses often know what is needed, they may not know how to make it happen.

You can now access amazing amounts of information about dementia, but increasingly I am asked “how to make change happen.” 

Here are five ideas that can help.

One - Know your stuff

Don’t just complain, “They are not paying enough attention to dementia”. That is only an opinion.  Better to be an expert who says, “Research shows that in the UK we spend more on dementia than cancer, heart disease and stroke put together.  In the light of that, do you focus enough on dementia issues?”   Make sure you are better informed than the person you are persuading and ask them what they are going to do about your information.

Two - Know the system

Who in the system has the power to make change happen?  For example, you might be having hurried meal times because the trolleys get rushed back to the kitchen too early.  Don’t complain to the porter.  He is only carrying out his orders.  Negotiate with whoever is in charge.  You may discover that they rush your meal delivery because of pressures from a different department, like the pharmacy.  It may be that consulting with the chief pharmacist to encourage her to change her delivery time is the paramount move.  How could you have known that without knowing the system?   Find out “who’s who?” in your world.  And check out what is time sensitive, and what is not.

Three - Be known

You have to be known for your expertise and professionalism.  When you ask the decision maker for something, it’s better if you don’t have to start off by explaining your qualifications.  Bring yourself to the notice of those in authority by unassuming things like introducing yourself at the end of a meeting.  Say hello and be nice.  Senior people get whined at all the time and you’ll be energizing – they like and remember that.

Four - Use high impact communication

The person that you have to influence is extremely busy.  They don’t have time to read huge briefings, so be concise.  They won’t listen to long winded explanations, so crunch your case down into thirty seconds.  You may have difficulty in getting an opening in their calendar, so use every chance encounter.  Think.  What would you say if you found yourself in the lift with your chief executive for a minute?  Apply the first three rules.  Be pleasant and open.  Be professional.  Introduce yourself again in case they don’t remember who you are …they’re busy).  If you are “selling” a new idea start relate it to whatever is probably keeping them awake at night. 

In the current economic climate, don’t just ask the Chief Executive for money for extra staff.   She’s thinking “No!” before you stop speaking.  Instead say “If I could show you a way of saving money, would you be interested?”    Of course she says “Hmmm. Maybe…”   And you say, “We could reduce adverse incidents that increase length of stay and therefore total costs by £300k per year, at the cost of two more staff nurses.”  She might not say yes at once, but she is listening.

Five- Be lucky

The best luck is what you make yourself by being persistent and never giving up.  Get going!