Foolproof Ways To Build Better Relationships With Nursing Homes

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Hospice care is delivered anywhere the patient calls home and for many elderly, this includes the nursing home. Learn how you can build better relationships with nursing homes while delivering quality hospice care.

As a hospice nurse, it’s likely that you will provide care to nursing home patients. In fact, your agency probably has contracts with several different skilled nursing facilities (SNF).

While you don’t work for the SNF, it’s crucial that you learn how to communicate and support the staff at the nursing home.

Now, you might be thinking you’re just there to take care of the patient and you’d be wrong.

And if you think you’re going to walk in and start giving orders, you’d be doubly wrong.

To make matters more complicated, sometimes, conflict can occur between hospice and SNF staff. I wish this wasn’t true!!

If you want to build strong relationships with nursing facilities, then you’ve come to the right place.

So, let’s jump right in!

Foolproof Ways to Build Better Relationships with Nursing Homes

DISCLAIMER: Delivering hospice care in a facility is complex and you should consult and follow your agency’s guidelines!

Now that we have that out of the way, we can talk candidly about providing hospice care in the nursing home.

First and foremost, you are a guest in the nursing home!

When you provide care at the nursing home, you must follow the regulatory standards of the SNF, Medicare, and your agency.

Benefits of Building Better Relationships with Nursing Homes

If you’ve never worked in a nursing home, it can be a little intimidating. Not only are you an outsider, but you may not always be welcomed by the staff.

Let me be clear, I’m not hating on SNFs or their teams. If fact, I worked at a SNF, and if it’s one thing I know, it’s that over time, my patients became my family.

I can fondly remember one of my patients who used to sleep during the day because she liked hanging out with me at the nurses’ station in the evenings after my med pass.

My point, there are many benefits to building better relationships with nursing homes, but you won’t get there if you don’t build strong relationships with facility staff.

Now, back to my original point. Benefits!

BENEFITS FOR NURSES

Less travel time– your agency might not tell you this, but if you have multiple patients in one location, you’re less likely to have as much travel. On the contrary, if you’re someone who loves the open road, then the NH may not be for you.

Another key point is, that when you have several patients in one location, you can see them all and chart must more efficiently. Not to mention that you can have set days and more consistency in your schedule.

More support- Unlike providing care in the home, when you’re at the SNF, you’ll have support and a second set of hands, eyes, and ears. This can be helpful when providing hospice care to complex patients.

More time with your patient– While you’re at the facility, you can spend more time with your patient and you can watch them at various times during your visit

This list could go on but I think you get the point.

So, what are the benefits for the patient?

BENEFITS FOR PATIENTS/FAMILIES

• Fewer hospitalizations and ER visits
• Better symptom management
• Additional support/education for the family
• Bereavement support for the family
• Decreased pain at the end-of-life

5 Foolproof Ways to Build Better Relationships with Nursing Homes

This takes me to my first point and it’s the most important of all. (In my opinion)

1. Establish Clear Communication

Communication is KING!

At the risk of sounding cliche, good communication is the key to building better relationships with nursing homes.

To be blunt, the only way to communicate is to communicate.

Key Communication Tips to Build Better Relationships with Nursing Homes

• Check-in and out with staff – this includes nurses and administration. Sometimes it’s difficult to find a staff member, so make sure you know where break rooms are and where staff may be especially during their busy times.
• Use a communication log– let them know when you visited, the care provided, the next scheduled visit, etc.
• Call the family/caregiver– this goes a long way and can decrease the number of calls staff receive from family about the care you gave.

2. Mind Your Behaviors and Comments

First, if you’re a nurse, I know you’ve had times where you went to the breakroom and cut loose about the patient and family that was driving you crazy! (LOL, maybe that’s just me.)

For those saints out there, please don’t judge me!!!

Anyway, try to remember that the facility staff is like family so if you wouldn’t say it in front of the family, don’t say it in front of the staff.

Yes, they are your peer, but you are a guest in their home so try to keep it together.

On the same vane, don’t complain about how busy you are to facility staff. They don’t need to know your issues. Furthermore, it can hurt your relationship with them.

Remain professional at all times, it will go a long way!

3. Maintain Proper Documentation

This may sound like a no-brainer, but nursing homes are highly regulated and the care provided by hospice agencies is heavily scrutinized by surveyors.

That being said, it’s up to you to accurately document all care and communication that occurs with your hospice patient.

For instance, you should:

• Clarify and document who’s responsible for providing certain care (i.e. wounds)
• Attend facility care plan meetings when possible and document updates in the plan of care
• Document any education provided to the staff and/or family
• Provide IDG notes and POC to the facility
• Use a communication log if available
• Visit your patient at different times so that you can accurately capture decline and variations in behaviors
• Seek clarification about the rules and regulations at the facility and your agency. I can’t say this enough. The last thing you want is for the facility to receive a citation because you didn’t document appropriately.

I’ve been there, done that and it was no fun.

RECOMMENDED ARTICLE: 3 Common Mistakes Hospice Nurses Make and How to Avoid Them

4. Offer Education

Even though the nursing home staff are capable of caring for patients at the end of life, they do not have the same training as hospice nurses.

You might get some pushback when you’re providing information or education to facility staff. Remember, you are not there to tell them what to do, but you have an obligation to the patient to make sure they’re comfortable.

This can get tricky when you’re trying to manage pain and symptoms. For instance, the facility may not allow certain medications in their facility, and it’s up to you to document and communicate it with others on the care team.

You can also use this time to educate the family. Even though the patient is in the nursing home, the family should be included in the care and training.

Furthermore, the family should be notified of changes in condition and what they might expect. This is also a good way to ensure ongoing communication and understanding of the care being provided.

That’s right, it’s up to you to first understand the relationship that facility staff has with the patient and their family.

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5. Establish a Dedicated Care Team

This was one of my favorite ways to build relationships and trust in the facility. It is also a way to ensure more consistent care for the patient.

You can do this by having an interdisciplinary team that is assigned to the facility. As a nurse, this can reduce the number of calls to the agency and increase communication between the facility, the family, and you.

Also, you should get to know the staff. This can also help if and when conflict occurs.

With dedicated care teams, the facility doesn’t always have to review policies, entry codes, etc. with different nurses. It also helps to establish the best visit days and can help you establish your hospice aide schedules.

BONUS TIP To Build Better Relationships with Nursing Homes

Show up for celebrations and activities

I’ll be the first to agree that you can’t be everywhere or attend everything, but you should make an effort to attend events at the facility if you can. Allow me to clarify before you disagree.

If your hospice participates in We Honor Veterans, and they are recognizing a veteran, try to be there. Also, if there is an activity such as bingo or whatever, offer to stay for 30 minutes to help out. When you show genuine interest, the facility will notice and they will be more likely to help you in a pinch.

Let’s Wrap it Up!

If you want to build positive relationships in the nursing home, you can start with good communication and a healthy dose of respect. Remember you’re there to help the patient and to support the nursing home.

Honestly, offering additional care and time to nursing home patients is a special task and you are up to it!

For a successful relationship with the nursing home, you can implement these tools and you’ll be on your way!

• Communicate
• Mind Your Behavior
• Document
• Educate
• Dedicate time

I wish you the best!- Rochelle