Sign Up to Receive PHI Alerts

COACH’S CORNER: Combating Negativity with Appreciative Inquiry

February 27, 2015

Negativity surrounds us. It is everywhere in long-term care, deeply ingrained in mindsets, systems, and behaviors. By negativity, I mean the pervasive ways in which the entire spectrum of long-term care operates from a deficit- or problem-based perspective. Practitioners see diagnosis, supervisors see employee weakness, and federal and state surveyors see non-compliance. The impact of this deficit-based way of being is a long-term care culture that literally pulls good people into its vortex. We have all witnessed this phenomenon as those who enter with positive, hopeful attitudes fall victim to the centripetal force of this negative spiral, and slowly but surely give in to a system that feels beyond their control to change.

Just imagine how different it could be to work in a strengths-based culture. Imagine being surrounded by people who see wellness rather than illness, who see our potential rather than weaknesses. This shift is possible through the practice of Appreciative Inquiry (AI). AI is a collaborative, strengths-based approach to personal and organizational development that has proven to be an effective approach to transformation and improvement in all business communities. This approach has been eye-opening for me, and I have worked hard to rewire my thinking, so that when I look at people and organizations I see their strengths and potential.

Part of the reason I needed to rewire my thinking is because my nursing school education did a great job of teaching me to see “what is wrong.” In fact, at the time I attended the UConn School of Nursing, they taught us something called the “crisis theory” which placed all people into either pre-crisis, crisis, or post-crisis categories. How is that for a glass-half-empty perspective? Later, when I became a director of nursing I inherited a similar deficit-based assessment system in the employee evaluation and discipline processes. Our feedback systems gave us tools that focused on identifying where employees fell short, and getting called to the office was certainly never for a compliment!

Today, I am grateful to work at PHI with a team of people who both study and practice appreciative inquiry. The AI principles and practices are embedded in all that we teach and are at the core of our Coaching Approach®. Through the use of AI, we disrupt the deficit-based culture and bring about change that shares leadership and learning among all employees.

Through seeing the best in ourselves and each other, the pace of change is greatly accelerated. People feel valued and appreciated, and they feel known.  There is greater trust in the organization as employees are not simply waiting to get “written up” and instead are engaged and involved in creating change.  Elders and their family members feel the difference as well, as staff relate to them in completely different ways. When our interactions with elders and family members are guided by the person’s diagnosis, their illness somehow becomes their new identity. When our interactions are guided by knowing the whole person, by discovering their strengths and potential, the person is whole again.

For more information on Appreciative Inquiry, I recommend reading Appreciative Inquiry: Change at the Speed of Imagination by Jane Macgruder Watkins, Bernard Mohr, and Ralph Kelly.

— by Susan Misiorski, PHI National Director of Coaching & Consulting Services

Caring for the Future

Our new policy report takes an extensive look at today's direct care workforce—in five installments.

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.