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LeadingAge magazine November/December 2012

Putting Ethical Issues on the Radar Screen

by Daphne Schreiber
The Village at Heritage Point is a small 130-unit retirement community in Morgantown, WV. We are owned and operated by Mon General Hospital and have approximately 50 full-time employees.

In spring 2011, Leading Age distributed an “Ethical Workplace Assessment” survey designed to help members determine their staff members’ perceptions of organizational policies and practices related to ethics. While we did not have any specific concerns at The Village, we felt that improving ethics awareness and knowledge could only enhance our mission. We also knew that residents and prospective residents would be extremely supportive of this initiative, and that it would contribute to their peace of mind, knowing that we placed a high priority on ethics awareness and education.

LeadingAge e-mag Nov-Dec12 Ethical Vill Heritage 2ppl 335w
The Village at Heritage Point

Open discussions about ethical issues has helped staff reaffirm their compassion for residents, and understand the value of talking about the ethics of day-to-day issues.

We distributed the assessment to employees in July 2011 (the response rate was 84%) and analyzed the results, making note of areas where improvements were needed and then developing an action plan to address some of the weaknesses identified, such as offering training in ethical conduct, accessing ethical resources while at work, and management assistance with ethical issues.

The action plan included adding a specific segment to each monthly staff meeting on various ethics topics. We started with a conversation about what ethics is, and took either real-life examples of issues we’d read about in the news or in our field, topics from seminars, and articles in journals or newspapers that could be used to form the basis for ethics education. We also wove a variety of reflective topics into our discussions. For example, we talked about our individual codes of conduct—the ground rules by which we live our lives—and the importance of thinking in advance about our priorities and our consciences. Staff were not pressured to voice opinions or talk personally about their positions. The topics were raised and rhetorical questions asked.

One of the most poignant examples we used was from an article printed in the New York Times, Deciding to Die, Then Shown the Door.” This article describes the decision by a resident couple to voluntarily stop eating and drinking when they felt the time was right. We talked about the many points of views that arose, and that the “right” thing may have depended on whether you were the parents, the children, the community and/or the medical team brought into the situation. Another example, also from the New York Times, called “The Undeserving Parent” described a daughter’s perception about how her mother’s community viewed her, when they didn’t know the circumstances surrounding her behavior. This too posed many questions for us to consider and gave us perhaps a better perspective on judging those we serve.

The survey was re-administered to the staff in June 2012 (the response rate was 65%) to determine whether the material covered over the prior 12 months had had an impact on staff members as reported through this assessment. The results were quite remarkable. There were significant improvements across the board in all 13 of the areas on the assessment. Each and every question showed a higher score in the “strongly agree” category.

In the wake of our efforts to discuss ethics, employees have remarked that it makes them think about how they will want to be treated when they get older; that it reaffirms their compassion for the residents, who become our family; and that it makes them grateful for the families they have, and helped them to empathize with those whose families are not present in the lives of our residents.

Many of the questions that arise in our work will present opportunities for ethical soul searching, and we believe we have raised the staff’s awareness of ethics in the workplace, that there is a better understanding by all of us as to the importance of this, and that when there are questions, we know where to turn. As a result, we believe that, with the guidance of the assessment tool, we have achieved our goal of enhancing our comfort level, knowledge and ability to address ethical questions that arise in our daily lives.