The concept of empowerment has been increasingly linked to
one category of assisted living employees—nurses—particularly
as employers look for ways to combat the impact of the nursing
shortage through recruitment and retention strategies. A number of studies indicate that the amount of empowerment nurses
have in their jobs has direct impact on their decision to take a
job and intent to stay in it.
For example, a 2005 study found that hospitals that participated in the Magnet Recognition Program at the Medical Center of
Central Georgia recorded higher levels of job satisfaction among
nurses than non-Magnet facilities. (The study was conducted by
Sandra Copeland, a clinical nurse specialist at the medical center
in Juliette, Georgia, and published in the Journal of Continuing
Education in Nursing.) Empowerment is a key component of the
program, and Copeland’s research found that access to empowerment of work conditions not only increases job satisfaction but
also nurses’ capacity to practice in a professional manner and
deliver superior care. Another study by K.V. Rondeau and T.H.
Wagar, two Canadian researchers, published in the Journal of
Nursing Management linked an employee-centered culture emphasizing greater employee empowerment in Canadian nursing
homes with both higher nurse and resident satisfaction.
In long-term care, empowerment is a crucial strategy for both
recruitment and combating turnover, says Nicole Nedd, Ed.D.
ARNP, associate chief of nursing services/hospital education for
Edith Nourse Rogers Memorial VA Hospital in Bedford, Massachusetts. Nedd penned an article on the relationship between
empowerment and retention for Nursing Economics.
While nurses have long wanted to be more involved in decision-making, the norm has been that employers have expected
them to follow orders made by physicians, Nedd says. However,
the nursing shortage has been driving a change in that attitude
from employers who want to distinguish themselves in this competitive job market. The problem becomes even more acute when
one considers that 60 percent of nursing graduates stay at their
first job for less than a year.
“We may not have control over salary and benefits, but [empowerment] is something we do have control over,” Nedd adds.
confidence and Passion
Assisted living leaders agree that empowerment can be a powerful
retention tool for all types of employees in assisted living, as well
as a secret to success in market share.
Mike ulm, vice president of organizational development for
Tampa, Florida-based horizon Bay senior communities, recalls
his grandfather’s grocery store where all the employees were
college students, but his grandfather made each feel like a part
owner of his small business.
“If we can make employees feel empowered, it makes such
a difference when you’re not around,” Ulm says. “They respond
not only appropriately but with passion.”
A common mistake is confusing empowerment with leaving
people alone, Ulm adds. At Horizon Bay communities, training
at all stages incorporates the tools people need to make spontaneous decisions. For empowerment to work, it needs a foundation
that incorporates a learning culture where employees are not
penalized for mistakes, but rather helped through a situation
with a supervisor who trusts them.
Everyone from the frontline staff on up now becomes part
of a “team full of owners” who have a stake in the company’s
success, making them not just more committed to making the
right decision for customer satisfaction but also to staying with
the company, says Ulm.
Training gives employees knowledge and confidence in their
ability to make decisions; leaders who micromanage will not
bring out the best in their employees, adds edie gerelli, vice president of operations for Summit, New Jersey-based chelsea senior
Living. When empowered employees make mistakes, coaching
and mentoring, rather than reprimands, are key to transforming error into opportunity by creating a growth experience that
ultimately keeps them with the company and elevates them up
the corporate ladder, offers Gerelli.
Liability related to giving caregivers autonomy isn’t any more
significant in assisted living than in other industries, Gerelli says.
However, empowering employees should come after they have
received the training they need to make decisions they’re likely
to encounter on the job.
At Chelsea Senior Living communities, executive directors are
empowered to run their own residences without having to go to
corporate for most decisions, Gerelli says. The executive director
can’t be around 24 hours a day, so department directors and all
caregivers are also given decision-making power appropriate to
their position. Housekeepers, dining staff, and other employees are not given autonomy in caregiving but are empowered
in their areas of expertise. Empowerment shouldn’t discourage
employees from consulting their managers when they’re unsure
“There still has to be a leader, someone looked to at that level,”
Gerelli adds. “There’s going to be a time when you don’t feel you
are able to make a decision. Everyone should have [empowerment]
but at different levels.” ❏
Anya Martin is a contributing writer to Assisted Living Executive. Reach
her at email@example.com.
Contact information for members in this article.
› edie gerelli, firstname.lastname@example.org
› Mike ulm, email@example.com
To comment on this article and/or share your experiences,
go to www.alfa.org/blogs to access the Assisted Living
more on this topic:
› “Star Performers,” Assisted Living Executive, April 2007, www.
› “At the Top of Their Game,” Assisted Living Executive, July/
August 2007, www.alfa.org/ALExecJulAug07/Game
› “Nurse Shortage Woes,” Assisted Living Executive, July/August