Daisy Dalegowski, Director of Nursing at BrightStar Care Central Denver, shares why training is important for morale and retention, the differences between a good and bad program, and how every DON can keep caregivers engaged by making training fun and interesting.
Daisy Dalegowski, Director of Nursing at BrightStar Care Central Denver, shares why training is important for morale and retention, the differences between a good and bad program, and how every DON can keep caregivers engaged by making training fun and interesting.
Melissa Mendez: (00:09)
Welcome to vision, the home care leaders podcast. I'm Melissa Mendes with home care pulse. We're gonna start off season two with a great topic today. Five things, every home care director of nursing needs to know. I'd like to introduce Daisy Dalegowski from BrightStar Care out of Denver, Colorado, where Daisy is the director of nursing. A quick snippet about Daisy is that she's a former nurse with a strong passion for teaching. She grew bright star care central Denver's location training program from the ground up and is here today to talk more about the important training actions you need to know and take as a director of nursing or in any training role within your agency. So welcome Daisy. Before we jump into our topic for the day and get to know Daisy. I'd like to briefly mention that for those in our audience today, for any questions that you may have for Daisy, please send them over in our chat so we can kind of keep that conversation flowing. So, Daisy, thank you for joining me today and tell us a little bit more about yourself and your passion.
Daisy Dalegowski: (01:13)
Sure. Um, like I said, my name's Daisy, I'm the DON of Brightstar care of Metro Denver. And, um, I started my nursing career, you know, out in the field, working in the hospitals, I've done a little bit of everything from OB to critical care, cardiac stepped down and all of those things really loved it. Uh, but my passion hasn't always, uh, will be education. So I went and pursued my master's in nursing education and then taught at a university for a few years and then found myself in home care for lots of unexpected reasons, but I absolutely love it. Um, and so, yeah, I've been the director here for three years and it's been very exciting, uh, to work with our administrative team to try to improve patient care every day.
Melissa Mendez: (02:06)
That's great. I love it. I love, uh, what you've provided, um, to bright star care. So, um, let's get into it with some of the questions, uh, that we have for you today. The first one is why training as a director of nursing. You have a variety of functions in an agency, but why should employee training be your number one focus?
Daisy Dalegowski: (02:29)
I mean, training definitely is critical to any kind of healthcare service delivery. Um, it probably, there are very few industries that change as often as healthcare does, things are one way, one day and the next day it's a totally different way. And new evidence is coming out. There's new practice coming out today. This is the great way to do it tomorrow. It's not. And so no matter what care level of care is being provided, the care standards are always changing. And so it's not just important for you to know what those care standards are, but you have to make sure that the people who are actually providing the care out there also know what that is. And not just know it also are doing that care out in the field because sometimes habits are hard to break. And so, oh, I've been doing this the same way for 20 years. Okay. Well now this is the way it really needs to be done. And so making sure that you're having that hands on training, making sure that you're really connecting with your employees to ensure that they're out there really doing that best practice care is, is really how you're gonna be successful.
Melissa Mendez: (03:36)
Definitely, definitely. I think, you know, getting out there, giving that great care is important. Um, some of the big buzzwords that we hear in the industry are retention, morale, employee satisfaction. So moving into our next question, training improves retention and morale. So starting with morale, how do as a director of nursing build a culture of education within your organization?
Daisy Dalegowski: (04:02)
Uh, sure. Uh, with morale, uh, I think is probably one of the biggest struggles, particularly with home care. Um, there are lots of things that people look for in a job when they start working. And you're looking for things like, uh, some, a sense of belonging. You're looking for a sense that you're making a difference, something that you're being able to care for people and that your work matters. Um, and with home care, it's a little bit different because you don't have that same kind of peer comradery that you get with other jobs. So, you know, when you work in a hospital, you work in a facility, you have another person that's there with you and you can tag team and, you know, work over a patient and turn the, you know, turn them this way and turn them that way. And they're helping you give a bath and things like that.
Daisy Dalegowski: (04:57)
And during all of that time, you're building relationships with your, your coworkers, with your teammates, um, in home care that doesn't really exist. Very rarely. Do you have situations where you have an overlap of care? Maybe you'll have a nurse in a CNA for our really, really acute patients, but most of the time it's one provider at a time and there's very little overlap, if any. And so you could be working with a company that has a hundred, 150 200 employees, and they'll never see each other. And so then that could be really isolating in the sense that, you know, am I alone out there as anyone actually experiencing the same things that I am? You know, am I doing the best that I can do? There's a lot of those questions that kind of go out and the answer for a lot of employees.
Daisy Dalegowski: (05:42)
And so providing in-person trainings like I do really brings in an opportunity for these employees to get together, to know each other, to kind of mingle, to, you know, build those relationships that they can continue outside of, you know, the home care environment. And so then they do still have that camaraderie. They still do have that sense of belonging, um, because I foster it on purpose because I know that it can be super, super isolating out there. And when you have people that know what you're experiencing and they're feeling those same things, and you have someone to commiserate with that makes you feel better, even if you, even if we're all sitting around saying, wow, today was a really tough day. It feels good to know that everyone felt like it was a tough day. Um, and so having those, uh, opportunities for relationships really is important. And that's what in person training can help provide
Melissa Mendez: (06:35)
Definitely in, you know, camaraderie, getting together, making people, um, giving them opportunities to build those relationships, makes them want to stay, which, you know, retention's a big thing right now. So what direct impact does that training have on both client and caregiver retention?
Daisy Dalegowski: (06:58)
Yeah. Uh, you know, caregiver retention is like right now, that's the huge buzz buzzword. Everyone's like, how can I keep my employees? There's a hundred places they can go and lots of money that can be made elsewhere. So how do I effectively keep those really good, uh, employees working for me? There's something to be said about investing in people and, and being intentional about that investment. You know, when we create our training programs, we do our best to ensure that their quality programs that we put a lot of work into them. We put a lot of work into what the environment looks like. We put a lot of work into the content and who's providing that content, um, so that they know that we have invested a lot of time into this and we are investing time into their education. Um, I feel like there's nothing more empowering to a person than knowing that they have the tools necessary to do their job, you know, with any job, as soon as you start working, it really doesn't matter what the field is.
Daisy Dalegowski: (08:02)
I feel like there's a little bit of imposter syndrome that happens, or like really, how did I get this job? Why did I get this job? Am I qualified to do this job? And that, that uncertainty can be kind of crippling at first. And so having these trainings where, you know, sometimes it's just reinforcing good behaviors. Sometimes it's like, yes, this is the best way to do this. That helps kind of cure that imposter syndrome a little bit. And they can say, oh yeah, that is right. I am doing things the right way. I am providing the highest standard of care. I am doing things according to best practice, and that makes them feel more comfortable in their own practice. And as they learn new techniques or, you know, new changes to the way that they're supposed to provide care, it also empowers them to know I am doing the best.
Daisy Dalegowski: (08:47)
And when they have the tools to be able to do their best, they will do their best. And then when they're doing their best, then you have great client outcomes. And when you have great client outcomes, clients wanna stay with you and they invite their friends and say, you know, I work with this company and they have really great CNAs and they're doing a really great job and they take really good care of me. You should get care from them too. I think you would like it. And that word of mouth is super powerful. And CNA word of mouth is super powerful too. You know, we have a referral program where we tell them, bring your friends, come work for us. Uh, and they do. And one of the things that gets talked about a lot is our focus on education and training and making sure that they are equipped and empowered to do their best all of the time for our clients.
Melissa Mendez: (09:34)
I love it. I love, you know, the words intentional, right? Being intentional about what you're doing and what you're giving to your caregivers, which in turn is what your clients receive. Um, empowerment, like really putting the power back in the learners, the caregivers, um, you know, hands, which kind of leads into the next, you know, all training is not created equal. So I mean, give it to us straight. Daisy, what does bad training look like? And on the opposite end of the spectrum, what does good and exceptional training look like?
Daisy Dalegowski: (10:08)
Sure. Um, when we talk about training, you know, everyone has been a part of a mandatory meeting. Uh, everyone has had to attend one and you know, when the person who is standing in front of you does not wanna be there. You can tell, you can feel it in the way that they deliver the message. You can feel it in the way that they have prepared their PowerPoints and the way the room is prepared. All of that is very evident. The vibe, as soon as you walk in the door, you can feel it. And you know, when this is, I'm just going through the motions because I've gotta check off this box or Hey, this person is super excited to be here and they can't wait to share. And they're excited to see me and they're, you know, making this conversation and trying to engage with me.
Daisy Dalegowski: (10:52)
So first all like love what you're doing. , if you're not loving doing training, then find someone who loves doing training because it is going to be a huge waste of everyone's time. If the person who's in charge of it is not enjoying what they're doing. Um, secondly, you have to make it relevant. Um, people know, like if you were sitting there talking to them about mercury Chrome who uses that anymore, zero people, that's not a thing. And so why would I go on and on telling you about a practice that's not being used. It needs to be relevant to today's practice and to what's going on in the field. So one of the things that I do as part of our quarterly, you know, quality improvements, I'm looking at our hand washing numbers, I'm looking at our falls, I'm looking at our infection rates.
Daisy Dalegowski: (11:42)
And if I see any of those, you know, starting to dip or increase, depending on which way they're supposed to be going, I'm gonna include that as part of my training and I'm not shy about my numbers. So, um, during the pandemic, we had a dip in our hand, washing numbers, and I was like, why is this happening the most critical time to be washing your hands? And we have the worst hand washing numbers in the history that we've ever had. And I was really upset about it. And so what did I do? I took it right back to my employees and during our training, I put it up on the board and I said, look, our hand washing numbers right now are 85%. They've never been worse. And now 85%, isn't terrible. But come on, we're talking about hand washing. Everyone can wash hands.
Daisy Dalegowski: (12:30)
Everyone can do this properly. It's one of the first things that's taught to you as a CNA, as a nurse, any healthcare provider. And so I put it right back on them. I said, the person responsible for this number is you who does their hand washing? It's not me. I'm watching you, but you're the ones that are out there in the field actually doing this. And so I made it relevant to them. We talked about what is good hand washing and why is it important and making it relevant to their practice. And it was amazing within one, one quarter, the very next quarter, my numbers were back over 90. And then a quarter after that, they were up at 95. Um, and that's pretty much where they've stayed since then. And quarterly, I report to them what our hand washing numbers are, what are our false numbers?
Daisy Dalegowski: (13:13)
What are our infection numbers? Because now they own that information. The people who control that is them. They wash their hands, we have low infections, they provide safe care, we have low falls and, you know, they own that information. And with education and information, now they can take out there and, you know, make a difference. And so making it relevant to what they're looking at and what they're seeing every day is important. Um, another really big thing is don't be boring. , um, you know, you, you have to enjoy what you're doing. It has to be relevant, but it also has to be interesting, you know, incorporate things about it. You know, about the training that are really gonna attract people, bring in stories. Uh, sometimes I have funny stories that kind of just stop people and they just laugh. They're like, oh, wait, is this supposed to be funny?
Daisy Dalegowski: (14:09)
Yes, it's supposed to be funny. Please laugh. Um, and then sometimes I have kind of devastating stories and the room will get real quiet. And, you know, we'll just kind of have to sit for a moment in, in the moment of sadness or grief as we all process, you know, how this could have gone better and using those stories as a learning device. But they're my real stories, their stories about our clients here and again, making that relevant and making sure that it's just exciting if it's not conveying, you know, important educational topics. If it's not interesting, if it's not engaging, they're gonna feel like you're wasting their time. And if you have their time to waste, then that means you don't value them. And in their minds, their time is just as valuable as yours. And even if you pay them, they don't want to have their time wasted. Um, and so making sure that they know, you know, what's, what's important and that it's important to you.
Melissa Mendez: (15:15)
Most certainly. I, I love that you kind of rolled in the fourth item too, of making training fun. Um, the interest and excitement around training varies widely amongst employees. So how do you make it fun and engaging? Um, you know, we talked about previously that you bring everybody in, you know, what little intentional details do you do that go a long way to show that respect to your caregivers and their time?
Daisy Dalegowski: (15:44)
So one of the few things I do is I send out all of the quizzes for the, uh, trainings ahead of time. There is no surprises as to what topic I'm gonna cover. And I give them the opportunity to sign up on their own. I have five dates, different times, different days of the week, um, over the course of a month. And they choose the time that they're gonna be able to come. And so that allows for their flexibility to make sure that it's gonna fit into their schedule. And then once they come in, the room is prepared. We have, um, I always have snacks because I feel like a learning environment that doesn't have food is not a good learning environment. Um, it also has to be really relaxed. You know, you can't have, when, when you think about the places where you felt like you've learned the most, like really stiff, really quiet library environments are not really it, you know, like you're so nervous and you're so anxious, especially if this is your first, uh, training, you don't know what to expect.
Daisy Dalegowski: (16:46)
And so it has to be inviting. It has to be welcoming. So I always have snacks. And just depending on whether it's a morning, you know, we'll have more of a breakfasty snack, or if it's in the afternoon, we'll have more of a, you know, savory snack, whatever. Um, but that's important because you know, they, they want to, you know, do something and I try to make sure that it's nice snacks too. It's not just like, here's a little, you know, Lunchable and enjoy, you know, I try to have like fruit and waters and different types of beverages, things like that. So they know that again, we've put a lot of work and time into this. Um, I especially curated a playlist for my trainings. I have it on, uh, one of my music platforms and I've chosen every song that's on there. Um, and it's, and it's hype music.
Daisy Dalegowski: (17:37)
Okay. So there are no sad songs. There's no boring songs, there's no slow songs. It's all like, let's go. And it covers all the genres from, you know, I have disco music in there. I have pop music in there, you know, rock music, something to attract to every person. There will be some song that will peak somebody's interest. Um, and, and I know all the words, , that's the other really important part. So as they're coming in, I'm singing along, I'm dancing, I'm having a good time. You know, I'm making sure that the environment feels really light and fun. Um, and you know, just making it feel like less pressure is involved. I also have a little kind of goody bag gift at every single station. So every place where someone can sit, there's a goody bag, it has a big name tag thing that they can put their name on so that I can see it from the front when I'm, uh, speaking to them mostly because when I speak in front of people, I tend to panic and forget all of their names.
Daisy Dalegowski: (18:39)
and I don't wanna say their name wrong, or, you know, forget or call them you, you know, I wanna be able to address them all by their name, um, or what they wanna be called. So I have them write that on the card, they all wear name tags, and then I have prepared packets with all of the required information. All the quizzes are in there. Um, and so I have all of those things, I'm telling funny stories. And then as they're coming in, I use this time to interact, cuz they usually kind of trickle in, you know, one or two at a time. So I'll take a minute or two to go up to each one of them as they're coming in and say, Hey, how you doing? How are things going? I try to remember at least one important thing about every, um, employees so that I can go back to that.
Daisy Dalegowski: (19:23)
So, Hey, how's school going? I know you're studying and how's that going? And are you progressing or how's it, you know, that kind of thing or I'll go, or how are your kids, how, you know, how's school, are they almost done? Are they graduating? You know, what are their plans for next year? And try to keep those little tidbits and make those connections with my employees. Um, so that they feel like, Hey, this is something that, you know, they're taking the time to get to know me. And they're remembering stuff about me. They're curious. They wanna know about my life. Um, but yeah, I just try to keep the training environment really loose and fun. Um, and even when I'm telling stories or doing the teaching part are, you know, I'll do ridiculous things like, you know, I'll, we're talking about, um, bathroom safety and having bath maps that aren't secured or not.
Daisy Dalegowski: (20:17)
They don't have rubber around the bottom. And I was like, Hey, have you ever stayed at a hotel and had one of those little towels that they put on the, you know, they gave you to put on the floor as your bath mat and then you step on it and all of a sudden instant lunge and I'll do a lunge right there in the middle of the room and say like, well, no need to go to the gym today. You did it as you were getting out of the shower. Um, you know, so trying to make it like fun and silly and, and I don't take myself too seriously. Um, you know, if they're laughing at me, if I'm doing funny things, I mean, if that's, what's gonna help them remember and be safe and keep the information, then that's really what's important,
Melissa Mendez: (20:54)
Right? Yes, absolutely. You know, it, it makes it memorable so that when they're in the client's home and there's doing those steps, exactly. They a light bulb right. In your mind of, oh, let's make sure we check these things, um, prior. So I love the little, um, uniqueness that you provide to your caregivers. That's great. Um, and then kind of the last question that we have that is, is I think a very vital part, but it's collecting and accepting feedback. Training programs often need refining some, sometimes even a complete overhaul. So why is getting caregiver feedback a great place to start there?
Daisy Dalegowski: (21:33)
Yeah. Uh, because they're the ones that are in it. I mean, they have, they're the ones that are sitting there listening to you or, you know, having to attend these trainings. And so they're the ones that know is this worth their time or not? Um, they're gonna tell you if you ask for it and, and you are respecting of their results, uh, so you could ask for feedback and then if they tell you, you know, that was kind of boring. And I really felt like it wasn't relevant to what we were talking about. And if your response to that is, yeah, well, that's what we need to talk about. So, you know, just deal with it. You're not gonna get feedback. , it's just not gonna, it's just not gonna come back to you anymore. If they know that you're not going to do anything with that information.
Daisy Dalegowski: (22:20)
So being open and honest with yourself and being able to receive feedback is critical because right. I love to teach it's my favorite thing. Um, but it doesn't always come out the way I plan. And sometimes things kind of get a little bit crazy or, you know, an idea that I had formulated in my brain doesn't necessarily translate to, you know, what they were understanding. And so being aware of that and being able to receive that feedback and say, you know, oh, I'm reading this and it says, yeah, you know, this wasn't your best one. And like, these are things that you can do better. I'm gonna take that. Um, and then be open to all the feedback. Just say, I don't care what it is you tell me, you know, is this, you know, I, I provide a structured kind of feedback where I like say out of one to five, how do you feel I did covering the topics?
Daisy Dalegowski: (23:07)
Do you feel like this is relevant? Do you feel, um, like you're gonna use this information, but then I also provide a free text space where I'm like, what else do you wanna tell me about this training? And you know, what else should I know? And I get all kinds of stuff. Like I've gotten people say this training was not relevant. I feel like this was a waste of time. And so then I've gotta look back and see, like, how can I fix that? And how can I reach out to that person? And I also think like, what types of clients does that person see? Cuz not all of my CMA see all of the different clients. And so did I miss something that they're seeing that not everyone else is seeing? Um, but then I've also gotten things like you need different snacks. Every time I come, it's the same five snacks.
Daisy Dalegowski: (23:48)
And I'm like, oh, you know, they always seem to come at the same time and I kind of have the standard go to for breakfast. So I guess I'll have to mix it up and you know, I did. And then I got feedback like, Hey, the snacks were amazing this time. Uh, and then sometimes I, you know, good feedback that, you know, makes me feel nice. Like I love this training and you're a great teacher and can't wait for the next one. Um, and so, you know, that always feels good too, but just knowing at them, knowing that you're listening to the feedback and taking it seriously and making changes based on, you know, what they're telling you that is, what's gonna keep that feedback coming. It's letting them know that they have a voice and they have a say in, you know, what's important. And I offer them the opportunity to say, Hey, what do you think I should talk about next time? Is there something that you think I'm missing? You know, what can I add to it? And then, you know, when they know that they're being listened to, it also opens up dialogue for later, if there's a serious issue that they need to discuss, they know you're gonna listen because you've listened before. And so then now you have an opening for them to come to you with other more serious issues in the future as well.
Melissa Mendez: (24:59)
Yeah. Giving, giving caregivers a safe place to voice their opinions. It really shapes the training program. And I mean, you know, what, what better feeling than as an employee when you voice something and then they turn around and, and they implement that. That's such an amazing feeling. It makes you wanna stay. It makes you wanna keep giving back. So it's, it's that never ending circle. So I think that is wonderful. Stacy, thank you so much. It was such a great conversation. I hope that everyone was able to take away some of these talking points and found that new found passion towards your agency's training program. Um, I've really enjoyed Daisy getting to know you and listened to your, your passion, uh, for training. And I appreciate it very much and everyone else thank you for tuning in and we will catch you all next week for another great discussion. Thanks.