Just one more question

Like the great TV detective Columbo, Long-Term Living columnist Gary Tetz (Funny You Should Ask) always has one more question. In this bimonthly feature, he talks with long-term care leaders about anything that pops into his mind. He’s as surprised as you are that they’ll speak to him, and apologizes in advance for whatever inanity he might blurt out in the pressure of the moment.

I had heard nothing but glowing testimonials about Jennifer Scully, and it took only one paragraph of her bio for me to feel inadequate and underachieving.

From about every point on the continuum, she’s been helping deliver quality care to the elderly for more than 30 years. Before founding Clinical Resources, she served as executive vice president of clinical services for Mariner Health Care, providing oversight and direction to almost 500 long-term care facilities in 27 states.

Jennifer is a registered nurse, licensed nursing home administrator, and paralegal, and holds certifications in more areas than I have strength to type. Just a few days before we talked, she received the Ernst and Young Winning Woman Award for 2009 in recognition of her entrepreneurial efforts.

She started the conversation with an apology, so as a contrite Canadian, I liked her already.

Good afternoon, Gary. Sorry I kept you waiting.

Oh, that’s no problem at all. You were just at the American Health Care Association convention, correct?

Actually, I had to cancel.

You left rows of disappointed people sitting expectantly in a conference room?

No, that’s not the case at all. I was there with everyone in spirit.

You’re not related to former CMS administrator Tom Scully are you?

No relation.

Good, because he was accused of withholding information from Congress. I’d hate to think you were involved in something like that.

No, not the same Scully.

So here’s what I’m struck by. You just won the Winning Woman Award, and I just stayed up half the night working on my taxes.

Oh no!

My 2008 taxes.

(Inappropriately long laugh) I have no sympathy for you.

See, I need a consultant slash life coach. Does your company offer that?

No, we don’t.

Your résumé is longer than a Joe Biden speech, and you’ve accomplished a lot. What has kept you in this profession all these years?

When I came into this arena in the early ’90s, I’d come from a critical care background, and I was struck by the many challenges that I saw. Working in long-term care, there’s always an opportunity, always something new to learn, and I love it. There’s never a dull moment and that’s what keeps me going. I’ve also met dedicated people, very passionate people, educated people, innovative people. I’ve built a network of friends and colleagues that is really heartwarming to me. So yes, I love long-term care.

And you must love seniors, too.

I believe in taking care of our nation’s elderly. Every time I interact with our seniors, I’m always impressed by the wealth of knowledge they have, but we live in a culture where we don’t necessarily respect and revere them. If I can do anything over the years, it’s to instill in others the desire to respect our elders and help them in any way we can.

What do you do, exactly?

My business is providing management personnel to nursing homes, assisted living, and CCRCs across the country. We don’t do direct care staffing. We do the leadership positions.

How much are you away from home every year?

Probably 50% of the time.

What’s the worst airport in America?

Let me see. Eureka, California. The person who tickets you is the same one who takes your luggage and flies the plane.

Have you ever recruited a future long-term care administrator while waiting for a plane in an airport bar?

Oh yes, absolutely. And I also met two FBI agents who were investigating Medicare fraud.

So there’s no time wasted on the road.

Exactly.

What has this recession done in the areas you represent?

There are many people out of work, so we are seeing literally mountains of résumés, but the number of truly qualified candidates who carry compassion and dedication for our nation’s elderly are few and far between. So you have to be very selective. Unless you find someone who has the same focus and commitment you do and fits the culture and vision of your company, they’re not going to be the right hire.

What are the most common mistakes people make in trying to hook themselves up with a great career in long-term care?

Two things stand out for me in particular. We see a lot of very talented people who don’t have professionally presented résumés. I would say that’s probably more so with nurses than other positions, maybe because there’s a certain modesty associated with that profession, and they don’t do as good a job putting their successes and skill sets on paper.

Shouldn’t the regulatory system have taught them not to leave anything out?

You are absolutely right. Maybe they’re so busy documenting everything else that they don’t take care of themselves. Now that’s a caregiver.

If they pretended their résumé was the MDS, the problem would be solved.

(Laugh) True. The other thing is that it’s not uncommon for people in long-term care to have moved frequently throughout their careers as they get promoted or opportunities come up, so they sometimes appear as job-jumpers. I advise candidates to make sure to carefully explain their career transitions.

So let’s say I’m the governor of Alaska and quit my job months before the end of my term. You wouldn’t view my résumé very positively?

No, I would not.

That job interview would be a bridge to nowhere.

Exactly.

Once you’ve found all those good people, what’s the key to keeping them in this profession?

I think that ties back to culture. If people have the same vision and strategic goals and are receiving recognition for a job well done, they won’t leave. So we as management and supervisors need to make sure we do that well. It doesn’t always have to be a monetary gesture. Sometimes it’s as simple as a quick e-mail or pat on the back saying, “Great job. Thank you.” People like to work where they feel recognized. You don’t need to “retain” somebody. Reward them and they will stay.

As a consultant, how hard is it to get people to do what you say?

It’s always difficult. The key is letting people know you’re part of the team and are there to help them and make their lives more efficient, not just to create work or point out things they’ve done wrong. They need to know that you’ll never ask them to do something you wouldn’t do yourself and, of course, that you’re interested in their ideas.

But they’ve seen your résumé and they know you could do every job better than they can. Aren’t they intimidated?

No, I have such reverence for the caregivers at facilities. I’m a big advocate for nurses, and I believe those who work in senior care are the best of the best and are under-recognized. When I was a critical care nurse, I took care of one kind of patient. But the nurses that work in nursing homes take care of a stroke patient in one room, an orthopedic post-trauma patient in the next, a hospice patient in the next, and a person with an infectious disease in the next. Now that’s an incredible nurse.

So when you’re in a facility and somebody’s doing something wrong, you’re never tempted to just push them out of the way and say, “Let me do that”?

No. Absolutely not. In fact, let me tell you a story. Once I was at a facility fairly early in the morning and the charge nurse had called in with an emergency. The med pass still needed to be done and I was licensed in that state, so I said I’d be glad to do it. That built teamwork instantly on the spot, of course, because everyone knew I would help them in any way. But by 11:15 a.m., I was in tears, and the residents who could were coming to me and asking for their medications. I had a new respect for these nurses because it was not an easy task. By stepping in, it renewed my faith.

What is the most ridiculous thing you’ve ever heard in your years of consulting?

I did a mock survey once and found so many compliance issues that I went to the administrator and asked if we could talk for a few minutes. I said, “Tell me what you know about OBRA,” and he responded, “Well, we admitted her last week, and I know she’s on an ambulation program.”

And yet you keep doing this.

Everywhere I go, I see teams of focused and dedicated people who are trying to do the right thing in an environment that can be very difficult. It’s a lot easier to look in from the outside and find everything wrong than it is to be on the inside and try to make a difference. So that’s why I keep at this.

To send your comments to the editor, please e-mail mhrehocik@iadvanceseniorcare.com

Long-Term Living 2009 November;58(11):41-43

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