- February 21, 2023
When we first experienced the 7:00 PM celebration or banging of pots and pans, rather, where Kiwanis Care Center is, there are at least three towers of independent living or supportive housing, and it was amazing to be surrounded by that sound for the first month. And then, as it progressed, you could hear it getting fainter.
Pierre Florendo is the Director of Care at Kiwanis Care Centre in New Westminster, BC. During this episode, Sean and Pierre discuss the difficulties of the pandemic, the mindset of working in continuing care, balancing work and family, and the importance of quality leadership.
Sean Burke: [00:00:00] Welcome to the Care2Listen podcast, where we interview frontline workers and healthcare experts who will share their stories and passions. This is a podcast to let you know that you’re not alone. The goal of this series is to reduce the mental health stigma in healthcare and provide accessible support for caregivers just like yourself.
Sean Burke: Today’s episode is being broadcasted to you on the unceded and traditional territories of the Musqueam (xʷməθkʷəy̓əm), Squamish (Sḵwx̱wú7mesh Úxwumixw), and Tsleil-Waututh (səl̓ilw̓ətaʔɬ) Nations.
Sean Burke: Hello everybody and welcome to the first episode of the Care2Listen podcast. I’m your host, Sean Burke, the founder and CEO of CheckingIn. Joining me today is Pierre Florendo, the Director of Care at the Kiwanis Care Center. We’re so excited to have you to talk a little bit about some of the challenges like going through the pandemic, and the mental health issues and concerns that have come up. So, thank you for joining us.
Pierre Florendo: Thank you for having me.
Sean Burke: So, Pierre, thanks for joining us. [00:01:00] Obviously you’re somebody who has been an integral contributor towards helping people get through and navigate this pandemic. Being the Director of Care at a long-term care home, there’s obviously so much we can cover and talk about today. Before we do, I’d just love for you to do an introduction and let people know who you are.
Pierre Florendo: My name is Pierre Florendo. I am the Director of Care at Kiwanis Care Center. It is a 75-bed care home in New Westminster. I’ve been there for about three years and two weeks to be exact. So, I started just before the pandemic and it was interesting to see the change from what we considered normal back then to what normal is now, and it’s been a really interesting transition. There’s a lot of stories I can share about that.
Sean Burke: Awesome. We appreciate it. And, obviously having some pre-conversations, father of three, also having a wife who works in [00:02:00] more acute care, but again, near and dear to your heart, serving others and being a big support when it came to getting through the pandemic. Walk me through when you were first starting, when covid was introduced. What was your first experience and how did that show up for you?
Pierre Florendo: So, when we were hearing rumblings of something happening, keep in mind I had just started at this care home, so I was still getting accustomed to: How do things work here? Who are the residents? Who are the staff? So, there was that transition I had to deal with, but there were also messages coming from the news, from the health authority, other care homes saying, “okay, what’s happening here? What’s going on?” And so, when we started seeing the news from other care homes that there were cases getting in, and the first case that happened in British Columbia there was apprehension.
Pierre Florendo: There was confusion as to what to do next, [00:03:00] and trying to figure out what the best thing to do was, not only for the care home, but also personal considerations. Because as you mentioned, one of my kids is three years old, so that means she was born about six months before the pandemic started. Seeing that, thinking about, and if that’s my experience, we’ve got all the other staff in the home thinking about their personal lives, their work lives, everything. That was a very interesting first couple months just trying to navigate through, “okay, what do we do now?”
Sean Burke: Walk me through, what was the psyche like for workers who were in the care homes, knowing that care homes and long-term care homes were a source of the initial epicenters of some of the transmissions, what was that like? What were the mental challenges that you guys faced, like?
Pierre Florendo: Well, there were varying responses. We’re not strangers to [00:04:00] respiratory outbreaks, like we had influenza outbreaks in long-term care. It’s not something new. But this felt somewhat different because we were hearing the news, we were hearing that this seems to be different, and what does it mean for residents and for staff? I mean in long-term care; we do have those challenges already for working with a vulnerable population. There was a lack of clarity as to what happens next. I think that’s always gonna be the big question is like, what do we do now and what happens next?
Sean Burke: Having that sort of lack of clarity, what was the outcome from a mental health perspective? How did your colleagues respond and what were some of the impacts there?
Pierre Florendo: Well, when you’re living a life of uncertainty or that feeling of, I don’t know what to do next, you’re always looking at it [00:05:00] like crisis mode that doesn’t resolve itself. So you feel like you’re on edge, but you don’t know what to feel on edge for. As the pandemic progressed, as we got more information, there was still that feeling of, “I don’t know what to do yet.” We’re not sure what to do at this point. We know we have to carry on, but we don’t know what else is gonna happen.
Sean Burke: Yeah, and I mean, I can totally visualize at the beginning of the pandemic, you had the general community coming out, I think it was seven o’clock banging pots and pans, being there, supportive. What, and how did that change in transformation as the pandemic continued on? How did that impact the long-term care workers?
Pierre Florendo: When we first experienced the 7:00 PM celebration, or banging of pots and pans, rather, where Kiwanis Care Center is, there are at least three towers of independent living or supportive housing [00:06:00] and it was amazing to be surrounded by that sound for the first month. And then as it progressed, you could hear it getting fainter. But at the same time, the reception that we had was, “Okay, that’s great that you’re doing that. Is there anything else that you can do?” Because, yeah, you are appreciating us, but at the same time, there’s nothing else really happening.
Pierre Florendo: Residents weren’t allowed to leave the building, and then we were dealing with that. Then they were allowed to receive one visitor, then they weren’t allowed to receive a visitor. Then they were allowed to receive a couple of visitors. As times changed, we had to adapt, but we never had that ability to take a moment and say, “okay, what’s happened here?”
Sean Burke: Yeah, and I think a lot of the work that we do around building that self-awareness, taking that pause, and allowing yourself to sort of process those emotions and [00:07:00] let them pass. It sounds like so much of the experience is that it’s just constantly go, go, go and there hasn’t been that opportunity. How does that impact the general psyche, the team morale when it comes to working in long-term care?
Pierre Florendo: Those who have worked in long-term care may understand the term “single site.” There was an order from the Ministry of Health to have staff work in one care home only, and before that there were staff working in multiple homes. They could work casual, or they could work lines in multiple places. So, what happened there is one single site was implemented, I believe in March of 2020 that really cut down our team already. In my perspective, what I had to deal with personally, I went from 21 nurses to 9 and that’s a huge cut.
Pierre Florendo: You already saw that team shrink and the workload didn’t shrink, but the way we work in long-term care was carry on. You would see that [00:08:00] as the days went, you could see eventual burnouts because there were no reinforcements coming because we couldn’t hire casuals fast enough because there weren’t any, everybody was fighting for the same amount of people working or we’re also competing with other aspects of healthcare, like acute care, home care. At times, you do have that despair that no one is coming. You have that feeling of that obligation that someone has to be here, but you’re also fighting with that obligation of, where am I supposed to be because I’ve got work – yes, I’ve got a bunch of people who need us, but I’ve also got my connection, my family, my health.
Sean Burke: Some of the horror stories when it came to not having that support, not having a full team, and really getting into healthcare to support the patient and some of the risks and, and challenges that come with [00:09:00] being short staffed and some of the sacrifices that you had to make. I’d love to hear just that, that story around the office and the office turning into a bedroom and everything else.
Pierre Florendo: Well, like I mentioned, I had nine nurses shrinking down to five nurses shrinking down to, if anyone calls in sick, there is no registered nurse coming, and I have a nurse license, so therefore I have to work. There was one time I recall where I was called in at 9:00 PM and had to work until 11:00 AM and then the morning nurse called in sick too. So, it was working an unexpected 16-hour shift night to day, and not sleeping the night before. So, I did tell my coworkers, look, I have to have some sort of a break, and the only place I could have was my office, using a sleeping bag and some sort of cushioning to try and get some rest because we recognize [00:10:00] that it’s almost like working impaired if you don’t get enough sleep. And it’s really dangerous when you’ve got your nurse who needs that break but hasn’t had that break. I will say that I wish that that was a unique story in long-term care, but we know that that was happening in many care homes. I’m sure some of the listeners can think of stories where they were short staffed and that is one personal story of what was happening.
Sean Burke: It’s the mindset and the psyche of, you’re there for your patients, you’re serving your patients. But at the same time, you touched on having a family and the need to balance, and also the fears, especially at the beginning, of the unknown of potentially bringing home covid. What was that like?
Pierre Florendo: That’s tough. I mean, my kids are asking, okay, “do you have to go to work?” And sometimes I do question that myself. I know [00:11:00] why I have to go to work. But when they ask me and they say, “you’re always there” and they’re right. I had the conversation with my wife trying to work out, okay, what are we gonna do here? Cause as mentioned, like, look how young they are. They’re eight, six, and three, and the older ones are going through a transition where they went from school to absolutely no school or school online. The youngest has really never known life without, without covid. And so we’re trying to provide our support, but also balancing. As mentioned, we have obligations in all these different places and trying to power through and figure out where I should be or where healthcare workers need to be. It was tough. It was a tough balancing act, and I’m sure years from now we’re still gonna have that conversation as to “did we make the right decisions as to where we were supposed to be?”
Sean Burke: What does [00:12:00] the industry and profession need in order to help process and work through those emotions from your perspective?
Pierre Florendo: I think the first thing that we need to do is have a change of value where we value the apparent strength of having the ability to keep going and instead recognize that we’re human. We do need time to process. Time to take that break. Time to talk about it. Time to get support. I know when you’re in healthcare, healthcare workers are sometimes the worst people to take care of their own health because we know too much and the way we feel is okay, we know enough to know where our boundary is and how much we can push. We can get overconfident and feel that “I can do just one more until your body says no you can’t.” And so [00:13:00] encouraging people to take their sick days if they’re not feeling great to go “You know what? Today we’ll take care of this. Then when it’s my turn to be sick, you can help cover for me.”
Pierre Florendo: Where we can all support each other, allow that vulnerability, and have those discussions. Even if you have 15 minutes to talk about how you are doing, rather than just going straight to how’s work, what things do we need, or what tasks do we need to get done today? Having that period to just say, how are you doing, how are you feeling, and is there something that we can support you with? As leaders, we have to not only allow, but encourage, having that conversation where I can feel free to tell my staff, look, I’m having trouble too. Cause, I would love more leaders to say that this is how it’s going, how I feel personally, this is what I feel like [00:14:00] right now. And so that opens the door to have other healthcare workers talk about that. As you get to know each other, as you get to see each other’s needs, that’s where we can all acknowledge, okay, this is what we need right now, this is what you need individually.
Pierre Florendo: Recognizing that you are more than just who you are at work. When leaders see their workers as more than just workers, but as people and acknowledge the entire list of things that they have to go through, and conversely, when workers also see that leaders are human too, and you all have that feeling that we are here, we’re all here together, we are this community, then I can see, that’s where the support will come from. And you can also extend that to beyond a single care home, you have [00:15:00] long-term care as a sector, healthcare as a sector, and then that builds up to the general population.
Sean Burke: Today’s episode is brought to you by the Care for Caregivers Program. Care for Caregivers is an online resource established to provide mental health supports for the dedicated healthcare workers. This initiative represents a partnership between the Canadian Mental Health Association, BC Division, and SafeCare BC, and is proudly supported by the BC Ministry of Mental Health and Addictions. One part of the Care for Caregivers program is the Care to Speak Line. Care to Speak is a peer-based phone, text, and web chat service that provides free and confidential support to health and social support workers in BC. Connect with us from Monday to Friday from 9:00 AM to 9:00 PM Pacific. Text or call 1-866-802-7337.
Sean Burke: As I’m hearing you sort of talk through some of the opportunities for us to reduce that stigma, to have those open [00:16:00] conversations, so much of it is a result of an individual seeking community, seeking support from colleagues, mentors, managers. What other supports are needed within the industry and profession to support the mental health of your industry?
Pierre Florendo: It’s a two-way street. If the individual is seeking community, there has to be a community there. So, if the industry changes their focus from this mentality of the assembly line: “We’re hiring you. Here’s a bunch of things that you have to get done. Here’s all the stuff you have to get done” and shift away from that and move towards, This is a community, this is a care home. This is the home part. We’re a home. Yes, we have to get things done, but primarily we live here. Some of us live here 24/7, the residents, some [00:17:00] of us live here for eight hours, but it’s not just work. It’s changing that value to this is where people live. This is where we live. If there’s a change in the structure and the purpose of a long-term care home, moving away from feeling like it’s a place where people need care, to this is a privilege for us to be in this home. And so now that we recognize that it is a home, how are we gonna think about it differently? What do you think of when you think of home and then how do we bring that to our current setup for long-term care?
Sean Burke: How does the industry move towards that model?
Pierre Florendo: I’m really focusing on the leaders here because they have the ability, when they model behavior and the values to step away from, okay, we need to get X number of baths done. We need to feed this number of [00:18:00] people, we need to do this, and instead say, “How can we best help you?” And when leaders say that, they’re not talking about residents, they’re talking about staff. And so when leaders move to the model of how can I best help you? So that staff can best help residents live life to the highest quality.
Pierre Florendo: And so that’s where I say it is that local level for leadership and when they empower their staff, staff can then help residents not only live another day, but flourish. And so, I’m not necessarily saying that it needs to come from the province, the health authorities, although it would help to get support. You can have a care home and you can have the care regulations, but two different care homes can carry that out in different ways. [00:19:00] Depending on how that culture is built, how it’s sustained, and how it’s transformed.
Sean Burke: Just based on your experience, what’s preventing or stopping different care homes from doing that?
Pierre Florendo: I feel that some care homes carry on with their tradition of this is how it’s always been done, and not that there’s anything wrong with that per se. People like stability, they like tradition. This is what has worked. Change can be difficult, sometimes the way the organization is set up, it can’t be as agile as others. Stigma is difficult. We acknowledge that. By its very nature, it can be difficult to reach out. There is that shame that’s involved, there is that feeling that the community does not value feeling like this or being like this. So, you do have that natural tendency to want to step away or not talk about it. For the [00:20:00] individual I just say, don’t go it alone. You do need to find and maintain and strengthen those connections that you have, and have that community that accepts you, and not only accepts you, but will help you.
Pierre Florendo: Sometimes the thing is you don’t even know what help you need at the moment because you can’t see through what you’re dealing with. So that’s where, again, you have the community that can tell you, honestly, we see that you’re struggling here, we won’t force the help that we think you need, but we have that relationship. We care about you and we’re here for you anytime. Continuously looking, having that self-awareness to go, how am I doing today? Also, having that organizational awareness of how are we doing? We kind of just want to hero through it because the message we were getting with the seven o’clock banging was, “Hey, it’s healthcare heroes”, but [00:21:00] heroes are human too.
Pierre Florendo: We need to take an honest look at ourselves to say that we don’t need to be strong all the time. We need our downtime. And then recognizing in the other as well, that you too need to also have that downtime. So how can we support each other? For those that are struggling or don’t have those relationships yet, I would encourage those people to find your network or to build up your network because you can’t keep going in alone. You’ll find your group that will help you as you help them as well.
Sean Burke: Heroes are human too. That’s such a powerful statement and I think from everything we covered today that’s somewhere that I would love to leave the listeners as we sign off here. I just wanted to say thank you very much for coming in, sharing your experiences, sharing some of your thoughts, and, helping be part of the conversation because the more people that talk about [00:22:00] this, the more that we’re gonna be able to build and foster those communities of support and provide those safe places for people to show up as authentically their true selves.
Sean Burke: So thank you Pierre, for coming in today and we wish you all the best.
Pierre Florendo: Thank you for having me.