Holding Fast: The Struggle to Create Resilient Caregiving Organizations
How can caregivers remain both caring and strong enough to withstand the stress of their work?
How can caregiving organizations effectively improve their management and practice?
Increasing pressure on caregiving organizations to serve more people with fewer resources means that epidemics of burnout, high staff turnover, dissatisfaction and internal conflict often appear inevitable. Holding Fast focuses on the particular stress of caregiving work, its influences on the people and organizations who do that work, and what they can do about it.
Illustrated by case studies based on extensive research in schools, hospitals, social work agencies, health care centres and religious institutions, Holding Fast identifies the problems faced by caregiving organizations, and outlines appropriate strategies for tackling these to create a resilient, effective organization. The book is divided into clear sections covering:
* an introduction to the nature of caregiving organizations
* the disturbances that can occur within them
*the skills required to effectively lead them.
Holding Fast offers a portrait of how organizations become, or are prevented from becoming, systems of caregiving. It will help leaders of caregiving organizations and their staff gain a better understanding of the difficulties encountered by their organizations, leading to improved management and practice.
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The nature of caregiving organizations
Caregiving organizations defined
The primacy of relationships
The nature of caregiving
Implications for organizing
The stress of caregiving work
The costly construction of safe havens
Greenvale Residential Treatment Center
Failures to collaborate
Teams real and imaginary
Sudbury Hospital emergency room
The strain of technique
The strain of absorption
The strain of relationship Part I
The strain of relationship Part II
Holding on letting go
Resilience under stress
Pressing toward integration
Holding environments at work
The creation of capacity
The underlying logic of system breakdowns
Organizational fault lines
The paradox of resilience
Disturbances in caregiving organizations
Caregivers and casualties
Reclaiming the casualties
Authority at work
Pulls toward irrational authority patterns
The choice of dependence
New Hope Childrens Hospital
The courage of selfauthorization
Divided they fall
From scarcity to safety
Thurston High School
Care versus control
Running in place
Maple Hospital surgical unit
Principles of movement
Letting go moving on
Leading caregiving organizations
The leadership task
Creating conditions for engagement
Convening for resilience
Holding the fort
Pulls toward dependence
The mature leaders stance
Playing for keeps
Leadership and change
absorb agency members anger anxiety authority become behalf behavior believe boundaries capacity caregiving organization members caregiving systems careseekers Chapter childcare workers clients clinical collude Community Groups program conflict contain context create culture department heads dependency dependency needs develop difficult director disturbed dysfunctional Effective leaders emotions engage examine experiences feel frustration functional Greenvale GRTC healing holding environments Hope Children's Hospital individuals integration intergroup involves issues leaders and members maintain mature medical errors meet members and leaders middle managers needs nurse manager occur ongoing organizational pain parents patients patterns physicians primary task projective identification relations relationships remain residential treatment center resilient organizations responsibility roles routinely seek senior managers shared simply social anxiety social defenses social workers split staff members strategies stress struggle Sudbury supervisor surgeons teachers team members therapists Thurston High School tions trauma unable unconscious underlying understand unit members unit's wish
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