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By Sandra Stimson ADC, CALA, CDP
Executive Director,
Alternative Solutions in Long Term Care
ETHICS: Ideas to Instill Ethics and Values in Your Employees

Does it pay the company to have strong ethics programs for your facility and employees? There are
studies that indicate that companies who are willing to put into place, strong ethics programs, ethics
committees and ethics officers, shows that you care deeply about your customers, employees and can
increase your revenue by 500 percent. So it obviously pays to have these strong programs in place.

Ethics programs are not one-day seminars or in-services! It is an ongoing process that begins from the
moment a new employee is interviewed, through new orientation and training and is incorporated into
your daily work life and personal life.

It can include but certainly not limited to ongoing training, mentoring programs for new employees,
community volunteer programs, to posted strong work ethic statements. Sunrise Corporation posts their
work ethic statement outside every elevator. It is not only a reminder to employees but also to the outside
community who visit the facility. Genesis Corporation posts their Ethics Motto in a beautifully displayed
poster in a glass case that is prominently displayed in their main center hallways.

Two” principles” of care giving that we should make clear to our employees and make sure they
understand are:

Autonomy: To allow for the residents right to choose. To encourage and permit the resident to make
informed choices.

Beneficence: To do what is in the resident’s best interest.
To do good. To prevent harm. To remove harm.

Here are some ideas to incorporate into your ethics program that may help your organization get
message across;
° Ongoing Training and In-services. Nothing is more valuable than training and education.
° Workshops and Role Playing. It is very impacting to all who participate when provided with an actual
situation and asking the group to come to an ethical decision. This can be very inspiring and thought
° Provide ethic resources. Make sure your break rooms are stocked with valuable information about
° Annual Ethics Awareness Day. If you do not have one, begin one.
° Respect others spiritual beliefs, don’t impose other beliefs which is disrespectful and violates
fundamental democratic values concerning religious freedom. Have cultural diversity days. Educate
everyone about different beliefs and cultures.
° Praise conduct that exemplifies the core ethical values, especially when the conduct was not easy.
° Ethics calendars for employees
° Screen Savers with 12 building blocks of trust and ethics questions.
° Code of Conduct and Ethics posted on your company web site.
° Email reminders of code of Ethics and Conduct.
° Post table tents with ethics posted on the cafeteria tables.
° Send out bulletins of ethic related issues.
° Wear Character count pins.
° Seasonal Ethics Bulletins, for example at Christmas, you send a policy about accepting gifts from
° Ethics and Character counts posters.
° Opinion surveys of your employees, customers and stockholders.
° Recruit and retain top quality people.
° Focus groups to gauge responses to Ethics Initiatives.
“You may not be able to measure the impact of Ethics training but you can read how employees view
ethics initiatives.”
° Build employee character during hiring, training and promotion activities.
° Fostering a more satisfying and productive working environment.
° Encourage mentoring-Think of your employees, especially your younger ones, as people whose
personal and work values will be influenced by what you expect of them and how you treat them.
° Wallet Size Cards that every employee carries that states Ethical and

Value Questions on the back of the card. Some questions could be:
• Is the action legal?
• Does it comply with your values?
• If you do it, will you feel bad?
• How will it look in the newspaper?
• If you know it’s wrong, don’t do it!
• If you’re not sure, ask.
• Keep asking until you get an answer.

A 2003 survey conducted, indicated that most long-term care facilities do not have ethics committees. It is
required of all hospitals but not nursing homes. Typically a nursing home may use the resources of your
local county ethics committee. In the state of NJ the program is called the NJ Seed Project.

The NJ Seed project goals are to:
*Strengthen and expand existing regional and long-term care ethics committees by providing ethics
education and case consultation skills for all participating facilities.
*To act as an educational resource for established ethics committees
*To create new regional long-term care ethics committees in NJ.
To enhance and utilize regional ethics committees case consultation
skills by addressing ethical issues at the bedside.
*To provide ongoing education and bedside support to regional ethics committees to facilitate growth
and continuity.
To develop and strengthen policy and consultation functions of all regional long term care ethics
committee in NJ
To conduct long-term care research.

To find a list of NJ Regional Ethics Committees, please go to or call
NJ office of the Ombudsman NJ Ethics Consortium 609 588 3607.
I had the pleasure of attending the December training by the NJ Seed Project and The NJ office of the
Ombudsman. I found it to be extremely interesting and professional, packed with tons of information. I
strongly encourage the NJ facilities to become actively involved in your regional committees. One of the
speakers was Deborah Whisnand. If you are looking for a dynamic and thought provoking Ethics
Speaker, we would highly recommend her you can contact her through

Weather we are talking about Ethical Decisions as it relates to medical issues or employee misconduct,
Ethical Committees serve a vital role in every facility. A recent survey that was conducted reported that
44% of employees do not report misconduct because:
1. Employees believe that no corrective action would be taken.
2. Employees were fearful that reports would not be confidential.
These are two very compelling reasons why ethics committees need to implemented and education and
training ongoing.

There are still facilities that are unclear of what to do with guardianship, DNR and DNH when faced with
serious life threatening issues.. There are some facilities whose policies are not to have DNR and DNH
in their facilities. You might have a confused resident who is still able to make decisions about health
care. Or, two family members with conflicting opinions about inserting a feeding tube. Ethics committees
make sense! If, for no other reason, than the many difficult medical issues that every facility at one point
will have to address. But remember, if you are going to begin an Ethics Committee, make sure you have
people who will have different opinions and not necessarily agree with each member.

It is a myth that employees are ethical, so we don’t need attention to business ethics. “Ethics programs
cultivate strong teamwork and productivity. A critical component in the work place is openness, integrity
and community which in turn, employees react with motivation and performance.” We can’t be afraid to
say, “your paid to smile, have a good attitude, to be ethical, to follow our moral code and report bad

Ethics Resources:

Forming a Moral Community: A Resource for Healthcare Ethics Committees available through The
Bioethics Consultation Group
510 486 0626 We strongly recommend this publication.
ISBN: 1-882674-00-6 NJ Ethics Committee
State Initiatives in End of Life Care Publication 816.221.1100 x 237 Elder Care Ethics Associates Ethics Officer Association
Code of Ethics for Healthcare
Alliance for Quality Nursing Home Care Code of Conduct American Academy of Hospice and Palliative Medicine. Dying Well Midwest Bioethics Center

NJ Protection and Advocacy, Inc. 1800 922 7233

Guardianship Services of NJ 1609 292 0055

The NJ Seed Project 856.234.7233

Sandra Stimson has experience as a
corporate consultant, Corporate
Trainer and National Speaker. Her
experience is in long term care, as
Activity Director, Director of
Alzheimer's Units and Assistant
Administrator of a 550 bed long term
care county home.  She is
Co-founder of Pet Express Pet
Therapy Club, is a Life Replay
Specialist.  Sandra implements
dementia units nationwide.  Sandra
has written several books, Volunteer
Management Essentials for Long
Term Care and Pet Express Pet
Therapy Program. Sandra has been a
facilitator for Alzheimer's support
groups and is the Awards Chair for the
NJ Association of Activity
Professionals.  Sandra is the
Executive Director of
Council of Certified Dementia

Alternative Solutions in Long Term
Care offers resources for health care
professionals in many areas of
dementia care, care plans,
Snoezelen products, dementia
activity calendars, adult day care
calendars, sensory calendars,
reminisce videos for dementia,
activity books, and dates to
remember, party supplies,
resources and links.
Copyright 2004-2006
The Activity Director's Office
All rights reserved
Music: "Peg of My Heart" furnished by Heart and Soul Music "Providing Quality Music for Nursing Homes"