Publication Date
11-9-2022
Item Type
Text
Executive Summary
New Horizon’s Staff Decisional Conflict Flowchart
New Horizons was founded in 1998 by Father Don, a Greek Orthodox priest who did street outreach with homeless youth outside a donut shop near Pike Place Market (New Horizons, n.d.). He discovered that youth would rather live on the backstreets of Seattle than seek shelter and help from current service providers. After conversations with the youth and young adults (YYA), Father Don started an institution that specifically targeted homeless youth and the unstable housed population. To be different and accessible to all individuals, New Horizons adopted a low barrier system designed to serve the most vulnerable youths between the ages of 13-25. Being a low barrier facility requires staff to frequently assess safety and agitation levels throughout complex situations they encounter. Our goal was to develop a tool that helps to train staff in the decision-making process during conflicts and reduces staff burnout.
Background
New Horizons is in the heart of Seattle, making it accessible to homeless youth that need a place to call home. Noble (2016) reports that almost 13,000 youth experience homelessness in Washington. To help address the high rates of homelessness in King County, New Horizons strives to be a low barrier facility that opens its doors to all individuals regardless of race, gender, size, history, socioeconomic status, drug use, pets, etc. The main priority is safety when serving vulnerable populations, as it can come with challenges like encountering individuals in states of psychosis. New Horizons values maintaining relationships with youth, which at times has contributed to ineffective application of rules and regulations. The high demands of the job coupled with lack of training can lead to staff burnout and an increased turnover rate. Research indicates that work anxiety, feeling unsafe, a negative team orientation, and lack of preparedness lead to untimely turnover intentions (Modaresnezhad et. al, 2021). The creation of a flowchart that informs decision-making will decrease staff anxiety, increase a sense of preparedness, and positively influence team orientation.
Activities with Rationale
We developed a tool consisting of several pathways that employees can follow to guide decisions during a crisis, especially those who do not have lived experience to reference. Our goals were to support employees, strengthen the relationship between staff and youth, prevent burnout, and improve employee retention. It is important for the staff to learn new skills to support the expansion of their role when working with homeless youth and to improve coping with challenging situations (Peters et al., 2021). Our flowchart will help staff members assess crisis situations and determine the next actionable steps, while maintaining a trusting relationship with the youth in New Horizons.
When structuring our flowchart, we prioritized physical, environmental, and emotional safety. “The concept of communication can be most appropriately considered in the context of three levels of the hierarchy: safety, love/belonging, and esteem. Of these, safety has the most intimate involvement with basic, ‘primitive’ needs” (Vertino, 2014). So, we addressed physical safety first by considering whether the subject of the conflict was safe, required medical attention, and if others around them were physically safe. Then, we focused on environmental safety and belongingness by engaging in conversation, verbal de-escalation, and connecting with resources. Finally, we addressed esteem and emotional well-being by determining triggers and educating on coping mechanisms. Our flowchart depicts these priorities by organizing them according to Maslow’s Hierarchy of Needs (Maslow, 1954). Therefore, environmental and emotional needs cannot be addressed before physical safety and our flowchart reflects that.
Sustaining long-term and trusting relationships while enforcing consequences is a struggle New Horizons has faced. A priority of this project was to support staff decisions and center on the value of preserving trusting relationships. Maintaining relational foundations during conflict helps youth to reengage with the staff and setting (Leonard et al., 2017). The act of barring residents fractures the valued staff and youth relationship. Thus, we produced three alternative consequences in our flowchart when confronting a crisis: verbal de-escalation, verbal warning/meeting with admin, and issuing a warning if needed. Barring is also included if the behavior does not stop or is jeopardizing the safety of others or the environment. Furthermore, there are pathways that rely on the staff’s opinion of the situation by considering if the offense is repeated and assessing agitation levels based on their relationship with the youth. Therefore, we created a flowchart that promotes trust between the staff and the youth by providing alternative consequences and allowing relationships to be a factor when determining them. For this reason, we chose to keep the various pathways broad to encompass as many unique situations as possible, which empowers the staff to make decisions during a crisis.
Outcomes
We received feedback from New Horizons’ Executive Director regarding the efficacy and application of our flowchart. He agreed that the flowchart would be most beneficial as a training tool for new employees who are learning the process behind decision-making in this context. Rather than utilizing this tool during a crisis, it is most helpful to prepare employees and inform prevention measures. The flowchart is expected to provide comfort and encouragement to staff by showing that the administration is trying to address staff burnout.
New Horizons presented a concern regarding the structure of our project in that people vary in their safety assessments, feelings of being safe, and in their assessments of agitation levels. Gender, physical size, trauma history, and one’s experience can all impact their perception of safety and agitation. It is also imperative to acknowledge that assessment of agitation levels is influenced by gender and racial biases. People of color and masculine-presenting people can be associated with harmful biases of increased agitation levels that would not be perceived that way in white, feminine contexts. If one attempted to remove implicit human bias from the assessment portion of our flowchart by curating strict definitions of agitation and safety, it would result in a tool that is not fluid enough to be applied to numerous situations and relationships. Our flowchart requires a personal assessment of agitation levels and safety, so we recommend it is presented alongside implicit bias training.
Conclusion
With the rising number of homeless youths in King County, as well as increased drug abuse and mental health crises, the need for safe homeless youth shelters like New Horizons is vital. Nevertheless, these vulnerable populations require a lot from staff. We met our goal of creating a flowchart for employees working with this vulnerable population that guides new staff members who do not have lived experience, addresses staff burnout, and reduces the amount of stress and anxiety staff may face. We acknowledged our privileged perspectives and did not want to assume that we were more informed than experienced staff when addressing crisis situations in this context. Therefore, we conducted a survey to further gain awareness of the experiences that staff have, for which no responses were received. Moreover, limited contact with the youth, shelter staff, and external partners made it difficult for us to gain insight into their encounters. In conclusion, we hope this flowchart can be a supplemental tool for inexperienced staff members at New Horizons and be a foundational flowchart that other personnel can refine for future use.
References
Leonard, N.R., Freeman, R., Ritchie, A.S., Gwadz, M.V., Tabac, L., Dickson, V.V., Cleland, C.M., Bolas, J., & Hirsh, M. (2017). “Coming from the place of walking with the youth—that feeds everything”: A mixed methods case study of a runaway and homeless youth organization. Child Adolescent Social Work Journal, 34(5), 443–459. https://doi.org/10.1007/s10560-016-0483-z
Maslow, A. (1954). Motivation and Personality. Harper and Row, Inc. https://www.eyco.org/nuovo/wp-content/uploads/2016/09/Motivation-and-Personality-A.H.Maslow.pdf
Modaresnezhad, M., Andrews, M. C., Mesmer, M. J., Viswesvaran, C., & Deshpande, S. (2021). Anxiety, job satisfaction, supervisor support and turnover intentions of mid‐career nurses: A structural equation model analysis. Journal of Nursing Management (John Wiley & Sons, Inc.), 29(5), 931–942. https://doi.org/10.1111/jonm.13229
New Horizons. (n.d.). Our Story. https://nhmin.org/about-new-horizons/
Noble, C. (2016). Youth homelessness in Washington. National Conference of State Legislatures. https://www.awayhomewa.org/wp-content/uploads/2016/09/YouthHomelessnessWA_LandscapeScan_August-2016.pdf
Peters, L., Hobson, C. W., & Samuel, V. (2021). A systematic review and meta‐synthesis of qualitative studies that investigate the emotional experiences of staff working in homeless settings. Health & Amp; Social Care in the Community, 30(1), 58–72. https://doi.org/10.1111/hsc.13502
Vertino, K. A. (2014). Effective interpersonal communication: A practical guide to improve your life. Online Journal of Issues in Nursing, 19(3), 1–15. https://doi.org/10.3912/OJIN.Vol19No03Man01
Recommended Citation
Hart, Tayler; Caoili, Aysha; Nguyen, Emily; Kanteh, Fatou; Chen, Julia; and Onu, Andra, "New Horizon's Staff Decisional Conflict Flowchart" (2022). Nursing Leadership in Community Engagement Projects. 23.
https://digitalcommons.spu.edu/shs_nlce/23
Copyright Status
http://rightsstatements.org/vocab/InC/1.0/
Additional Rights Information
Copyright held by authors, except where otherwise noted.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
