Journal of Poetry Therapy, Vol. 6, No. 4, 1993

Poetry as a Health Care Management Tool

Ralph K. Allen, Jr. m

An overlooked, or certainly infrequently seen form of management com- munique is the poem. Health care management provides a set of exam- pies---demonstrating psychotherapeutic value to the variety of groups living and working in such a setting. Poetry is shown to be an artful partner not only as a therapeutic tool, but also to have purposeful value in management practice.

The clinical practice of group therapy in the health care setting has close affinity to business group activity. Business groups, including depart- ment heads, employee empowerment groups, quality circles, total quality management teams, and other subsets of organized business exhibit inter- active dynamics that may be observed in the context of psychotherapy. In both sets of operations, the underlying principles of group dynamics work to produce positive and rewarding results for the larger entity while simul- taneously reinforcing individual perceptions and understanding of concepts, issues, and problem solving (Silvermarie, 1988; Allen, 1991).

As Mazza (1988a) stated, " . . . the net result of the group sessions [is] to restore decision making to group members, validate their feelings, and promote change" (p. 491). Management practices in many arenas have introduced such notions into the business atmosphere with increasing rec- ognition of the values inherent in participation-based dynamics rather than recipient-based practices (Mazza, 1988b).

1Ph.D., Licensed Nursing Home Administrator, Consultant, and Member of the Greater Spokane Council on Aging.

ZAddress reprint requests to Ralph K. Allen, Jr., W. 418 Euclid Ave., Spokane, WA 99205.

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�9 1993 Human Sciences Press, Inc.

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Poems, as one form of language use, communicate feelings, direction, principle, and message in a uniquely qualitative manner. When used in the business setting, they can produce positive responses at both the small group and individual levels. This is consistent with Mazza's (1988a) findings that, "in using poetry . . . . the aspects of expression and communication are of primary importance" (p 486).

In recent, semipopular and business management literature, a few ex- ecutives and managers have asserted their feelings about business in poetic ways (Power and Siconolfi (1990) in the Wall Street Journal; Farnham (1991) in Fortune Magazine; and Autry, 1992). Typical examples focus on personal impressions of business-related activity. The humanistic side of management is captured in titles such as "On Firing A Salesman," "V.I.P., A Conversation," and "The Directors."

During the past decade, I have used poetic license in both hospitals and nursing homes as management tools. Letters to vendors, staff recog- nition statements, memos, trade association correspondence, facility status updates, budget requests, and resident/volunteer celebrations have con- tained or been solely a function of poetic effort.

A poem in response to staff queries or emergent situations provides managers with an opportunity to communicate a message and demonstrate the humane side of the equation. For example, a memo to licensed staff regarding the need for a copy of their current license could take the form of a paycheck stuffer:

Sandra, your license renewal is due next month. Please provide the office with a copy by 9/15.

Alternatively, a preprinted, generic "piece" using the same memo paper can convey the message in a more informal and supportive manner:

ON BEING ON TIME FOR LICENSE/ REGISTRATION RENEWING

This is simply a friendly reminder that noted in your personnel binder is the fact that your STATE REGISTRATION expires with your birth celebration. Surveyors, when finding these little glitches become hysterics-baring fangs and twitches. So this little task we'd like you to do--- Please bring us a copy of renewal that's true. We'll place the proof in your personnel binder for legal support and a survey that's kinder.

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Communicating with employees engaged in the often frustrating care of the frail elderly through poetry or shared interpretation of a poem can be productive for team building, grief sharing, and employee/resident re- lations. For participants in such activities, the use of poems is often an effective and therapeutic experience.

"Caregiver's Moment" was written for staff after a longtime resident had expired. Both the social worker and chaplain spent a great deal of extra time in group sessions with staff working through the loss. Discussion of the poem was part of their therapy.

Caregiver's Moment

Every passage gives time to remember things from which experience is built and blessed.

Touched by those we serve, we may mourn the passage, yet recall the blessings and shared moments.

The caregiver's role in the passage is one of many stops along the way. Ours is often not the last - a blessing.

When it is, we are transformed by higher calling. This is time for memory's pause - an eddy in the infinite route

where calm and restoration of spirit can renew. It is a personal time of closure.

Take this time to build from memory. Your strength shall be enhanced

and your gifts of caring . . . tuned for future trial.

Difficult situations for individual staff members can generate ex- tremely supportive actions from other staff members. One situation was reviewed in a "senior-staff" meeting with the following poem used to gen- erate comments and ideas.

Stress Management

Management as caring rarely expresses itself through policy scribed on paper. What protocol is there to guide the young woman whose child

is molested by her brother-in-law as she baby-sits her sister's kid?

It gets more complicated. The child is across State line, her mother - working on the other side

fears the man will come to worksite . . . gun in hand, shotgun in truck, . . . drunk.

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The protocol? Call 911, do what they say.

"Wait and watch. When he crosses the property line you may request our assistance.

He isn't a problem here. The incident you report is across the line."

Comforting thought for the mother as she awaits a possible confrontation, which - on paper,

could result in job loss.

Comforting, I'm certain, while she waits for the end of shift - 11:00 PM and

leaves the safety of worksite to find her child, and to confront her relative's behavior which has

crippled her child, ruined two families, and threatens her being.

We learn, but not from the scraps of paper neatly three-hole punched, in policy manuals

how important our people really are.

In danger, we find support in cohesion and community . . . . not "the book."

Review of points expressed in the poem generated a set of positive solutions to the general problem of evening and night-shift security. Ref- ormation of extant policy demonstrated the value of employee empower- ment to both the individual and the institution.

Management spiced with poetic therapy adds a dimension to decision making at the facility level. For a strategic planning series, the art of poetry served as one tool to free minds as the future was contemplated.

Zen and the Art of Long-Term Care

The future's there when we look ahead and take the time to plan.

It moves, cat-like, through foggy haze spreading out as alluvial fan.

To chart a course or plot or map requires a goal in mind.

And, beacon-like, the sight of this, will guide us to our "find."

The start is often difficult, even though excitement's b r i g h t -

so leave at home your doubts and fear,

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you have such brilliant light. Remember , time cannot remove what's done,

or been the past; the hope of fu ture- -we make, as group . . .

those are thrills we cast. We'll do just fine, our ship is tight. Our journey launched, . . . we start.

So, my friends and colleagues, let's use spread-sheet . . . as ART!

Budget management and capital requests can often become sources of interdepartmental stress bordering on tribal warfare. During capital plan- ning sessions at one facility, a marvelous logic for a $40,000 motor home was presented as a legitimate "overexpenditure" item. The basis for the request centered on resident psychosocial needs. Beneath the veneer of the supporting documentat ion was an oft-repeated theme of trips to foot- ball games, Reno, and other exotic enticements, funded in part through "expected increases in popcorn sales."

The systemic shock to corporate officials was predictable. The denial of the proposal was circulated as a poem, "An Ode To Brilliance and Be- guiling Beauties." The message could have been achieved through memo. The path chosen was poetry. The results included new, and effective long- range justification for an expanded social service program package and a van for resident transportation.

CONCLUSION

There exists a number of uses for poetry in management. Courting psychotherapy as an adjunctive and powerful support base for managing at all levels, the use of poetry can result in improved worksite dynamics at both staff and client levels.

REFERENCES

Allen, R. K., Jr., (1991). Sonnets, odes, jingles and ditties. Nursing Homes, 40(3), 45-47. Autry, J. A. (1991). Love andprofit: The art of caring leadership. New York: William Morrow

& Company. Farnham, A. (1991). These poets know the bottom line. Fortune Magazine, 123 (4), 96-100. Mazza, N. (1988a). Poetry and popular music as adjunctive psychotherapy techniques. In P.

A. Keller & S. R. Heyman (Eds.) Innovations in clinical practice: A source book: Vol. 7 (pp 485-494). Sarasota, FL: Professional Resource Exchange, Inc.

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Mazza, N. (1988b). The therapeutic use of poetry with the elderly. Clinical Gerontologist, 7 (3), 81-85.

Power, W. & Siconolfi, M. (1990, February 15). Memo to: Mr. Ball. RE: Your Messages. Sir: They're Weird. The Wall Street Journal, pp. A1, A8.

Silvermarie, S. (1988). Poetry therapy with frail elderly in a nursing home. Journal of Poetry Therapy, 2 (2), 72-83.