Staff Wellness for Home Visitors

Staff Wellness for Home Visitors

Randi Hopper: Hi everybody, and thank you so much for joining us today. I'm so glad that you're able to come in and have us share this information with you. So many of you are from across the regions. It's great to see everybody.

Today, we're going to be talking about staff wellness for home visitors. My name is Randi Hopper, and I'm from the National Center on Early Childhood Development, Teaching, and Learning. And today with me is Donna Ruhland. She is a senior subject matter specialist also with DTL.

And so, before we get started, I'd really like to go over some of the information regarding the webinar. We have some cool features that you get to experience through what's called the widgets on your screen. So, at the bottom, you'll notice that there are a couple of these figures, these icons, that you see. And so, if you have any questions during the webcast, we ask you to submit these through the purple Q&A widget. We'll try to answer as many of these throughout the course of the webinar, but we do capture these questions, and this is where you also would put any tech questions if you happen to have them.

A copy of today's slide deck, along with one handout, is also on the resource list, which is the green widget. We encourage you to download any resources or links that you may find helpful. Also throughout this webinar, we will be using the blue group chat widget to engage with each other. We'll have some chat questions that will go into there. This will be general for the sharing. And you can also find some additional questions to some common technical issues located in the yellow help widget at the bottom of your screen. You can also find that we have some closed-caption widgets in both English and Spanish.

So, each of these widgets are resizable and movable, so you can customize your own experience. You simply click on the widget, move it by dragging and dropping, and it will resize using the arrows at the top corners. So finally, if you have any trouble refreshing your browser, just press F5, and also make sure to log off of your VPN and exit out of any other browsers. We find that this kind of extenuates your—your bandwidth and allows you to view this information kind of seamlessly. So, let's push forward to see our session objectives for today. We have three of them here. We're really going to focus on identifying the many roles and job responsibilities that home visitors juggle on a daily, weekly, monthly, yearly basis. We're also going to examine some strategy.

This will be primarily over how to balance those roles and responsibilities in connection to countering stress and being able to promote overall wellness. We're also going to share and use resources that support staff wellness for home visitors overall. So, the next thing we're going to do is we're going to have a poll question about how you promote your own self-wellness. So, the poll is going to come up in a pop-up box as soon as I shift over, and you'll have a minute to select your answers. You can select as many answers as you want. As soon as you press submit, the box will disappear, but we'll take a look at the results as soon as they're ready. So, your pop-up box should come up for you.

So the question is, "How do you promote your own self-wellness?" The options we put out there were: exercise, practice mindfulness, listen to or play music, engage in hobbies, read books or magazines, engage in relaxing activities, spend time with family, cook and clean. So, feel free to answer. There is a little timer at the bottom as well, so you kind of see how long you have. Alright. I see some great results and participation throughout. As soon as we're ready, I'll push this to the screen—to your screen so you can see all the lovely colors that are coming up on the poll.

Alright. So, we're going to push this to the audience so you can see what we're seeing, and you see that there were many answers. A lot of people really like to listen and play music. That's one of our biggest ones, as well as spend time with family. Some people engage in relaxing activ—exer—activities and some do exercise. So, you can see that all of us are engaging in some sort of self-wellness, but it's all different because it really depends on the individual. So, we're going to push forward with talking about some job factors that, you know, home visiting staff can be challenged with. So, there are many factors within any job that can contribute to stress, and enough stress can lead to burnout.

So, when we say burnout, we mean this is the state of emotional, physical, mental exhaustion caused by excessive and prolonged stress. So, this occurs when you feel overwhelmed, emotionally drained, and you're really just unable to meet those constant demands, or your desire to achieve certain standards or expectations, and this builds up over time. And burnout can happen at home with those stresses and/or at work with professional stresses. So, when we identify the factors that can easily lead to burnout, we are then able to have strategies to prevent us from being overwhelmed.

 So, many home visitors, we have great satisfaction with the work that we do, and you really enjoy being part of the success, whether those successes are large or small, and no matter what we see with the families we work with. The fact that most home visiting programs experience a fairly high turnover rate really does highlight that even though there are many moments of joy in the work that we're doing with home visiting, there are also many moments of challenges and stress. So, let's work to remember the rewarding parts of the job. As we dive into the ... Addressing some of the more demanding aspects of the work.

So, we were able to find that within Early Head Start and Head Start home-based programs, home visitors are really required to provide a comprehensive set of services to families in the context of their homes. They also promote child health and development, and enhance parenting, family functioning, and family self-sufficiency. So, knowing these expectations, we want you to share the major sources of stress that these responsibilities can bring to us. So, I'm going to put that into our chat box here. And while you're answering that question, I'm going to share my own experience.

So, when I started out as a home visitor, I found that my sources of stress really focused on creating a balance. So, creating a balance between my work life, going to school, and my own family time, as well as the balance between the paperwork that I needed to create and complete, as well as spending the time to provide the services to families. So, those were my major sources of stress, but also just the expectations for myself and being able to provide as many sources as possible to families. So, these are—those were some of the things that I experienced. And I see that some of the answers are starting to come in: paperwork, family challenges that have no solutions or answers, the lack of resources, compassion fatigue, and paperwork. We're seeing kind of those common threads with some of our answers, being able to have that balance that goes on with it.

So, I'm going to come back as we—as we kind of push through and talk about some of the research. I'm also going to keep an eye on our chat box of things that we're sharing. Deadlines, paperwork. Yup, that paperwork seems to be a source of stress for all of us. But it doesn't seem to be going anywhere, really. As we're going through, we're highlighting some sources of stress. Some of those things that you've already said are already here. Not having resources, balancing responsibilities is already there. Feeling helpless or isolated, we haven't seen that, but home visiting we do tend to work in isolation sometimes if you're the only home visitor there, or you have passing expectations and schedules.

And addressing family challenges, of course. So, we're going to be able to push forward a little bit, and look at some challenges that were identified through a study of Early Head Start home visitors. So, this study really pointed out that some home visitors really just didn't feel prepared to address the many needs of families, like we're seeing across the group chat. We're seeing that even though home visitors are not expected to treat things like mental health and substance abuse and domestic violence and other family challenges, you are still expected to be able to identify those needs and refer families to services, and that can be very stressful when it really seems like there are no available services to families for them to be able to access, and then families aren't able to then really get those services and help that they feel they really need and that you really want to provide to them.

So, when we walk away, this also makes the home visitor who is trying to support the family really then have to focus their efforts on that challenge. And the study showed that it was a struggle to then turn around and facilitate that child's healthy development with parents because they were very focused on the family challenge that was present. Another thing that this research brought up was maintaining barriers.

Now, I didn't really see maintaining barriers up here in the group chat. I saw it a couple of times, but didn't see it as much, but it was pointed out in this research that it is a source of stress because the ability to maintain boundaries it becomes a very big gray area for some because home visitors definitely, many times, live in the communities in which they serve, and sometimes you do know families outside of your professional role. And so we're ... Looking at professional boundaries is going to be a big part of when we talk about strategy. We also talk about personal involvement.

We are working very closely with families, and so visitors within this research also shared that they had an emotional involvement with the families, and so things like the disconnection of, you know, not having that connection of speaking to them, and you get that sense of ... There were comments like, "The family deserted me," or, "They never listen to me," or, "I don't ... I feel kind of helpless." You have that emotional, personal connection to that family. That can sometimes cause added stress because you're taking on a little bit of that challenge that that family is having, and it's weighing on you, so it does increase the chance of prolonged stress over time.

The family engagement aspect that this research noted was a challenge in facilitating that parent-child interaction during home visit, which this is the main goal of the home-based program. So, in some cases, the home visitors were stating that they would spend a lot of the visit listening to the parent talk and would provide some relief for the parent by them focusing one-on-one with the child while the parent was able to then step back and/or either even do other things.

And so, we know that the focus for home-based is very much the parent-child relationship and the facilitation that comes with boosting parent knowledge. So, it can be an added stress to go in with a plan and then get kind of bombarded with the family challenge that kind of takes over, and so then switching gears can cause a little bit of stress there. So, we talk about, when we're facilitating this, about those planned activities, right? We come in with a plan because we should be planning jointly with the parents from the week before. And so, we're also making sure that we want to stick to that plan, even though we are having the family challenges. We want to be able to kind of take a look at what that does in adding stress to the family, adding stress to the child, and even adding stress to yourself.

So, some of the home visitors within the study came with that prepared visit, and then they would engage with that infant or child, and then the mother would kind of watch or the father would watch, rather than being engaged. And while some of the home visitors did realize that this wasn't ideal, they ... It was more about being involved with the parent and being there in the moment. And when we have family challenges, it's very hard for parents to focus. But we do want to strive to promote balance. And so, another added piece of stress is the balance that comes with work and life.

And so, we take a look at a focus group that was done where supervisors were asked about their experience with visitors and the people that they supervise. And they did find that many of their home visitors were ... After they were working with all these families, they were, in addition, going to school. At least half of them—at least half of them were balancing other responsibilities, whether that was school, taking care of their own family, and then also having difficulty, then going through and ... They were showing difficulty in sleeping. They were showing difficulty because they weren't able to connect with their home visitors. A lot of supervision sessions were canceled. They were having difficulty engaging with their families and with their peers.

So, when balance becomes non-balanced, we have other areas that are impacted. So, throughout this research and what we've heard across regional training, we do see that many feelings can be experienced by a home visitor. OK. Along with that joy of the job, many feel helpless or inadequate in just trying to support a family with many issues, concerns with the actions that are taken, the lack of resources. And you may feel at times that you are not up to the task and the situations are helpless. But you are a caring individual, and you care what happens to families that you serve, and so this leads to additional stress and eventually causes that burnout.

These multiple feelings also are multiplied by each family that's on your caseload, so this can cause feelings of being overwhelmed. And home visitors in the field can feel very isolated, like I mentioned. And some families are far apart; some are in rural areas, and some home visitors are placed at one particular location, and other home visitors at a different one.

And it's hard to connect to other people to see if they're feeling the same feelings that you are. Juggling these schedules, documenting, keeping up with that paperwork, driving—all of these can be taxing and frustrating. We have feelings of anxiety, and these can escalate. But we want to work within a professional nature with working with families, working with children. And we feel these protective urges sometimes.

So, we can feel protective of families, and it's natural and normal to feel that way because we are nurturing and caring people who do this work. But we have to really be able to look and see that these feelings can be concerning for home visitors as it makes it so that we have added stress, and that added stress can then can contribute to illness and can contribute to burnout, and can, even more, contribute to that turnover rate. So, before I hand this off to Donna to start talking about some strategies, we want to push forward a poll and kind of get an idea of the sense, within those of you who are participating, about who has felt this way before? Those feelings that we talked about.

Have you ever experienced any of the feelings? Helpless, inadequate, overwhelmed, frustrated, anxious, protective, concerned. Pick all that apply. You're absolutely able to pick every single one if that is what applies to you. And you have about 45, 30 more seconds to do it. So, I would say pick all that apply, and then we'll take a look to see what our ... what we're looking at. So, think about what's happening. Oh, I'm seeing in our chat box that it's only letting me pick one. I'm so sorry. But I would say pick the one that you're feeling the most right now then. Pick the one that you're definitely feeling the most right now, and we know that there are multiple ones that can be selected.

So, I'm going to push this to the audience, and we're seeing that a majority of people are saying that they are feeling overwhelmed, and that does not surprise me, seeing as a lot of our things...

We're saying, "Paperwork, balance." All of those things were very much in that first question. And so, keeping in mind these things, I'm hoping that these strategies that we talk about next with Donna as we move through will really help all of you.

Donna Ruhland: Thank you so much, Randi. We're going to be looking at those strategies to reduce the impact of job factors that contribute to stress. And we have an opportunity for a chat. And if you'd place these into that box, that would be great. Click on that widget. What do you think professional boundaries have to do with staff wellness? So, what do you think professional boundaries have to do with staff wellness?

OK. Everything. All of them. Yes. So, not taking work home. It's important to leave ... At work ... Overall ... Helping to stay balanced. That's a really important one. Empowering families, leaving work at work, healthier relationships. Again, not taking work home. Boundaries keeps you from becoming burned out, and that's a really important point.

Going to go forward, even though the ideas are still coming, but we'll be able to share those back and forth then. Think I went too far. There we go. I want to make sure we are on the right slide. Boundaries draw the line between professional and personal relationships. They provide a pathway to remaining objective. Working with families can bring up strong feelings, and acting on those feelings can lead to decisions that could be harmful to families, when you react just with pure emotion.

Building a trusting relationship with families can feel similar to a friendship. Friends might call each other any time of the night or day, loan each other money, give each other rides, or babysit for one another. Those are things that friends do, and they are examples of circumstances where home visitors have to be careful of maintaining a close relationship with the family, yet at the same time make sure that those professional boundaries are kept. You might strongly identify with the family.

They might really resonate with you for a variety of reasons, and that may lead to feeling that you become overly responsible for their well-being, and then you know that you really need to look at that boundary issue. Now, you see on your screen the boundaries continuum, and as mentioned, an individual's approach to professional boundaries can vary, and this can vary by families as well. The boundaries continuum provides information and a visual example to help home visitors, help us all stay balanced. If you look at your screen to the left at the under-involved end of the spectrum, professionals would remain aloof, seem distant and uncaring. Perhaps that's an attitude of just getting the job done, or maybe the professional remains aloof by too rigid of a sense of boundary-setting.

And then way at the far end, at the right of your screen, that's where the professional is over-involved, taking on activities for the family that the family should undertake. Perhaps it's a misguided thought that the family won't do these things on their own, the sense of being more about what the professional is doing and less about the professional ... How the professional facilitates and supports the family in doing. It's like that old adage about teaching someone to fish rather than giving them a fried fish meal.

So, what I'd like you to do is, in the chat box, share just a little bit as you think and reflect on the families we serve. Think about where you're at with your families, and for supervisors on the call, you can think about the families and think about where you feel that your home visitors are on average with your work with families. OK. So, just reflect for a moment about where you feel your work is at with families.

OK. Great. Zone of helpfulness, and that's that mid-section which has a little bit of wiggle room to it. So, that's great. In the zone of helpfulness—zone of helpfulness, wonderful. As those come in, we'll move on. So, we need to clarify role and expectations at the beginning. So, discussing the purpose of the program, the role of the parent during visits, and the role of the home visitor during visits, and doing this from the beginning is really important to set those boundaries. This is more about what the home visitor can and cannot provide for the family. The discussion sets the boundaries and expectations from the beginning. Reflective supervision, or reflecting with a peer, is helpful in discussing and thinking about how to get this method of communicating roles and expectations with families.

And even though I said from the beginning, it's really never too late to go back and do boundary-setting, and talking and reflection can help you figure out how to do that with current families. I see a number of different icons on the screen. So, in thinking about things that come up, setting boundaries might be the easy part, but maintaining and keeping those boundaries intact can be challenging when some of these things happen.

How do you maintain boundaries when the family calls you on the weekend, the parent needs money to pay the electric bill, the family invites you to the child's first birthday party, the family needs a ride to the pediatrician, the parent asks for a reference for a job, and the parent asks you about your personal life? So, take a moment to think about these situations or some that you may experience while working with families. These are not all the situations that you may encounter, but each situation experienced triggers, different emotions in people, which can make boundary setting harder to maintain.

So, as we think through these, we're not looking to answer how to deal with each of the situations independently, but we'll be focusing on an overall approach to maintaining those boundaries. And I think that the next slide will have some helpful recommendations for us. So, with maintaining boundaries, it's important to remain objective when working with families. Be aware of your own emotions, and focus on the purpose of the program.

Be aware of your own desires to be liked by the family or to rescue them. Those are all signals and red flags that you are no longer being objective. Talk with your supervisor or a peer to reflect if you are struggling to maintain boundaries with a family. And in your chat box, if you could share some other thoughts on maintaining boundaries, that would be lovely, I think, very helpful for others on the call.

So, we have, "Be clear since ... At the beginning and explain your role as a home visitor." Wonderful. "My work phone stays in my work bag when not ... Or in the office." That's a very awesome tip. "Providing them the understanding that I'm available during work hours, but if contacted after hours, then I'll respond when work hours resume." Great boundary setting. "Be fair across the board, so what you do with one ... And that way you can make sure that you're not pushing those boundaries with different families." "Be clear and concise about roles staying consistent." "The program policies can be very helpful in maintaining professional boundaries." Perfect. "Explain policy to clients." "Not talking about other families." Very important. "Consent for services. Here we explain that we can't do, like, things like going to birthday parties and such." So again, relying on the policies of the program.

So, lots of great ideas that you can see coming in. Support by supervisors and by the program or the organization is essential for home visitors to overcome feelings of being isolated or feelings of helplessness. And I think with some of the comments about policies and with programs, the expectations they have really resonate with this piece. Home visitors can feel overwhelmed by family needs, all of the families and their needs. In addition, personal stressors can become an issue as well. Support is essential for home visitors to reflect on these feelings, to understand that they're supported by the program.

Feeling that support aids home visitors in their support of families. It's that parallel process. Reflection, reflective supervision is key to the success of home visitors. To be reflected and reflective, to have a safe place to air concerns with a supervisor, and to talk those issues through is just such an incredibly important piece and professional development as well. Peer discussion is also helpful, especially when home visitors can find out how others are feeling and that they feel the same way they are. Using platforms like MyPeers is helpful and can be a resource for tips and ideas, and all while maintaining confidentiality. So, thinking about those feelings of helplessness or being overwhelmed, remember resources for families as well as home visitors can assist in this.

Keeping home visitors current on what's available to families and to them can empower the home visitor and the work. Professional development, both initially and ongoing, helps to reduce stress, provide solutions and strategies, and reduce burnout when the content is appropriate and relevant. Organizational climate aids—or adds in the parallel process that I mentioned earlier, and can provide that additional safety net, kind of like the Bronfenbrenner Ecological Systems Theory. If you remember from child development courses, those circles and the babies in the middle, the organization climate includes: policies, practices, and benefits. And when those are in support of the home visitor, they surround with that safety net and that secure base.

But this can also negatively impact as well when those pieces are not in place. There was an interesting survey that was done. It had 179 home visitors nationwide, or statewide, excuse me, respond to voluntary home visiting program. Researchers with that study found significant direct effect of the positive organizational climate predicting lower levels of burnout as well as mediating effects of worker empowerment on that burnout. The findings suggest that there is benefits focusing on improving the work environment, and thus empowering workers. Among factors impacting worker burnout, work pressure has been identified as being responsible for a significant amount of the job strain in all human-services professions, most of those helping professions.

This pressure mainly comes from workload and time pressures, combined with not feeling prepared to do the work, as well as a lack of supervisory support. Frequent and sensitive supervision is critical in maintaining morale and professional confidence and increases the feelings of self-efficacy and empowerment for home visitors. It's interesting to note that home visitors, whose primary role is to facilitate healthy family functioning and increase families' sense of self-efficacy, need to feel that exact same thing in their role as a home visitor. Without a sense of being empowered, home visitors are at a higher risk for burnout.

So, each home-based program should have policies and procedures, and I love that someone had that in the chat, that promotes safety for home visitors while traveling to home visits, during home visits, and after home visits. Each home visitor should receive training on how to prevent and handle safety concerns before heading out on that first home visit. Home visitor safety is a topic worthy of, well, several days of training. All we can do within this session is to take time to think about these safety concerns and considerations, and how well your program might be addressing those with policies, procedures, emergency protocols, and especially adequate training on safety practices and considerations for home visitors. We'll be going, transitioning, to a little video clip. And this video was created by the Oregon Health Authority, Oregon Public Health Division, Maternal and Child Health Section.

The intended audience for this is public health home visitors, but they have great tips and topics that they discuss that are applicable to Head Start ... Early Head Start home visitors as well. And this, by the way, was published to YouTube on Aug. 16, 2016. So, with that, we're going to transition to the video clip.

[Video begins]

Brenda Dolan: My name is Brenda Dolan. I've been a home visitor for 14 years. I love being able to coach a parent and see the joy that they have, the light in their eyes when they know that they have made a difference in their child's life. One of the most rewarding things about being a home visitor is the relationship that you get to establish working with the families, but it can be very challenging because it's a dynamic environment. You never know what situation you will face walking up to that home and when you walk inside the door. Today, I'm heading to visit Brian and Raquel, and they have recently moved. This will be my first time seeing them at their new home.

[Both speaking in Spanish]

Brenda: Today's visit with Raquel and Brian was great, but thinking back, there were a number of things that I did to ensure my own personal safety.

[Video ends]

Donna: OK. And we'll be able to revisit that same video, kind of another piece of it, in just a moment. But what I'd like you to do now, in the chat, think about some of the safety considerations you make before, during, and after a home visit. So, in the chat box, if you could add some of those considerations and we'll look at them before we go to the next part of that video. So, "Be aware of your surroundings," so incredibly important. "Position yourself for easy access if needed." "Be aware of dogs." Yes. "Back into a driveway." Wonderful tip. "Lock the vehicles." "Never sit with your back to the door." "Always carry your necessary items with you." "Watch for drug exposure." "Parking with an easy escape." "Update the calendar with the visits so your supervisor knows where you're at." "Wear your badge." "Keep calendar up-to-date," again, that's so incredibly important.

Let's see. We have so many coming in. These are great. "Be alert to the surroundings." "We have a GPS, so that capability is there. They always know where you're at." "Park nearby." "PAY ATTENTION TO THE SURROUNDINGS," in caps.

So, those are all incredibly important, and I think we'll see some of those as we go forward. And I'm going to, just because there's time, move on to the next part of the video.

[Video begins]

Brenda: First, before the visit, I let my supervisor know who I was going to visit, where I was going, and when I planned to return. Second, because Raquel had moved and this was the first time I would be visiting her at her new home, I called ahead of time to gather important information that would keep me safe. I confirmed the address, asked her about where to park, and if there were any safety hazards in the neighborhood, like dangerous animals to watch out for. I also asked her who would be in the home during the visit.

As I was arriving in my car, I took some time to drive around a bit and orient myself to the location. I always try to be aware of any people or groups of people that might be lingering around the home. In some cases, I've had to reschedule my visit if there were an unavoidable group of people between myself and the home I plan to visit. I was also looking for any "No Trespassing" signs or "Beware of Dog" signs, or any other indication of animals in the neighborhood. After doing my usual scan from the car, I decided it looks safe. I chose a parking spot on the street so I wouldn't be blocked in the driveway if I needed to leave quickly. I parked my car facing away from the home for that same reason and locked the doors, being sure to leave any valuables in the car and out of sight.

I put my phone away so I could stay vigilant to my surroundings as I approached her door. Raquel's apartment was a good distance away from where I had to park. You never know who else is aware of your arrival and what their intentions are, so I always try to walk tall and confidently toward the home. Raquel's home was on the ground level, but when I visit families who live on the second floor of an apartment complex, I'm always cautious about entryways and stairwells. In this case, I told Raquel to be looking for me at the time of our scheduled visit. As I entered Raquel's home, there was a whole new set of safety challenges. My goal was to make a warm introduction and then make sure that I would be safe inside her home. After asking Raquel for permission to sit down, I chose to avoid any locations where I wouldn't be able to see what was going on behind me. When possible, I try to sit close to an exit so I can leave quickly if necessary.

Once seated, I asked Raquel who else was in the home and if she expected anyone else to join us. [Speaking in Spanish] As I walked out the door, I took out my keys so that when I got to my car, I could easily unlock it. I began looking around to notice any people, activity or animals, checking to see if the environment had changed while I was inside the home. Within a few minutes, I was at my car and on my way back to the office. Home visiting is an exciting, rewarding but challenging job. It's important to remember we can't get our job done if we're not taking steps to actively keep ourselves safe in the field. I've learned from years of experience that we always have to be aware of our surroundings and trust our instincts. Know and follow your agency's safety policies. Enjoy the relationships you make along the way, but remember, ultimately you're responsible for keeping yourself safe. [Video ends]

Donna: OK. So, we had quite a few ideas shared in our chat, as well as in the video, and I think we've really addressed most of these with participating in safety training, think about transporting families if your policies allow that, and then what's involved with that, thinking it through to car seats and such, keeping up on schedules, definitely. Keeping cell phones on you. Personal identification is so important. Maintaining vehicle safety; full tank of gas or at least enough to get you to where you're going.

Knowing about traffic and such problems that are happening, if you have a GPS. Snowy, cold areas, having emergency kits for that in addition to the ones that are listed on our slide. Pets, that was brought up by ... In our chat. It's just important to have those protocols in place when you need to leave a home visit or have another home visit ... Another location for a home visit if the current place, the family's home, is not safe for whatever reason. Also, considerations for when the family is sick, or if the home visitor is sick, with a transmittable disease or illness is really important.

Thinking about inclement weather. Concerns in the neighborhood, that was brought up as well. And drug activity and such was also brought up. Also, any concerns about chemical hazards, presence of weapons and such, other matters of personal safety and threats and concerns. I still remember I was on a home visit during 9/11, and our supervisor called us all in because at that point, we didn't know what was going to happen, so it's just really important to have that protocol in place.

And having that in place for specific incidents, including when a supervisor would call for an emergency, and also, in turn, when the home visitor herself or himself would need to call in. Again, these things were mentioned with drug activity, dangerous animals in the home. If you feel that children or family members are at risk or there may be harm, firearms, weapons and any health, chemical hazards concerns. If you're asked to leave, and any perceived sexual advances or things that make you feel uncomfortable. And with that I'm going to go ... Oh, and keeping alert is, it was mentioned several times. Knowing your surroundings, that's so incredibly important. And now I'm going to turn this over—back over to Randi to discuss strategies to reduce stress.

Randi: Alright. So, as we wrap up today's webinar, we're going to talk about these strategies moving forward, and so do want you to share, once again, about the strategies that really have helped you when you first started. Let me see. I'm going to put it in chat box really quick right here. So, sharing the strategies that really helped you when you first started in your home visiting work, and we're going to also be ... As I go through the next couple slides, I'll be checking back with what people have shared.

So, we're talking about staff-selection process, identifying and hiring staff with the qualities and abilities that really match the responsibilities of the position, taking a look at intentional professional development as well as making time to reflect, not only alone, but with peers and in supervision. And the biggest thing that I think we tend to not do is putting self-care first as a priority. I am even guilty of that myself. And creating a staff wellness plan.

Now sometimes staff wellness plans are created at an agency level. Some are only personal between you and your supervisor. So, whichever way you plan to go, it's good to make a plan to be able to then check back with your plan during your times of reflection. And I see some positive feedback talking about culture. All of those things are being put into the chat box, and I think that really goes into that professional development piece as well as the qualities and abilities piece. And it also ties into what we're sharing about making sure that the job is a good fit. So, thinking back to when you first got in it, and what people are sharing.

Did you know exactly what you were getting into when you took this job and you joined home—home base? I can tell you from personal experience when I first joined as a home visitor, I had no clue what I was getting into, but I absolutely loved it because I really wanted to work with families and children, and coming from private child care and things like that into ... Was a wonderful introduction to the world of Head Start, and because I worked in a very collaborative place, and so it was very helpful that, over time, I was able to give them some feedback about making sure that all of those great things that we really want to be are included in those job descriptions.

Training and professional development, being very intentional with what we're doing. Even though many professional development and training aspects are across-the-board between classroom teachers and home visitors, there are some very specific areas that are home-visitor related, and making sure that our home visitors really do get that, as well as the research behind home visiting, the impacts behind home visiting.

Those are all great things to focus on as we move forward with that, and being ... Having chance for reflection. And so, tying it back to our June webinar, where we did talk about reflective practice, having those times together ... I just saw it come up on the group chat about reflective practice and self-care. And so, taking that time to be reflective, whether it is in between home visits where you take a minute to breathe, reset, move on, reflect on what you just did, reflect on what you're going to do next, do it at the end of the day.

And even help families be reflective in what's happening within the home visit. Nurturing yourself, being mindful, these best practices for self-care have really been developed, and they've been studied. And there was a survey that went out actually in Pennsylvania where home visitors reported that their ability to be mindfulness and working together in building those positive relationships were very much set on having practices in place for self-reflection and being mindful about the situation and having peer groups together. These were all very helpful aspects that really allowed them to move forward.

And when we talk about self-care being a priority, it's absolutely serious. We had to even say it twice because taking care of yourself is essential. It's one of those things about, when you hear it, when you go on planes and you hear the flight attendant, "Put your oxygen mask on first, and then help others." Really the stress that we feel, the burnout that we feel sometimes, that impacts us. There's other things that contribute to that, but ultimately it impacts us, and it impacts the relationships that we build with our own families, with our coworkers, and ultimately it does come back and impact the works that we do.

But we do need to focus on ourselves first, and I highly encourage you to go back and listen to that June webinar about reflective practice and even come and join us for our December webinar next where we're going to talk about professional development. So, here's some resources that we're going to highlight, and I really want to ... I'm not going to spend too much time on them, but I really want you take a minute to explore what's here. We have, "Taking Care of Ourselves," that really focuses on stress and relaxation. "Reflective Practice Guide and Mindfulness," all of these focus on key elements, and within your webinar slides, you have those links, as well as those ... If you haven't seen the stress reduction posters, they are wonderful.

I have sets of them around my office, which really come up with some great strategies. And they're even wonderful to share with parents because you're able to then go and show them some really great techniques. Things like the stress-reduction workshop and the mental health consultation are wonderful resources. And, "What Makes Supervision Work" is a great resource in a survey that went out and some research that was done about home visitors giving their feedback into how reflective supervision actually really works for them and gives some actual suggestions about what to adjust and practices to put in place for programs.

So today, we're just going to so sum it up in what we did, and we're really hoping that you will take at least one thing away and be able to put it into place within your program and for yourself. And so, with that, we're going to share one more piece ... And where we're going to talk about MyPeers. I saw so many people and saying MyPeers, and telling people where to find it, and I love that. I'm a big voice on My Peers as I put things up and I make sure I manage that, but it's a very active community that shares a great deal of knowledge with people. The iPD has very flexible PD options. The Text4Home Visitors is a newer option. That is great, and I love that people are starting to get very excited about it and receiving those practices.

So, join those and check them out when you can. And as we close out for the day, I just want to say thank you.

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