Riverview Hospital Staff Manuals. Richard J. Wiseman

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Riverview Hospital Staff Manuals - Richard J. Wiseman

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the child’s performance for the week will be reviewed and any special savings dollars purchases can be made.

      6. Each full time staff member will be allotted 100 savings dollars per week. These savings dollars can be given at the discretion of the staff member in the form of bonuses. Like fine slips, there will also be bonus slips which the staff can issue as she sees behavior which she wants to encourage.

      7. Staff will be responsible to spell out expectations for good behavior. Expectation should be spelled out before an activity is embarked on. This is especially true where savings dollars are at stake.

      8. Our leverage in this system will be gained by being consistent in our implementation of definitions. Should there be need to change a definition or procedure, this will ONLY be done at a full staff meeting where all staff can agree on the change and the implementation of that change. Changes of this nature will go into effect on a specified day, and not necessarily directly after the staff meeting. All changes must receive the approval of the BLEU Director.

      9. Our job is to teach new behavior. In this light, we must all realize that positive reinforcement teaches more and better than punishment. We must remember that a child in his room alone cannot learn how not to get into trouble. He can only learn that when he can get into trouble, but understands that it does not pay off.

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      GENERAL RULES AND POINTERS

      All liquid assets will be turned in at the end of each day and turned into savings assets at a 2-to-1 rate. For example, if a child has 6 liquid dollars, they are converted to 3 savings dollars. This is to encourage spending.

      Children who have enough savings to go home will be rebated for good visits home. The rebate will be 500 savings dollars below the original price, which means the child will have to work that week to visit home the next week. Other rebates will also be possible.

      Preferably all dollars should be handed to the child upon completion of the task and should certainly be handed out at the end of that period. In all cases a child should be told FOR WHAT GOOD BEHAVIOR HE OR SHE IS RECEIVING THE “MONEY”.

      If a child loses saving credit, he or she should be told of that loss upon returning to the ward. No threats should ever be made. This is a go-no go, either/or, system. There should be no question when action either positive or negative should take place.

      Any time during an activity period a child wants one-to-one staff time, he can purchase it during an activity period in terms of Visitor in Room or Game in Room.

      We will move toward a group interest savings plan. This will mean that the greater the number of dollars earned, the greater the savings to each individual above and beyond what he individually earned. For example, if the total BLEU program is averaging 10,000 BLEU dollars per week, we will notify the children that for each 10 BLEU dollars over that each child will receive one extra BLEU savings dollar. This and other schemes will attempt to encourage group contingency behaviors.

      There are actually three levels of negative consequences for maladaptive behavior:

      Level 1 is losing opportunity for earnings or savings rebate on activities.

      Level 2 is being fined.

      Level 3 is being fined and isolated, i.e. out of control.

      Any child paying for an activity and changes his mind can switch to a higher cost activity by paying the difference or to a lower cost activity but will not receive any liquid rebate. Thus, if a child chooses to have a game in his room for 4 dollars and changes his mind and wants to watch T.V. for 10 dollars, he pays 6 dollars. Conversely, if a child, having paid for T.V. at $10 wants to have a game in his room, he leaves the T.V. room and gets the game in room without paying any extra or receiving back the $6 difference.

      RISING ROUTINE

      1. Up

      a. Definition: A child will have earned his dollars if by 7:30 the child has two feet on the floor and has verbally responded to the staff member’s questions, prompts, etc.

      b. Idea: To get the children up on the right side of the bed with minimum hassle and bad feelings for all involved.

      c. Procedure: All children will be approached 3 times during the half hour and given some type of verbal prompt. For example: “Time to get up, Andy. Good morning!” On the third prompt, weep and wail some about how much the chill will miss by sleeping. If no response, lock door and go to entry into economy procedure. In many cases the verbal prompt may be accompanied by a motor prompt.

      2. Washed

      a. Definition: All children who have no “sleep” in their eyes, whose face is not greasy and who have damp hair around the temples and/or forehead will have earned their dollars for washing.

      b. Idea: To get the child to wash. To get each child to begin to take some interest in personal grooming. Once again, this should be done with a minimum of hassle for all concerned.

      c. Procedure: Once up, all children will be told to wash 3 times during the half hour. Any verbal prompt Sd such as “Wash up” or “Don’t forget to wash your face, Andy” can be used. There should be no reason for a child to receive a motor prompt for washing unless he or she does not know how to wash.

      3. Teeth Brushed

      a. Definition: Any child who gets his or her toothbrush, and whose breath smells from toothpaste and who does not have any obvious food particles in or on his teeth will receive credit.

      b. Idea: To get the child to brush his teeth with minimum hassle.

      c. Procedure: This is included as part of the wash-up routine. Thus, along with being told to wash, a child should also be reminded to brush his teeth a maximum of 3 times during the half hour.

      4. Hair Combed

      a. Definition: Any child whose hair is not tangled, snarled, matted and looks like it has been placed in a styled manner will receive credit.

      b. Idea: As with Teeth Brushing, the idea is to teach and motivate the child to look presentable.

      c. Procedure: Along with the other washing prompts, each child should also be reminded up to three times during the half hour to comb his or her hair.

      5. Dressed

      a. Definition: Any child who puts on assigned or chosen clothes in the manner for which the clothes were designed. This will include: underwear; shirt or blouse tucked in if have tails; pants; skirts; dresses, etc., all buttoned and zipped; socks on; shoes tied. All children who are dressed by the end of the period will receive credit.

      b. Idea: To have the child dressed in an appropriate manner.

      c. Procedure: All children will be provided with clothes and told to get dressed a maximum of 3 times during the half hour.

      BONUSES FOR RISING ROUTINE

      a. Complete – Any child, regardless of number of prompts who by 7:30 has completed tasks 1-5 will receive credit.

      b. Non-Prompted – Any child who completes

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