"She's Always Like That": The Quiet Phrase That Keeps Us Right of the Bang

You’ve heard it.
You’ve maybe said it…“She’s always like that.”

In nursing homes, that phrase can slip into conversation without a second thought. It
sounds harmless—like a helpful heads-up. But when it becomes the default response, it
can keep us from seeing something that’s actually new… important… or quietly serious.

Because the truth is, that phrase often signals the end of curiosity.

And in a field where early recognition is everything, losing curiosity is a risk we can’t
afford.
When we start explaining things away—
“She’s always like that.”
“She’s just having one of her days.”
“That’s just how she is.”
—we might stop asking questions that matter.
But what if we slowed down for a second and asked:

• Is this really her usual?
• What would we do if this was happening with a new resident?
• Could this be a clue, not a quirk?

Situational awareness isn’t about waiting for something big to happen. It’s about
noticing the small shifts. The off-pattern behaviors. The moments that don’t line up with
what we’ve come to expect.

It’s not always easy—but it is possible to shift how we see and respond. And it starts by
understanding why this phrase shows up in the first place.

Why Do We Say “She’s Always Like That”?

This isn’t about blame it’s about patterns. Let’s unpack some of the habits that keep this
phrase alive, even in teams that care deeply and work hard every day. 

1. Inherited Normalization

• Most frontline training of CNAs and Nurses happens peer-to-peer.

• If a new CNA is told, “She always yells when you change her briefs,” enough
  times, that gets stored as normal—even if it’s actually pain, fear, trauma, or
  progression of disease.
•  Over time, pre-event indicators (red flags of future Bangs) get mistaken for stable
  behavior.

Root Problem:
What’s actually a deviation (or even worse, a pre-event indicator) from baseline
becomes part of the expected routine.

2. Burnout Defense Mechanism

• When staff are overwhelmed or emotionally spent, they naturally start filtering
  what they notice.
• And realistically? Every new behavior usually means new documentation, an
  added intervention, or another care plan change—it’s a lot.

Root Problem:
Protecting energy becomes more important than clinical curiosity.

3. Avoidance of Accountability

•  Saying something might be wrong can open a floodgate of questions:
  “Why wasn’t this reported earlier?”
  “Why didn’t anyone notice yesterday?”
• Add in tight timeframes and fear of getting something wrong, and it becomes
  easier to stay vague.

Root Problem:
It can be hard to speak up AND feel safe at the same time.

4. Lack of Shared Language

• “Baseline” is a common term in clinical conversations—but that doesn’t always
  translate into practical, observable language for frontline staff.
• CNAs often notice when something feels off—but they don’t always have the
  words or confidence to say it out loud.
• Without a shared definition of “what’s normal,” it’s easy to miss what’s new.

Root Problem:
We use important language that hasn’t been made usable for everyone.

5. The Lie of Stability

•  Once someone has a chronic condition, like dementia, it’s easy to assume that
  change is no longer meaningful.
• When someone becomes more withdrawn, more irritable, or more confused, we
  sometimes chalk it up to “the disease process” instead of asking what might be
  new.

Root Problem:
Chronic conditions can create a false sense that reassessment isn’t needed.

6. The Uncertainty Gap

•  Sometimes the problem isn’t a lack of awareness—it’s knowing what to do once
  something is noticed.
•  That uncertainty can lead to hesitation, second-guessing, or the ever-familiar
  phrase: “We’ll just monitor.”

Root Problem:
If the next step isn’t clear, the default becomes doing nothing.

Moving Forward
This is about awareness and root cause.
When we understand the why behind a phrase like “she’s always like that,” we’re better
equipped to challenge it with care, with clarity, and with support.
We can shift the culture of noticing—not by pushing harder, but by getting clearer.
By making it easier for staff to say, “Something’s different today.” And giving them the
tools to know what to do next.

Want to Support Your Team’s Shift Left of the Bang?
I work with nursing homes to strengthen observation, communication, and
response—so that your staff feels confident recognizing the early signs, not just reacting
to the aftermath.
Let’s build systems and language that help your team notice what matters.