Be In the Know!

Everyone has heard of Goodwill, right?  You may have dropped off some clothing or furniture that you no longer needed at a local Goodwill store.  But, if you’re like me, you might not have heard of the free online learning offered by Goodwill Community Foundation.

Recently, I happened to see a TV commercial about their online learning program.  My first thought was, “What…?  Goodwill has online training?” It turns out that this program has been in effect for more than a decade and has served over two million learners around the world.  And, it’s all free!  How great is that?

The GCFLearnFree website offers “quality, innovative online learning opportunities to anyone who wants to improve the technology, literacy, and math skills necessary for them to be successful in both work and life.” Their list of classes is extensive and includes:

• Computer basics…even explaining what all the buttons do!
• Internet basics such as email and how to “surf” the web for information
• How to apply and/or interview for a job
• Math skills…from brushing up on fractions to counting change
• Reading skills for people who would like to enhance their literacy

They also have a broad range of “Everyday Life” classes, such as:

• Using an ATM
• Reading a bus map
• Depositing money
• Reading a food label
• Making a grocery list
• Using a microwave
• Paying bills

…and many more!

All together, GCFLearnFree offers more than 750 free classes.  Many of them are also offered in Spanish on their sister site: GCFLatino.

On the website, I read dozens of wonderful testimonials so it’s clear that the classes are having an impact.  Here are what just a few people had to say:

“I just tried out the Everyday Life section of the GCFLearnFree.org website and it’s my new favorite! What a great way to teach life skills! It’s fun, interactive, and practical. “

“I just heard about your website and I love it!  I’m a teacher and it will be great to use with my ABE and ESL students.  Thank you! ”

“These courses will enable me to get a better job and be computer literate with up-to-date skills for today’s computer world.”

“Wonderful class and great boost to my confidence. As an older student, I find your classes easy to understand and use. Thank you!”

“I learned some things in this class that I probably should have learned a long time ago in school but I just didn’t get.”

Here at In the Know, I shared the GCF link with all my employees and the response has been nothing but positive.  For example, one employee wants to learn more about Excel.  Another just upgraded to Office 2010 and needs to learn the “bells and whistles”.

So, please take a few minutes to look over GCF’s list of classes.  Like me, I bet you’ll think of a number of ways you might utilize them with both employees and clients!

Happy Teaching!

Linda

Whether we’re RNs, LPNs or CNAs, most of us got into nursing out of a desire to help people.  But, like it or not, health care is a business…with both external customers (patients) and internal customers (co-workers).  How each of us treats our “customers” has a big impact on our most important outcome:  patient health and well-being.

I was reminded of that today, in a small way, when I went to the drug store to pick up a prescription.  The pharmacist greeted me and asked how she could help.  I told her my name and she brought my prescription to the counter.  She asked if I had any questions…the usual drill.  Then, instead of ringing up my prescription and sending me on my merry way, she said, “My assistant will be with you shortly.”

Unfortunately, her assistant was swamped with people who were dropping off prescriptions.  And, the “drop off” line kept getting longer as I stood at the register.  This meant that people who arrived after me were being served first.  Meanwhile, the pharmacist stood a mere five feet from the register.  I was the only person waiting to pay, so she could have checked me out in less than a minute.  In fact, in the time it took her to tell me the assistant would help me, she could have been halfway through the process!  Instead, I was forced to wait more than ten minutes for the pharmacy assistant.

OK, I get it.  The pharmacist went to school for a lot longer than her assistant.  And, I’m sure the pharmacist had plenty of prescriptions to fill.  But, she did not demonstrate good customer service to me (the “patient”) or to her co-worker.  She was in full-on “it’s not my job” mode!

We’ve probably all been guilty of ignoring the needs of a patient or co-worker with the justification that we had something more important to do or that the task wasn’t in our job description.  In my work with CNAs, I’ve heard stories that make me cringe: the nurse who brushed off the patient who asked for fresh water because that was the aide’s job (so the patient waited 30 minutes for water).  Or the CNA who ignored her co-worker’s plea for help making an occupied bed…because she didn’t like the co-worker.

We all get busy, caught up with fulfilling the responsibilities of our daily assignment.  But who suffers in the above examples? The patient.  Each and every time.

There’s no way around it:  every interaction between two nursing co-workers has an impact, either positive or negative, on patient care. If you think your staff could use a reminder of this fact, consider downloading our FREE inservice, Customer Service in Health Care.  It focuses on issues like internal and external customers, customer expectations, the price of poor customer service, handling customer complaints…and much more.  Like all our CNA inservices, it provides an hour of inservice credit.

And feel free to share your customer service stories–for example, a story of exceptional customer service by one of your CNAs or a cautionary tale of what not to do!

Happy Teaching,

Linda

Picture an average health care facility.  Think about all the supplies, paper, equipment and food that get thrown out every day.  Can you guess how much trash all of us health care providers are generating every year?  While the exact number is impossible to determine, researchers estimate that hospitals add nearly 6 million tons of trash to our landfills every year.  And that’s just hospitals! Add nursing homes, clinics, home health agencies, public health departments and so on…and that number gets even scarier.  We may be tasked with doing no harm to our patients, but what about the environment?

There is good news.  Across the nation, healthcare workers are leading a revolution in waste management!  While some waste is unavoidable, much of it can be eliminated.  And, American healthcare workers are making changes.  Even “small” ideas can lead to reduced waste—and huge savings.

Here are examples of what is working:

• Switching from disposable to reusable sharps containers saves a medium-sized facility as much as $175,000 a year.
• Eliminating plastic trash bag liners in administrative areas saves $20,000 a year.
• Replacing paper towels with air dryers saves $45,000 a year.
• Switching from disposable to reusable food service items saves $500,000 and prevents 400,000 pounds of waste.
• A Health System in Portland, Oregon switched from disposable coffee cups to an all-plastic recyclable cup. Employees were also encouraged to bring their own mug to the cafeteria for a discount. This resulted in a savings of $24,000 and waste reduction of 28,333 pounds per year!

And then there’s paper.  Anyone who’s worked in health care knows that we kill a lot of trees.  In fact, researchers estimate that nearly half of those annual 6 million tons consist of paper and cardboard.  As more health care facilities move to computer-based charting, this figure may drop.   In the meantime, does your organization recycle paper and cardboard?  If not, how about asking the powers-that-be to get with the program?  Then, rally your nursing assistants and other co-workers to make recycling at work a habit.

Even if you or your nursing assistants are not into “being green,” there’s a more personal reason for providing cost-efficient care.  For the average health care workplace, supplies take up 20% of the budget.  Inefficient use of those supplies “steals” money from the budget that might go to employee raises and benefits!

So, remind your nursing assistants to use supplies wisely and pay attention to waste.  Every time they throw away an unused item, they are costing the consumer money, adding garbage to our nation’s landfills and possibly denying themselves a raise!  And be sure to ask them for their ideas on minimizing waste–and doing no harm to the environment.

As you know, one of the primary roles of the nursing assistant is to collect and communicate information.  The information is collected by observing clients and communicated by reporting to the nurse and/or documenting in the client’s chart.  So, how good are your CNAs at observing and communicating important information about their clients?

For example, do they know the difference between information that is urgent, important or significant?  And do they communicate these three types of information appropriately?  For example, urgent observations are those that are immediately life threatening.  If your aides consider a client going one day without a bowel movement urgent information, you might want to give them a review of this topic.

Do your CNAs distinguish between objective and subjective observations?  When was the last time you reminded them that for information to be objective, they must be able to see, hear, feel or measure it…or have it confirmed by another person?  If the reports from your nursing assistants tend to sound like opinion instead of fact, they may need to brush up on this skill.

In both acute and long term care, things can change fast for your clients.  Your nursing assistants need to be knowledgeable about what is normal so they can recognize what is abnormal.  This applies to vital signs, mental status, elimination, the skin…and so much more.  While most CNAs learned the “norm” in school, it is helpful to give them a refresher on abnormal observations once in a while.

Here are some inservice ideas to help your CNAs hone their observation and reporting skills:

• Spend an hour giving an overview of the human body.  Review each of the body’s miraculous systems…and discuss how important each one is to a person’s overall health.   Then, your CNAs can use what they learn to help their clients live healthier, longer lives.

• Present an inservice about basic human needs.  Remind your nursing assistants that they aren’t caring for bodies, they are caring for people.  And, all their clients have very basic needs, including physical and psychological needs–fundamental needs that are the same, regardless of where or how they live. Review the five levels of Maslow’s hierarchy of human needs.

• Teach them about the normal aging process so they know what to expect when working with elderly clients.  For example, do your aides know that the elderly have fewer sweat glands, so they have trouble keeping their body temperature stable?   Or that the heart muscle becomes less “elastic” so it pumps with less force?  To make up for this, the heart beats more frequently.

• Give your aides a vital signs update.  While many organizations rely on technology to measure vital signs, your CNAs should never lose the basic skills of taking a client’s temperature, pulse and blood pressure.  And, since pain is considered the fifth vital sign, be sure to provide information about pain management.

• Review reporting and/or documenting client care information. During this inservice, remind your nursing assistants that if they are providing care for clients without documenting thoroughly and carefully—your organization may not get reimbursed for their work.  Or, if they are documenting care that they did not perform, your organization may not get reimbursed, and could possibly be fined for the false records.  Both situations result in a financial loss.  And, a loss for the organization is a loss for you, your CNAs and your clients!

If you don’t have the time to put together inservices on one or more of the above topics, remember that, at In the Know, we have done it for you.  You can click on the links throughout this article to see what we have to offer.  And, if you have ideas for inservices that you’d like our team of nurses to write, please send an email to info@knowingmore.com.  We’d love to hear from you!

If your client population is comprised mostly of seniors, the National Mental Health Information Center has some terrific (and free) resources for you.  As you probably know, mental health is a big issue for seniors.  In fact, people over age 65 have one of the highest suicide rates of any age group in the United States!

At the National Mental Health Information Center, you can download (at no charge) toolkits, fact sheets and staff workshops all aimed at preventing suicide and promoting optimal mental health among senior citizens.  All you need to take advantage of these materials is Acrobat Reader.

As your nurse aides provide personal care and assist with ADLs, it’s vital that they also pay attention to their clients’ mental health status.  If you are looking for additional mental health resources, don’t forget In the Know inservices.  We offer the following related topics:

• Understanding Depression
• Working with the Mentally Ill
• Understanding Schizophrenia
• Understanding Common Phobias
• Understanding Suicide

Because your CNAs spend so much time with your clients, they are in a good position to notice changes in mental health.  So, be sure to arm your nursing assistants with the knowledge they need to make (and report) appropriate observations about their clients’ mental health.

Your CNAs make observations about their clients all day long.  Therefore, it’s incredibly important that each of your CNAs know what, when and how to report what they see.  Not only should your nurse aides know the procedure for reporting and documenting client care, they should also be aware of what observations are considered abnormal.  After completing our new inservice topic, “Recognizing and Reporting Abnormal Observations”, your nurse aides will be able to:

• Distinguish between normal and abnormal observations in their clients.
• Identify the specific course of action to take with each abnormal observation they may encounter.
• List at least three abnormal observations they might make in regards to:  vital signs, mental status, nutrition and pain.
• Distinguish between objective and subjective observations.
• Demonstrate the ability to recognize and properly report abnormal observations in their daily work.

Would you like to see a sample page from the inservice? Click here to view the PDF file.

Interested in ordering this topic? Click here to visit our website.  If you would prefer to order over the phone, call us toll-free at 877.809.5515 and one of our helpful associates will be happy to assist you!

It’s CNA Week and that’s a great time to think about how you can help your nursing assistants continue to learn on the job.  Here at In the Know, we’re all about lifelong learning.  And we know that the best learning experiences are often a bit “outside the box”.  So, here are some tips that might spur both critical thinking and learning among your direct care staff:

• Institute a “Learning Award” and present it to the nursing assistant who completes the most hours of continuing education in a specific time period (calendar quarter or year) or on a specific subject pertinent to your workplace (patient rights or workplace safety).

• Encourage and support skills that go beyond client care, such as money management, parenting, career planning, resume writing, etc.

• Have a different nursing assistant lead each inservice meeting with you.

• Consider developing a tuition reimbursement plan and/or a college scholarship program for the nursing assistants at your workplace.

• Ask a CNA or two to join you when a medical equipment representative comes in to demonstrate or promote a new product.  The CNAs may know best if the equipment in question will work at your facility.

• Encourage your nursing assistants to volunteer for committees at work–ethics, quality improvement, safety, etc.  Then, give them the time and support to attend the meetings.

• At home health or hospice client care meetings, ask your aides to present each of their clients.  Don’t let them sit there quietly when they probably have such valuable input to share.

• On your CNAs’ yearly performance evaluations, make sure that at least one of their goals has to do with learning.

• Build a library of books at your workplace on a variety of subjects:  health care, motivation, parenting, physical fitness, healthy eating, etc.  Allow your CNAs to “check out” the books.

• Encourage your CNAs to become computer literate (if they aren’t already).\

• Start each inservice or staff meeting by asking your CNAs to share one thing they have learned since the last meeting.

• Assess the learning needs of your nursing assistants quarterly…or at least annually.

• Teach your CNAs to speak up if they are assigned to a client with an unfamiliar diagnosis.

• Have your nursing assistants lead a book club for the residents in your facility or teach the residents one of their favorite hobbies.

Whew…as you can see, the possibilities are endless!  But the bottom line remains the same:  give your nursing assistants the opportunity to learn and grow and they will be happier, more productive employees.  And, you’ll have a team of top-notch CNAs!

As you know, nursing assistants provide up to 90% of hands-on care for our sick and elderly.  Yet, even after all of their hard work, many CNAs feel unappreciated.  Throughout the U.S., we are losing many dedicated nursing assistants who can’t handle putting their “all” into a job for which they do not feel respected.  (It’s not unlike the way it was for nurses in the past, right?)

Has your organization been affected by the CNA shortage? Unfortunately, the problem is only going to get worse.  In the United States alone, there are more than 3 million direct care workers, but we will need one million more by 2016!  And, over the next ten years, it is estimated that we’ll need 30% more home health aides.  This rate of growth is much faster than the average for all occupations.

Our mission at In the Know has always been to enhance the professionalism of nursing assistants everywhere. So, to do just that, we have created a website where the general public can gain a better understanding of the important work done by CNAs.  And, at Just for Nursing Assistants, people are free to let nursing assistants know they care by offering words of support, a personal experience or simply expressions of gratitude.

Some of you have already submitted your thoughts to us.  If so, your comments will be published on Just for Nursing Assistants in the coming weeks.  If you have not expressed your feelings, please consider doing so now…and help us spread the word about the dedication and compassion of CNAs.  And, feel free to share the website address (www.justfornursingassistants.com) with all your direct care staff.

Take care,

Linda

Linda Leekley BS, RN