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

Much of the day-to-day work of a nursing assistant has to do with competencies.  For example, does the CNA know how to make an occupied bed, transfer a person safely from a bed to a wheelchair or take an accurate blood pressure reading?  But are task-based competencies enough to ensure quality client care?

If you ask Daniel Goleman, the answer would be no.  In the 1990s, he researched and wrote the book, Emotional Intelligence.  His theory was that people could enhance their personal and professional success by mastering five key emotional competencies.  How do you think your nursing assistants rank when it comes to emotional intelligence?

1.      Awareness of Self and Others.

People with a high “emotional IQ,” also called “EQ,” should be able to identify their feelings accurately.  Imagine your CNAs are working with a difficult client.  Can they tell if they are feeling irritated, hurt or angry when the client is unfriendly?  Can they look past their own emotions and realize that their actions affect how other people feel?

2.      Managing Their Moods.

Emotional intelligence includes controlling impulses and handling anger constructively.  Let’s revisit that scenario with the combative client.  If your nurse aides feel angry when caring for a disruptive client, can they manage that anger without taking it out on the client—even in subtle, non-verbal ways?

3.      Motivating Themselves.

Having a high emotional IQ helps people set goals and work towards them with a positive attitude—even when faced with setbacks.  Do your nursing assistants have an inner drive that keeps them inspired and determined to do their best, no matter what the challenge?

4.      Empathy.

Can your nurse aides put themselves in someone else’s shoes—to see and feel the perspective of a client or a co-worker?  For example, when it comes to a grouchy client, can they see past the angry surface to understand the fear and loneliness that is fueling the client’s hostility?

5.      Managing relationships.

Working as a CNA is all about relationships—with clients, family members, co-workers and supervisors.  How skilled are your nursing assistants at resolving conflict?  Do they cooperate with their clinical team members?  Can you count on experienced aides to share what they know with new employees?

According to author Daniel Goleman, the mastery of these five competencies results in enhanced emotional intelligence. You might be thinking, “So what?” Well, studies show that emotionally intelligent employees communicate more effectively, manage change better and have higher levels of productivity—all great qualities for anyone who works in health care.

In an ideal world, it would be great to have a system in place at every workplace to assess for emotional intelligence during the hiring process.  However, it’s never too late to develop and improve the emotional intelligence of your current employees. You can find a number of resources—both in print and online—to assist you with EQ training.  Or, you can avoid reinventing the wheel by sharing some of the following In the Know inservices with your nurse aides.  Each one offers knowledge and skills that promote a high “EQ.”

Customer Service in Health Care (It’s free! Just fill out the registration form.)

The CNA/Nurse Relationship

Building Trust & Confidence with Clients

Working with a Team

Stress Management Skills

The Caring Qualities of a CNA

Conflict in the Workplace

Dealing with Difficult & Combative People

Being Assertive

Professionalism & Work Ethic

Happy Teaching!

Linda

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!

Has your budget for continuing education been cut or put on hold during this economic downturn?  When money is tight, it’s typical for many organizations to look at staff training as “non-essential”.  But, consider these results from a recent study of nearly 1200 companies, comparing the impact of recruiting externally with that of developing current employees.

• 75% of the 1,189 companies involved in the study felt that training their own staff was more beneficial to their business than recruiting people from outside.
• 50% of the companies discovered that training staff made them more likely to stay.
• 33% found that continuing education increased staff motivation, and
• Almost 50% saved money in the process.

In an article about the study, senior researcher, Emma Parry, said: “With training budgets often the first to go in a recession, this research demonstrates that ‘growing your own’ is an effective way for organizations to obtain the skills that they need while saving money.”

“I wasn’t surprised by the findings, but it is nice to have the evidence,” she said, adding that it makes sense that money spent on advertising, interviews and orientation programs can often be better spent on existing staff.

“It also helps staff retention because employees are more likely to stay if they are being developed. They are more committed and are more likely to go the extra mile if they feel the company is helping them to expand their skills,” she said.

Parry added that the problem was that companies often didn’t see the value of investing in training until it was too late. “Sometimes training is seen as nonessential, and when budgets get tight, companies start to look at what they can save money on. But to be honest, cutting training is a false economy.”

What’s the bottom line?  Organizations must focus on nurturing the employees they have if they are to survive, grow and succeed.  This is especially true for certified nursing assistants due to the increasing demand for their services. As the above study shows, effective training reduces staff turnover and absenteeism, improves motivation, increases productivity and helps boost customer satisfaction.

Don’t let a tight budget diminish the quality of your continuing education program.  For starters, be sure to download our free inservice, Customer Service in Health Care.  And, if you’d like help creating a cost-efficient CNA inservice plan, give us a call at 877-809-5515.  We offer options suitable for every education budget!

It’s a fact: adult learners enjoy lively continuing education sessions.  But, coming up with ways to spice up your CNA inservice meetings can be challenging.  Here are six tips that may help:

1.  Every month, insert a crisp new $1.00 bill in a couple of the inservice handout packets.  If you conduct your inservices in a group setting, ask the lucky recipients to read part of the inservice out loud or to “volunteer” for the participatory activities.
2.  To promote participation during the inservice, pick a “secret word” or “secret phrase” prior to the inservice.  It should be a word or phrase that is likely to be said by a participant during the learning session.  Write it down on a piece of paper and seal it in an envelope.  When someone says the secret word or phrase, make a big fuss and give that person a prize.  You can even have two or three secret words prepared to keep the group alert and active throughout the entire inservice.
3.  During an inservice–especially one that’s on a serious topic–take a few minutes to get rid of stress.  Pass out some “stress-reducers” such as squeeze balls, bubble gum or rubber bands.  Make paper airplanes and race them.  Or inflate balloons and let them loose.
4.  Reward participation during inservice meetings.  using “Monopoly money”, give out a bill for each contribution to the topic at hand.  Allow your CNAs to redeem the play money for little prizes (candy, magazines, pretty pens, etc.) that “cost” a certain amount of play money each.
5.  Put a disposable tablecloth on the table during your inservices.  Let your nurse aides draw or write on it (before and after the inservice and during a two minute break in the middle of the meeting).
6.  To encourage group discussion or to make it easier to break into teams, copy each inservice onto two or more different colors of pastel paper.  Group the participants together based on the color of their inservice.  Or, ask for a member of each group to comment on a discussion question.

Using one or more of these simple strategies is bound to enliven your educational sessions and enhance learning…so, happy teaching!

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!

How do your nursing assistants handle workplace conflict? Do they ignore it and pretend it isn’t happening? Do they give in just to make it go away? Or, do they compromise respectfully with each other? At your next CNA inservice meeting, consider using this case study as a way to open a discussion about conflict management at your organization.

You Can’t Avoid Conflict

It’s true: whenever people spend day after day together, conflict cannot be avoided completely. You may be nodding in agreement or you may be thinking that you’ve never had a dispute with anyone. However, conflict at work happens to everyone at some point in his or her career.

A dispute between people usually begins with a disagreement. When you and a co-worker disagree, you have one opinion and your co-worker has another. Often, it doesn’t really matter to either of you what the other person thinks. You both go on with your lives, each sticking to your own opinion. Usually, disagreements consist of only words and they do not affect how people interact with each other.

For example, Tim and Connie, both CNAs, disagree one day at work about the proper way to give a bath to a bedridden client. They each express their opinion, saying that’s how they were taught in school. They end the discussion by saying, “OK…you do it your way and I’ll do it mine.” Tim and Connie disagree, but they respect each other’s opinion and have no trouble working together.

A full-blown conflict can begin with different opinions, but it grows into something much larger. Generally, it is not what people say, but how they act, that causes a disagreement to escalate into a conflict. In almost all conflicts, the problem is not the initial disagreement, but the way in which it is handled.

Let’s take another look at Tim and Connie’s situation. Imagine that instead of agreeing to disagree about bathing a client, they get into an ongoing struggle about who is right.

Tim starts telling other co-workers that Connie doesn’t know how to give a proper bath. Connie gives Tim hateful looks and refuses to work with him. They have entered into a contest of opposing forces. Having gone past the point of disagreement, Tim and Connie are in a full-blown conflict, which can start causing a disruption among their co-workers and eventually in job performance. Both Tim and Connie are creating a situation where neither will back down; each thinks that they would appear to be wrong by offering a truce. Unless their conflict is resolved, work will remain an unpleasant place for both of them!

Tim and Connie must put an end to their conflict, as it is hurting them both… and is also causing a disruption to the rest of the workplace. Let’s see them fix the problem by going through five simple steps:

1. Connie realizes that they need to stop this fight and asks Tim politely if she can speak to him. Tim agrees and they sit in an empty meeting room together–away from their coworkers.
2. They take turns telling one another their points of view. One speaks while the other actively listens.
3. They see that the problem is they each have a strong personality, are competitive and like to be right. They agree that the problem was never the actual bathing technique—but how they communicated.
4. They discuss the bathing method they each use and decide that both techniques are acceptable. However, Tim and Connie say they will continue using their own method. Neither person wins or loses.
5. Tim and Connie decide that, in the future, they will keep their own techniques to themselves. As long as the job is getting done, they can agree to disagree on the proper method. If either Tim or Connie uses a method that is not getting the job done, they will discuss it politely at that time. In the meantime, they agree that the conflict is over, and they both decide to apologize to their co-workers.

Would Your Nursing Assistants Like to Know More?

If you’d like to give your CNAs more information about workplace conflict, consider presenting an inservice on conflict resolution that includes:

• The common ways that people approach conflict.
• A step-by-step process for resolving workplace conflict.
• How gossip and workplace bullying promote conflict.
• How to respond to an unprofessional coworker.
• How to handle conflict with a supervisor or a client.

Don’t have time to put together your own inservice?  Then, please check out our inservice called Conflict in the Workplace.  It covers all of the above information…and more.

Happy Teaching!

There’s a book I’d like to recommend to nursing supervisors and educators everywhere.  It has nothing to do with health care or nursing specifically, but has everything to do with helping us inspire those around us.  The book, Start with Why, emphasizes the importance of uncovering what makes you “tick”.  Its author, Simon Sinek, encourages readers to reach past the “what” and “how” of their jobs and dig deeply for their “why”—the purpose, cause or belief that gets them out of bed every morning.

For example, here’s how I examined myself after reading the book:

WHAT I do:  I run a company that sells continuing education for nursing assistants.

HOW I do it:  Along with a team of writers, I create CNA inservices and sell them to health care organizations around the globe.

WHY I do what I do:  Here’s where it got challenging.  The process of mining my personality for my “why” took some time.  Basically, here’s how it evolved…

• I create inservices for nursing assistants because I’m a nurse. Well, yes, being a nurse is a requisite, but I could have taken my nursing career in many different directions.  So that’s not the answer.

• I create CNA inservices because I like to teach. Sure, that’s true.  But that’s not exactly what makes me eager to come to the office every day.  I had to start thinking beyond the obvious and look for my purpose, my true beliefs.

• So, I began looking around me, examining the company that I had created.  Then it struck me.  I had named my company In the Know.  The website address I established is made up of the words knowing and more.  My employees are all encouraged to continue learning…and even have library time during their workday when they can read up on any subject of interest to them.  Together, we create learning materials.  Everything pointed toward the same thing: knowledge.

• I believe that knowledge is power. Hmm…I felt like I was getting close!  But thinking of knowledge as power paints a static picture.  My “why” felt more dynamic than that.

• I believe that lifelong learning is essential to both personal and professional success. Ah ha!  That’s more like it!  Learning is an ongoing, fluid process.  Learning brings people together—and when two people share what they know, they both come away with more than they had before.  That’s my personal and professional “why” and is what inspires all of us at In the Know to do our very best!

As a nursing supervisor or educator, are you tapping into your “why” when it comes to inservicing your nursing assistants?  For example:

WHAT you do:  Present inservices to your CNAs.

HOW you do it:  By passing out and discussing handouts at monthly one hour meetings.

WHY you do it:  Because it’s required? That’s just the surface.  To share your knowledge with your nursing assistants? Maybe, but author Simon Sinek would have you dig deeper.  To join together with your aides to learn something new? That’s better.  Because you believe that the more your CNAs know, the more they can achieve? Maybe…but only you can figure out your “why” and use it to inspire not only yourself but everyone around you.

If you don’t have time to read Simon’s book, at least take a quick peek at his blog.  You’re sure to find inspiration in his words.  And, have fun pondering your own personal and professional “why”!

Maintaining a fully staffed team of CNAs can be a challenge.  Let’s say you’re short staffed and rushing to fill those job vacancies.  You take the time to advertise for CNAs, interview prospective employees and complete the entire hiring process.  You’re tempted to get those new CNAs on the schedule as soon as possible.  However, the best thing you can do to make sure that both time and money haven’t been wasted is to orient your new nursing assistants.

Nurse aides have the least amount of pre-employment training of any other clinical employee.  Your CNAs may come to you with only weeks of clinical schooling.  As a result, they require—and deserve—an extensive introduction to their jobs.

A thorough orientation has many benefits—for your workplace, your new employee and you.  These benefits include:

• Reduced anxiety. By providing new employees with specific guidelines, an orientation helps them know what is expected of them from day one.

• Increased job satisfaction. Orientation helps ensure that new employees are well-prepared to perform their assigned duties instead of feeling overwhelmed, stressed out and ready to leave!

• Time savings for supervisors and coworkers. A thorough orientation makes new employees self-sufficient sooner—so they don’t pull you and your other aides away from your own jobs to answer questions or provide constant assistance.

• An improved employee retention rate. Across the nation, turnover of nursing assistants costs healthcare organizations more than $4 billion every year!  However, studies have shown that organizations with a comprehensive orientation can expect to reduce their turnover rate by 50% within two years.

So, what should a CNA orientation program include?  Here are some suggestions that have been shown to get nursing assistants off to a good start:

• Working as a Nursing Assistant. Promote professionalism by providing your aides with the tools they need to be team players.  Review their job description with them, step by step, and discuss workplace policies on chain of command and delegation.

• Supporting Patient Rights. Emphasize the importance of patient rights, especially confidentiality—the cornerstone of the relationship between healthcare workers and their clients.  Help your CNAs understand advance directives and the signs and symptoms of abuse.

• Infection Control. Because nosocomial infections continue to be the most common cause of medical errors, new employees benefit from a review of handwashing protocol, standard precautions and drug-resistant infections.

• Client Care Tips. Nursing assistants, especially those who are “new grads”, can become overwhelmed quickly by the demands of client care.  If you arm them with practical tips that focus on personal care, nutrition and client safety, their on-the-job confidence will soar.

• Self Care. By spending orientation time on employee wellness, you’ll show your new aides that you care about them as people and recognize that they are your greatest resource.  If you ignore this crucial area, you run the risk of developing stressed-out, disgruntled CNAs within a matter of months.

• Providing Quality Care. By focusing on customer service, quality improvement and medical error prevention, you’ll instill a desire for excellence among your new CNAs.

• Writing It All Down. As every nurse knows, when it comes to client care, if you don’t write it down, you didn’t do it.  Devoting time to proper documentation (and/or oral reporting) is essential for every new employee.

Whew…that’s a lot of information.  Who has time to put together an orientation program like that?  The good news is that you don’t have to.  Instead of reinventing the wheel, check around for companies that offer an orientation course for nursing assistants.  For example, take a look at our comprehensive CNA Orientation Program:  Getting Off to a Good Start.  Not only does it provide your new CNAs with a top-notch orientation, it also gives them a whopping six hours of inservice credit!

Remember…by developing and retaining top-notch CNAs, you’ll recoup the money you spend on quality orientation materials in no time.