Be In the Know!

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.

If you are looking for more ideas to spice up your 2010 inservice schedule, consider presenting the following topics:

1.  Review the Normal Aging Process

During their short initial training time, nursing assistants learn a few basics about the human body. However, in order to enhance their observational skills, it’s good to provide more details about how humans age. Try presenting the information by body system. Talk about the lifestyle choices that slow aging and those that speed it up—and remind your CNAs how they can help their elderly clients enjoy a good quality of life.

2.  Discuss End of Life Care

To be outstanding, CNAs should be able to handle the full spectrum of life, including the dying process.  Give your aides information on the end of life, such as how to recognize symptoms that signal death is near, how to provide comfort for dying clients and their families and how to care for the body once death has occurred. Consider including information on death and cultural diversity and the stages of grief.

3.  Brush Up on Mouth Care

Top-notch CNAs understand the importance and benefits of good oral hygiene and how it can affect not just the quality of their clients’ lives, but also their overall health. How about presenting an inservice that goes beyond the mouth care protocol for your workplace? Give plenty of tips for performing oral hygiene, dealing with dentures, and observing for oral and dental problems.

4.  Delve into Basic Human Needs

To enhance your nursing assistants’ sense of empathy, give them an overview of Maslow’s Hierarchy of Needs. During the inservice, review the five levels of basic human needs, how the levels relate to each other and how illness affects a person’s place in the Hierarchy. With a greater understanding of what makes people “tick”, your aides will excel at providing holistic, client-centered care.

5.  Talk about Cost-Efficient Care

While cost-efficiency is always important in health care, it’s especially vital in today’s economy. Plan an inservice that provides practical tips for how nursing assistants can save money throughout their daily client care.  Be sure to cover how to minimize waste and how time management, healthcare associated infections and medical errors affect the bottom line. Top-notch CNAs know that saving money today means better working conditions tomorrow!

These are just a few ideas for rounding out your inservice offerings.  At the same time, you’ll keep your nursing assistants interested and be on your way to developing a team of top-notch CNAs!

Happy Teaching,

Linda

Linda Leekley BS, RN

At In the Know, we believe that lifelong learning is the key to both professional and personal success.  But, this isn’t just a meaningless mission statement stuck in a frame and hung on the wall.  Instead, it’s a way of life at our company. As the founder of In the Know, I created an atmosphere that encourages learning for each employee.

For example:  we have an In the Know library, filled with books relating to a variety of subjects—especially (but not limited to) health care.  Every employee has two hours of “library time” each week.  While they are encouraged to select reading material from the company library, they are free to read whatever they like.  The only “rule” is:  If you come across a great idea or are inspired by something you read, please share it with your coworkers.

What’s the result?  My employees and I are always reading, reviewing and researching…on a constant quest to continue learning.   Every day around our offices, you are likely to see a couple of excited employees huddled over a headline or hear someone say, “Wow…listen to what I just found out!”  New ideas are valued and it makes for motivated employees who enjoy coming to work.

How are things at your workplace?  Do you think your CNAs are inspired by you to add to their knowledge base and/or expand their skills?  At inservice time, do they sense your excitement about the topic at hand?  Do your nursing assistants know they can come to you for more information about a specific client care issue?

If you would like to promote lifelong learning among your aides, try sharing a few of these tips:

Instead of a “to do” list, keep a “to learn” list. Encourage your CNAs to jot down any learning needs they have.  For example, do they want to know more about diabetes, pressure sores or time management?  Put them on the list.  Would they like to learn more about quality improvement, patient rights or ethical issues?  They get added to the list, too.

Keep your eyes open! Suggest that your CNAs observe a coworker whom they admire.  A lot can be learned by watching, especially when you observe people who are really good at what they do.  Some of their habits may rub off!

Practice what you learn. Knowledge by itself is great…but it takes on real value when it is applied.  Share with your CNAs how you put new knowledge to work for you on the job and suggest they try the same thing.

Show others how it’s done. A great way to learn is by teaching others!  Ask your aides to help train new employees.  Or, each time you hold an inservice meeting, ask a different CNA to help lead the meeting.

Learn in groups. If your nursing assistants complete their inservices as self-study modules, suggest that they work together in groups of two or three.  They can bounce ideas off each other and, as a result, learn more than they would “going solo.”

Think outside the box. If your CNAs stick to the exact same routine every day, they may go on “autopilot” and stop learning.  Encourage them to switch things up a bit—as long as it doesn’t interfere with a client’s needs or rights.

Make learning a priority. The motivation to keep on learning has to come from within. Show your CNAs that lifelong learning is a daily habit for you and they may decide to make it a priority in their lives, too.

Do you have tips that have helped you create an environment of learning?  Please share them with us…we’re always open to learning new things!

Take care,

Linda

Linda Leekley BS, RN

President, In the Know

Back to "School" for CNAs

Summer is almost over and thousands of children and adults are headed back to the classroom for another year.  As for many teachers and professors, providing informative and interesting educational materials can be a challenge for nurse supervisors.  Researching topics, creating inservices and handouts…how do nurse supervisors keep learning interesting?  Below is a list of ten of our favorite tips that we believe can enhance your CNA education program:

• Do use the information from your CNA evaluations to determine what topics to cover.
• Do plan ahead!  Map out your inservice topics for the year in advance.
• Do find a local health care professional who would be willing to present on a topic they know.
• Do solicit a different nursing assistant to help teach each inservice.
• Do choose a theme for each inservice, and have goodies that you can give away.
• Don’t choose topics that are not relevant to your nurse aides and their clients.
• Don’t forget your CNAs who do “self study.”  Make sure you follow up with them in person to discuss the inservice.
• Don’t just lecture or read from the inservice material:  imagine if you were in the audience!
• Don’t forget those CNAs who can’t make it to the inservice.  Make sure you review the material with them verbally.
• Don’t talk down to your staff.  They are professionals just like you.  Many of them have decades of health care experience.

We hope the above tips add a zing to your CNA continuing education program so your nursing assistants can start this fall on the right foot…and with renewed energy!

How do you keep your nurse aides engaged in their continuing education? What teaching tips do you have to share?  We would love to hear from you!