Be In the Know!

Twenty years ago, when I worked at Duke University Medical Center, I remember clearly how some of my co-workers viewed their colleagues in home care.  I was precepting a newly hired nurse to our oncology unit.  A number of the “old timers” on the unit whispered to me, “Good luck training her!  She doesn’t have any skills…she’s been working as a home health nurse!” The general consensus seemed to be that home care was the “red-headed stepchild” of the health care industry.

Things have definitely changed!  Home care has now taken the lead as the fastest growing sector of the health care industry.  Here are some statistics to prove it:

• According to the Agency for Healthcare Research and Quality (AHRQ), the number of patients needing home care after hospitalization is up by a whopping 70 percent!

• The U.S. Bureau of Labor Statistics projects a 22 percent employment growth through 2018 for health care in general, but home health jobs are expected to increase by more than 46 percent.

Many of those job openings will be for home health aides.  As home care agencies struggle to fill positions, it will be more challenging than ever to develop and maintain a team of top-notch HHAs.  That’s where In the Know can help.  With more than 140 topics, we’ve got an inservice that addresses nearly any issue that might arise for your home health aides.  If you would like assistance in putting together either an orientation program for newly hired aides or a continuing education program, please give us a call.

Oh…and my colleagues at Duke were wrong.  That former home health nurse did just fine on the unit!  And, a couple of years later, I moved on from the hospital to work in home care myself.

Congratulations to home health for finally being recognized in the media as such an important part of our health care system.  And, a big thank you to all you home health nurses and aides out there for the vital work you do!

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!

The dictionary defines compassion as “a deep awareness of the suffering of another, coupled with the wish to relieve that suffering.” So, for someone to be compassionate, he or she must be able to put themselves in someone else’s shoes, AND act on his or her desire to lessen that person’s suffering or unhappiness.

It can be hard to always know whether or not your nurse aides act in a compassionate manner while on the job.  That’s why it’s so important to encourage compassionate behavior.  By studying our newly added inservice called “The Caring Qualities of a CNA,” your nurse aides will learn everything they can do to have more empathy, compassion, patience, dedication and respect for their clients.

A Peek Inside the Inservice:

Whether or not you can TEACH compassion is a question that is hard to answer.  However, as a nurse educator, you can ENCOURAGE your nurse aides to be more compassionate.  Try sharing the following tips with your CNAs:

• Remember to put your clients’ needs before your own.
• Treat people fairly and with respect and dignity.
• Show kindness without expecting rewards.
• Get to know your clients.
• Comfort your client’s family members who may be stressed and/or grieving.
• Be sensitive and allow people to vent their frustrations.
• Listen when people confide in you.
• Be friendly to any new co-workers who seem to be overwhelmed.
• Help a co-worker without being asked.
• Try to understand someone you don’t like or with whom you disagree.
• Accept people for who they are–faults and all!

Click here to see a sample page of “The Caring Qualities of a CNA.”

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 are well aware, a nurse aide’s job can be quite stressful.  Being on the frontlines of client care is tough!  Most nursing assistants are not fully prepared for the challenges that lie ahead on a daily basis.  As a result, job burnout and quick turnaround of CNAs are very real problems being faced by many administrators.

One way to help reduce the stress felt by your nurse aides is to implement a relaxed (but professional) continuing education program.  Here are some ideas for doing just that:

Home Study…Having the flexibility to study the material from the comfort of home is a great option.  With In the Know inservices, you have the freedom to make as many copies as you need (within your single facility) of the inservice topic.  You can send the learning materials home with your aides.  (If you have email addresses for your CNAs, you can also simply email the “learner’s section” of the inservice to each of them.)  All you’ll have to do is grade and file their quizzes!  This method allows your CNAs to complete their necessary continuing education at their own pace.

Grab a Partner…Allow your aides to partner up (or assign them a study partner).  Most of the time, having to work with someone else creates a higher sense of accountability.  Working as partners also fosters teamwork, promotes problem-solving skills and gets your CNAs talking amongst themselves about the learning materials.  They can think out loud, share ideas and learn from one another.

Take It As It Comes…Another idea is to create a library of inservices that is accessible to your CNAs during their work hours.  Develop a “sign up sheet” (or use the one provided by In the Know).  Then, allow your nurse aides to complete the inservices at work “on the clock” as time allows. Not only will you have more time for other aspects of your job, but your aides will feel like they are in control of their own learning.

With a flexible inservice plan, you’ll head off burnout and CNA turnover at your workplace.  For more information, give us a call at 877-809-5515.

Do you have any different methods for inservicing your CNAs that you’d like to share?  We would love to hear them!

Lack of support has often been cited as a major factor in the turnover of nurse aides.  One way your organization can reduce the crushing expense of nurse aide turnover is to implement a quality inservice program.  Think about this…….it costs on average, a year’s wages to replace an employee.  Do you know your nurse aide turnover rate?  It’s easy.

Divide the number of CNAs who terminated with you (for any reason) during the past 12 months by the average number of CNAs you had on staff for the same 12 months.  You will get a percentage number.  Ideally, the closer you are to 0%, the better, however, that is nearly impossible for any employer.  Did you know the industry average for CNA turnover is 93%?  That means that at least 9 out of 10 CNAs leave their employment within a 12 month period of being hired!

What can you do to keep the turnover rate low in your organization?  Consistent on-the-job training can make the difference between a CNA staying or leaving.  Certainly, competitive pay ranks as equally important but many employers find that their workers care very strongly about the training and education opportunities available to them at work.  Ongoing training is imperative to keeping nurse aides enthused and informed about their job responsibilities.  Most importantly, it gives them the tools they need to perform their duties properly.

Nursing assistants are the heart of your business!   Time is precious in the healthcare field, however, your nurse aides are on the “front line” everyday with their clients.  Empowering them with a solid, quality education program will result in lower turnover rates, and most importantly, enhanced client care.

How is the nurse aide retention rate in your organization?  Please share any tips you have for keeping quality nurse aides.  Or, share the challenges you have with your organization’s retention.  We would love to hear from you!

Best wishes,

Maria

Maria Easton (mariaeaston@knowingmore.com)