Are Your CNAs In the Know about Sexual Harassment?

Regardless of your political leanings, there is no denying that the current presidential election has brought the issue of sexual harassment to the forefront.  As healthcare professionals, we know that sexual harassment is an important topic, mandated as part of every employee’s training by the Joint Commission, OSHA and state regulations.

Still, it seems as if most women (and some men) have at least one story to tell about a time they were sexually harassed.  Mine occurred many years ago, when, as a 22-year-old college senior, I landed an internship at a well-regarded children’s hospital.  Back then, parents weren’t allowed in the pre-operative area, so my role was to stay with the children and tend to their physical and emotional needs prior to surgery.

One day, as I was comforting a seven-year-old boy who was frightened about his imminent operation, the anesthesiologist assigned to his case came up to the boy’s stretcher.  Loudly enough for the patient to hear, he said to me, “I sure wish you’d hold my hand, lean over me, and talk softly like that…but I’d want you to loosen another button or two on your blouse.”  His words shocked me; I blushed, feeling both embarrassed and angry, but kept my attention on my young patient.

Later that day, I told my supervisor what had happened.  In turn, she relayed the episode to the Chief of Surgery, who asked to meet with me.  He apologized on behalf of the department and said that the offending anesthesiologist would also apologize.  I was told that he had been reprimanded both verbally and in writing in his personnel file.  Soon after, the anesthesiologist did apologize.  He kept his distance for the remainder of my internship and I suffered no repercussions from reporting the harassment.

Looking back, I can’t help but wonder if I would have been so quick to report the incident had I been an employee at the hospital (instead of an unpaid intern).  Would I have potentially jeopardized my job and/or risked escalating the problem by reporting a man with whom I would have to work, day after day, month after month?  I’d like to think the answer is “yes,” especially because the physician’s offending behavior happened in front of a scared child whose life was soon to be in his hands.  But, of course, I’ll never know for sure.

Do your nurse aides understand what constitutes sexual harassment and how to respond if it happens to them?  Is “locker room talk” okay because it’s just words?  What types of actions are considered sexual harassment?  What if the offender is a person of power in your workplace?  What if the offender is a patient?

If your nurse aides could benefit from a better understanding of this important issue, consider our inservice, Sexual Harassment in the Workplace.  It answers all of these questions, and more.  And, because it is such a critical topic these days, we are offering it at a 25% discount now through November 11th.

Sexual Harassment in the WorkplacePlease note that while the inservice was written for nursing assistants and provides them with one hour of inservice credit, the information in the module would be useful for any and all of your employees.

Best wishes,


Linda H. Leekley BS, RN, President, In the Know


17 Facts about In the Know CNA Inservices

THANK YOU!! Because of you, we’ve been a leading provider of CNA and HH inservices for 17 YEARS! It’s been our mission from day one to offer cost-effective inservice training without sacrificing quality.  Your nurse aides work hard every day and deserve exceptional continuing education to help them succeed! Scroll down for seventeen facts about In the Know!

17 Facts about In the Know!

  1. CNAs, home health aides and other frontline caregivers remain our sole focus. Why? Because they deserve our undivided attention.  And, because nursing assistants play a crucial role on the health care team yet they have the least amount of pre-employment education of any clinical employees. Effective continuing education is crucial for their professional growth!
  2. In 1998, Handwashing was our first topic. Now, our library exceeds 200 modules. And, new topics are added monthly!  Here are our latest offerings.  Do you have a new topic suggestion?  Click here to tell us what topic you’d like to see in our library!
  3. A 60 day guarantee has been in place since our first day in business.  We believe in our product.  If your are unsatisfied for any reason, we offer a 60 day money back guarantee.  Just ship all of the materials back to us and we will offer you a full refund.
  4. Our “Classic” format was introduced in 1998 and is still our bestselling format!  Initially, it was offered in paper format only. Over time, based on your feedback, we added different delivery formats. Keep reading for more info…
  5. Floppy disk was our second format offering.  Of course, over the years, that evolved into CD Format! Having a CD filled with inservice PDFs keeps your files together in one place and allows you to print topics at will.
  6. About ten years ago, we added the option of email delivery.  Email format is perhaps our most convenient choice, and perfect for organizations who need materials quickly. Your inservice purchases are sent to the one email address of your choice.  Educators may then save the files to a computer for future use!
  7. Some customers still choose our original “Paper” format.  With paper format, a master copy of each inservice is sent, already printed and assembled within a clear plastic binder sleeve.  It is then the educator’s responsibility to photocopy the modules for their nurse aides–and to maintain that master paper copy. Generally, paper format is chosen only by organizations who do not have easy access to a computer.
  8. Based on your feedback, we added E-Learning to our offerings.  In the Know introduced a brand new E-Learning program within the last couple of years.  Your CNAs can complete inservices on our website. Educators can track each nurse aides’ progress to ensure that everyone is up to date!  Check it out here.
  9. Registered Nurses continue to write all In the Know inservices. Our team of writers have experience in home care, hospice, long-term care, hospital nursing, healthcare management and staff development. They perform extensive research to make sure each inservice contains the most recent information. We choose our inservice topics based on suggestions from customers as well as current “hot issues” in medicine, Medicare and JCAHO.
  10. In the Know maintains an Advisory Board consisting of registered nurses, human resource professionals and desktop publishing experts. In addition, we regularly solicit and encourage feedback from all our customers.
  11. In 1999, we began offering a free sample module on our website.  Today, you can still try us for FREE!  If you haven’t tested our inservices with your nurse aides yet, why wait any longer?  Right now our topic “How to Prioritize Your Work” is free and ready to download.  Just pick your format (or try them both!): Classic or E-Learning.
  12. Our goal has always been to keep CNAs in the know.  Periodically, we create free Fact Sheets.  You can find a number of these free ‘fact sheets’- 2 page info sheets spotlighting important and timely topics–on our website.  See the list of titles here.
  13. Our prices have been stable for more than a decade–so that we can offer your facility a cost-effective inservice program. For 17 years, our mission has been to meet the learning needs of your paraprofessional staff, encourage their critical thinking and professionalism, and save you valuable time and money.  We offer several different inservice plans- such as our bestselling GOLD Plan which offers your aides 13 hours of inservice credit!  Compare plans here.
  14. Clients like you tell us repeatedly that we provide great customer service! If you have any questions or comments about In the Know, please feel free to contact us at 877-809-5515 and one of our friendly associates will be happy to help.
  15. In 2012, In the Know published a book!  And that book became the basis for our Civility Training Program, an important tool to help you rid your workplace of incivility. The Joint Commission recommends education for all healthcare staff members on appropriate professional behavior. This program–complete with our book, ‘The Real Healthcare Reform‘ is the answer to that recommendation.
  16. In the early 2000′s, we began serving organizations with more than one physical location.  We offer significant discounts when you purchase materials for more than one office. Our Director of Corporate Relations, Maria Easton, is happy to answer any questions you may have about this program.  Or, contact her for your free consultation today! Click here to send her an email!
  17. In the Know keeps things current! We review and update our topics every two years. When an inservice is found to be out-of-date, our writers update the topic with at least 25% new information, a new quiz, new discussion questions and activities. If you are interested in purchasing updated inservices to titles you already own, call us and we’ll give you 50% off!  When you sign up for our Platinum Plan, you will receive these updates for FREE.
Thanks again for allowing us to meet the learning needs of your nurse aides–and, in turn–to make your job easier!  Our first customer in 1998 was a skilled nursing facility in Mississippi and, 17 years later, that facility remains a loyal customer.  That means more to us than we can express!
We appreciate all our customers–whether you are new to us or you have been with us for years. Should you have questions, comments or other feedback for us, please don’t hesitate to get in touch.


Top 5 Benefits of Civility Training

Does your organization suffer from a hidden culture of incivility—opening the door for dangerous medical errors, poor patient satisfaction and higher employee turnover? If so, you are not alone. In 2008, The Joint Commission recognized the widespread problem of “behaviors that undermine a culture of safety.”  In fact, uncivil behavior among healthcare employees now constitutes a sentinel event!

To combat this pervasive problem, The Joint Commission recommends that all accredited healthcare organizations be responsible for handling and preventing incivility in the workplace. In the Know’s REAL Healthcare Reform Civility Training Program makes fulfilling this recommendation easy.  Based on our popular book, “The REAL Healthcare Reform,” ITK’s program is a complete turnkey solution that contains everything you need to get a civility training program up and running immediately.

So, aside from meeting TJC’s recommendation, what’s in it for you? Healthcare organizations that implement civility training find that it:

  1. Reduces costly medical errors. Incivility ruins communication among your employees and poor communication is a direct threat to patient safety. Civility training decreases dangerous and potentially deadly medical errors by improving teamwork and communication.
  2. Increases employee retention. A staggering number of healthcare employees report having quit a job because of incivility. Civility training improves employee retention at every level, saving your organization the precious time and money involved in hiring and training new employees.
  3. Cuts down on “call-outs” and absenteeism. Working in a culture of incivility leads to more absenteeism.  As many as 47% of healthcare employees report spending less time at work because of incivility. Civility training creates an atmosphere that energizes and inspires those who are in it. Employees who are energized and inspired will look forward to coming to work, thus reducing the rate of absenteeism.
  4. Eliminates conflict and drama. Incivility leads to conflict and conflict equals DRAMA! Healthcare professionals who embrace civility are less likely to burn out, bully or “eat their young!” This means less conflict and drama among your employees!
  5. Improves client satisfaction and enhances the organizations reputation. Disgruntled, dissatisfied and disengaged employees don’t provide quality care to the clients they serve.  This leads to a decrease in client satisfaction. Clients who are dissatisfied with the care they receive share their negative experience with others in the community.  If your organizations embraces civility, you will enjoy improved client satisfaction and an enhanced reputation in the community.

Our Civility Training packages are available for as few as 12 learners and come complete with a copy of The REAL Healthcare Reform for each learner plus an Instructor’s Manual for the educator. You will find the Instructor’s Manual full of engaging classroom activities, thought-provoking discussion questions, convenient PowerPoint presentations, tips for improving participation and a CD with master copies of all the handouts and presentations.

The program materials are appropriate for every individual in your organization, clinical and non-clinical alike. Administrators, managers, nurses, aides, secretaries, and everyone in between, will find the program easy to use and understand. In addition, the program provides six hours of inservice credit for all your Certified Nursing Assistants.

To learn more about In the Know’s Civility Training Program, visit Embracing Civility then call 877-809-5515 to order your program today!

What Joint Commission Says about Incivility


Workplace incivility. Adult bullying. Lateral harassment. These terms make the news nearly every day, headlining another story about employees who are dealing with a toxic work environment.

Jana Raver is an organizational expert and professor at Queen’s University School of Business. She has done research proving that sixty percent of employees are exposed to workplace incivility—and that the “bullies” are often women. That’s bad news for an industry like ours which continues to be dominated by females.

And there is more bad news. While six of every ten employees are victims of workplace incivility, you can bet that the other four are affected by it indirectly. Harassing behaviors are distracting—especially for healthcare employees who must work as a team to meet the needs of their patients.

Ms. Raver says, “They start saying ‘this is not the place for me; I’m going to start looking for work elsewhere.’ And once you psychologically disengage from the organization then you’re not terribly motivated toward helping that organization to succeed, and you’ve always got one step out the door. Turnover is of course a logical consequence.”

This spells trouble, particularly for certified nursing assistants. As you know all too well, the annual turnover rate for CNAs can exceed 90%. If your organization has a “revolving door” when it comes to your nursing assistant staff, a culture of incivility only compounds the problem.

“Imagine how much more productive companies could be if they were to treat people with inclusion and respect and make sure that (workplace anti-harassment) policies are actually enforced,” Raver states.

This is exactly what the Joint Commission has in mind with their zero tolerance of disruptive or intimidating behaviors. Have you seen their statement on this issue?

Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.  Safety and quality of patient care is dependent on teamwork, communication, and a collaborative work environment. To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team.

The Joint Commission standards require that each organization institute “a code of conduct that defines acceptable and disruptive and inappropriate behaviors.” They also require that the institution “create and implement a process for managing disruptive and inappropriate behaviors.”

Creating policies that meet these Joint Commission standards are an important step. However, if your workplace has been infected with incivility, it’s going to take more than rubber stamping new policies. Every employee, from administration to the “front lines,” needs to partake in civility training. They need to understand the importance of civility—especially in a high stress environment like healthcare. The training should cover ethical behavior, professional relationships, teamwork and conflict resolution. And, it should emphasize this indisputable key point: that the power—and the responsibility—to overcome a culture of incivility rests within each of us.


If you would like to learn more about how embracing civility can inspire your employees to do their best work, check out The Real Healthcare Reform. (The book is also available from Amazon.) If you need assistance developing a civility training program for your organization, please give us a call at 877-809-5515. We’d be happy to discuss your options.

Civility = Self-Awareness

“The test of a civilized person is first self-awareness…” ~ Clarence Day

As you probably know, the Joint Commission has mandated civility training for all healthcare organizations in order to combat the rise of intimidating and disruptive behaviors among healthcare employees.  Civility training is tricky…it’s not like teaching a nursing skill or the facts about a disease process.  To truly embrace civility, your employees have to become more self-aware.   Here is some information you can use to start the conversation about self-awareness with your staff:

Self-awareness is when you realize that, although you are not the center of the universe, everything you say and do can affect those around you.

True self-awareness comes when you recognize that your own thoughts and feelings can lead you to act in a way that is either helpful or harmful to others.

Here’s an example of how your thoughts and feelings can lead you to act in a way that is harmful to others: You just paid your monthly bills and realize you don’t have enough money to sign your daughter up for the softball team she wants to join. You are stressed, embarrassed and angry.  You arrive at work to find a group of co-workers laughing in the break room. Their happiness annoys you and you lash out.

Here’s an extreme example of a lack of self-awareness: Recently, radio talk show host, Rush Limbaugh learned that a female Georgetown law student spoke out in support of mandating insurance coverage for contraceptives.  Her stance on the matter angered the talk show host, so he went on the air and called her a “slut” and a “prostitute.”  Then he demanded she post online videos of herself having sex. His words had a negative effect on his listeners, his sponsors, the woman to whom he was referring, his career and society at large.  In his apology he said, “In this instance, I chose the wrong words in my analogy of the situation. I did not mean a personal attack on Ms. Fluke.” Although he was further attacked for a lack of sincerity in his apology, his sentiment was right. Whether you agree with him or not, he has the right to disagree with the woman’s stance.  However, the words he chose were harmful and did nothing to help matters in this situation.  He was upset about the woman’s views and he lashed out without thinking about the consequences.

The bottom line is this:  It’s okay to feel stressed, angry and embarrassed.  It’s okay to disagree and speak your views.  However, when you have self-awareness (aka civility), you know how to keep your thoughts and feelings from translating into harmful words or actions against others.


If you would like more ideas for promoting a civil workplace and fulfilling the Joint Commission-required civility training, please check out a new book published by In the Know: The Real Healthcare Reform: How Embracing Civility Can Beat Back Burnout and Revive Your Healthcare Career.  It provides targeted, action-oriented information and specific exercises to help healthcare workers understand the epidemic of incivility, why it is happening and what they can do right now to make it stop.  You and your employees will find the tactics and strategies needed to put civility to work and resolve the toxic atmosphere that may be polluting your workplace.

Written in a friendly, conversational tone, the book is appropriate for all healthcare employees, regardless of their discipline or how long they have been on the job. You can utilize it with your CNAs, nurses, therapists, social workers and more! If you have any questions about The Real Healthcare Reform or would like information about bulk discounts for your workplace, please call us at 877-809-5515.