Be In the Know!

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

Have your heard about the study of 780 Medicare patients that was released today?  The study focused on adverse events during hospitalizations.  As reported by USA Today, the study found that:

• Of the 780 patients, twelve died as a result of hospital care.  Five were related to blood-thinning medication.
• Two other medication-related deaths involved inadequate insulin management (causing hypoglycemic coma) and over-sedation (causing respiratory failure).
• About one in seven Medicare hospital patients were harmed by their medical care.
• Another one in seven experienced temporary harm because the problem was caught in time and reversed.

Patients in the study suffered adverse effects such as bed sores, infections and excessive bleeding from blood-thinners.  Overall, the researchers estimate that 15,000 Medicare patients die each month in part because of care they receive while hospitalized.  Some of the adverse events were medical errors; some were unforeseen complications.  Still, the federal Agency for Healthcare Research and Quality called the results “alarming.”

Peter Pronovost, co-author of the book Safe Patients, Smart Hospitals, declared medical mistakes to be “an enormous public- health problem.” That should come as no surprise to anyone who works in nursing!  Mr. Pronovost also said, “We spend two pennies trying to deliver safe health care for every dollar we spend trying to develop new genes and new drugs.” That’s pretty shocking, right?  Especially since adverse events are so costly…to health care facilities and, most importantly, to patients.

Whether you work in acute or long term care, you can arm your nursing assistants with the knowledge they need to prevent adverse events.  The pennies you spend educating your aides may well save your organization thousands of dollars…and maybe even save a patient’s life!

Some ideas for inservice topics to promote patient safety include:

Preventing Medical Errors.  Teach your nursing assistants about the types of medical errors, the factors that contribute to mistakes and how they can take an active role in reducing medical errors at your workplace.

Understanding Drug Resistant Bacteria.  Review common drug- resistant bacteria (such as MRSA and VRE) with your CNAs and give them tips for how they can protect themselves and their clients from these deadly bugs.

Understanding Fall Risk Factors.  Remind your nurse aides about the factors that put clients at risk for falls including age-related factors, medical factors and environmental factors.  Be sure to include ways that your employees can help keep high-risk clients safe.

Preventing Pressure Ulcers.  Consider conducting an inservice on the causes of pressure ulcers and tips for preventing them.  As with other adverse events, make sure your CNAs understand how much easier it is to prevent a pressure ulcer than to cure one!

Providing Cost Efficient Care.  Preventing adverse events and saving money go hand in hand.  For example, how about reviewing the relationship between nosocomial infections and wasted dollars?  Give your CNAs practical tips for how nursing assistants can save money throughout their daily client care.

Client Safety Tips.  Give your nursing assistants an overview of client safety–whether their workplace is a facility or a client’s home.  Be sure to include information on fall prevention, nosocomial infections, faulty equipment, pressure ulcer prevention, medication and food safety.

By taking the time to educate your CNAs, you can help prevent adverse events such as the ones outlined in today’s new Medicare study.   Your relatively small investment now may save countless dollars later!

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.”

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.

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!

We all know that ongoing education leads to reduced turnover and greater job satisfaction. Not to mention that

Do your CNAs retain knowledge from inservices?

continuing education is a yearly requirement for nurse aides! But, how do you know the information you provide to your nurse aides “sticks?”  Here are some staggering statistics regarding adult learning retention. Over a period of three days:

• Adults retain 10% of information that is read
• Adults retain 30% of information that is seen
• Adults retain 50% of information that is seen and heard
• Adults retain 90% of information that is said and done (applying learning to real life situations)

Many factors affect adult learning retention including age, level of prior education and motivation.  In some of our previous posts, we have given you ideas on how to motivate your nurse aides by keeping education fresh and interesting.  Below are some additional strategies your organization can take with continuing education to ensure that your nurse aides actually retain the information you are giving them.

• Touch upon a medley of learning styles – As you know, our inservices may be used in a group setting or as self-study modules.  If you choose self-study, perhaps get the group in a few times a year to interact in team activities.
• Encourage nurse aide participation – If using the self-study option, set aside time to address any questions your nursing assistants may have regarding the inservice material. If using group participation, use real-life situations, etc. to stimulate discussion.
• Use variety – Adding visual aides to reading material, such as PowerPoints, greatly enhances learning retention.
• Use active learning – Group discussions and activities, problem solving activities that involve critical thinking skills, games, etc. all lead to greater learning retention.
• Review job performance – Check for retention by making sure your caregivers are applying what they have learned to their responsibilities.  Give continuous feedback and address any issues as they arise.

What do you do to make sure your nurse aides retain the information you share with them? Please share any tips and suggestions with us.  We would love to hear from you!

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!

As the “baby boomer” population in the United States ages, the need for additional nurse aides is something that cannot be ignored.  The Census Bureau projects that by 2030 there will be over 70 million Americans aged 65 and older, more that twice their number in 1995.  According to the Bureau of Labor Statistics (BLS), the overall number of nurse aide jobs is projected to grow an additional 36% — from 2.1 million to 2.9 million jobs.

Further, experts project there will be a demand for nearly 1 million more of these workers in the next decade, and perhaps a total of 3 million more by 2030 — when all surviving members of the 78-million-strong boomer generation are older than 65.  Attracting and retaining quality nurse aides will become an even greater focus for most healthcare organizations. One way you can do that is via a high-caliber continuing education program that helps your CNAs prepare for the demands of their jobs.

The consequences of ill-trained and overburdened nurse aides can be costly and painful to a healthcare organization.  A quality education program, attracts, retains and empowers your nurse aides to put their best foot forward everyday.  After all, knowledge is power!  And, the more your CNAs know, the more they can achieve.

The numbers are dramatic.  An older population means more people with health and personal care needs and greater use of health and long-term care services.  Are your nurse aides ready?  How is your organization preparing for the aging baby boomers?  We would love to hear from you!  Any tips or suggestions are highly encouraged and much appreciated!

Please add your comments to this blog or simply email me at mariaeaston@knowingmore.com.  Thanks!

It’s great to know that our inservices are helping health care organizations achieve measurable outcomes. Many customers tell us that it’s a “trickle down” effect; they save time and money with our inservices; the nurse aides add to their knowledge and skill set; and the clients benefit from being cared for by well-prepared staff.

Here are some more ways that In the Know customers have benefited from using our inservices:

“When I ordered ‘Understanding Depression’ from In the Know, I was really thinking of my employees. Gas prices were very high and it didn’t look like we would be having a increase in Medicaid reimbursement. However, since presenting the inservice, I have noticed in our aides weekly notes that they are more aware of their clients’ moods.”
Norma B.
American Healthcare Services
Mount Airy, North Carolina

“We love the ‘Importance of Activity for the Elderly’ inservice from In the Know.. We really believe that keeping our residents active, alert and stimulated mentally as well as physically provides a better quality of life. New staff members have a hard time recognizing the importance of this. However, once we have them do this inservice we notice a huge change in their attitude and we see them get more involved with the activities. Some employees even come to us with new activity ideas that they would like to try. This inservice has really made a difference!”
Teri S.
Latter Days Assisted Living
Santaquin, Utah

“To assist our CNAs in stepping up, we cultivated a group of nursing assistant preceptors. We utilized a number of In the Know inservices as their course content. This helped the preceptors become the ‘go to’ people for the other CNAs. The preceptors provide information and are seen as an ‘on unit’ resource. They also take responsibility for insuring that all the nursing assistants also complete the In the Know modules.”
Stephanie W.
Deborah Heart & Lung Center
Browns Mill, New Jersey

Are your CNA inservices helping you overcome challenges with your nursing assistants and/or client care? If not, they should be! Give us a call today at 877-809-5515 and tell us about a current problem you’d like to solve. We’ll help you find the best solution…guaranteed!

Take care,
Linda

Linda Leekley BS, RN
CEO, In the Know, Inc.

It’s common for nursing assistants to feel like they are powerless in the workplace. They may think of themselves as the least important employees—unable to make a difference no matter what they do. It’s important to remind your employees that they do have power…and to help them recognize it.

Their personal power comes from their communication skills and their desire for personal achievement.

Their relationship power comes from their ability to work well with others.

Their knowledge power comes from their experiences on the job and from their continuing education efforts. (Remind your employees that knowledge is power and that the more they know about their work, the more valuable they’ll be to your organization–and to their clients.)

Their task power comes from their daily work. Their close contact with clients gives them a unique ability to make suggestions for improving client care. Because nursing assistants perform up to 80% of the client care for your organization, they have the power to make or break the reputation of your company.

The Bottom Line: Encourage your nurse aides to make every decision on the job as if they owned the company! And be sure to acknowledge when you see them demonstrate their importance to your health care team.

Happy Teaching!
Linda