Be In the Know!

Quality inservices develop top-notch CNAs!

Is part of your job as a nursing supervisor or nurse educator to develop monthly inservices for your nursing assistants? If so, you know how time consuming that process can be. Perhaps you’ve considered purchasing “ready-made” topics from a company (like In the Know) that sells CNA inservices. You’re really tempted, but are not sure it’s worth the cost. Here are five tips for helping you make that decision:

1.  Tally Your Time.

Next time you need to prepare an inservice, keep track of how much time you spend. Remember to include the time it takes you to think of a topic, come up with learning objectives, research and write the inservice, create some handouts, develop a quiz and produce an evaluation form. Chances are, this will take at least 10 hours of your time. Multiply that by your salary and you’ll probably be shocked at what one inservice is costing your workplace! By purchasing inservices, you avoid “reinventing the wheel” and can bring down your cost per inservice considerably.

2.  Do a Quality Check.

No matter how knowledgeable you are about the nursing field, creating inservices may not come easily to you. It requires a variety of “non-nursing” skills such as knowing how to research quickly and effectively, being a good writer and having some computer savvy. Are the inservices you’re creating capturing the attention of your CNAs? Do they provide an in-depth study of each topic? If not, they may not be having a positive effect on client care. Inservices from a respected inservice company can spark interest for both you and your aides. However, before making a purchase, insist on trying out a sample inservice. You’ll want to see the quality of their product for yourself.

3.  Take a Look at Compliance.

We all get in a rut, causing us to do something a certain way just because that’s how it’s always been done. But, when you look at your current system for providing inservices, is it really working? For example, do your CNAs skip inservice meetings because they are too busy or just aren’t interested? Do you struggle to get all your nursing assistants to meet their inservice hours by the end of the year? If so, there is probably an easier way. A quality inservice provider can give you a flexible, easy-to-institute inservice program that will please you, your CNAs and any surveyors that come your way.

4.  Eye Your Inventory.

Over time, you’ve probably built up a library of inservice topics. Take a peek at what you’ve got to offer your nursing assistants. The basics are probably there: standard precautions, nutrition, Alzheimer’s disease, abuse, confidentiality. And, you might find yourself reusing these topics with each newly hired group of CNAs. But, it’s important to meet the learning needs of your aides by offering a wide variety of inservice topics. Coming up with mandatory topics, disease process inservices, psychosocial issues and basic skill reviews could be a full time job and/or eat into your personal time! A good inservice provider has dozens of topics from which to choose. And, the more your CNAs know, the more they can achieve!

5.  Ask Your CNAs.

To find out if your current inservice offerings are meeting the needs of your nursing assistants, ask them! You might distribute an evaluation form or have an informal group discussion. Ask questions such as: Do our current inservices prepare you to succeed at your job? Do you feel that your skills are enhanced by every inservice you complete? Are the inservices providing you with information that you can apply in your daily client care? If your CNAs answer “no” more often than “yes”, then it may be time to try an inservice provider. Quality inservice education should do more than fulfill state requirements. It should enhance the professionalism of your nurse aides and improve your client care. So, take the time to investigate inservice providers and find the one that helps you develop a team of top-notch CNAs.

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

Chances are, you have presented inservices to your CNAs on the typical topics: standard precautions, confidentiality, nutrition, pain management and dementia. Without question, these are all necessary inservices for nursing assistants.

However, to develop a team of top-notch CNAs, it’s important to go beyond what is necessary or mandated. Coming up with pertinent topics can be a challenge when you’re trying to fit inservice education into your already busy schedule. Here are 5 ideas for inservices that will get your nursing assistants thinking outside the box—and, in turn, have a real impact on the quality of their client care.

1.  Teach Your CNAs about Being Assertive

Why?  Because top-notch CNAs are assertive people. They understand the difference between communicating passively, aggressively and assertively. They use their assertiveness skills to deal with difficult people and challenging situations. And, because they respect the rights of others without ignoring their own rights, they are excellent team players. Consider presenting an inservice that includes a “personal assertiveness assessment” so that your nurse aides can gauge their current communication style.

2.  Examine Conflict in the Workplace

On-the-job conflict exists in every health care organization, so how about teaching your CNAs how to deal with it? Provide them with practical tips for resolving conflict. Be sure to cover the dangers of gossip and bullying in the workplace and how they can handle conflicts with supervisors and clients. Armed with this information, your CNAs will focus less on “workplace politics” and more on the needs of their clients.

3.  Discuss Maintaining a Professional Distance

One of the toughest things for anyone in nursing is to provide TLC to clients without overstepping professional boundaries. A top-notch CNA knows the difference between personal and professional relationships and can spot the warning signs that professional distance has been lost. Giving an inservice on this issue will help your nursing assistants be caring without veering from the plan of care.

4.  Promote the CNA/Nurse Relationship

In the same way that the relationship between nurses and physicians continues to evolve, so does the relationship between nurses and nursing assistants. Outstanding CNAs understand the importance of delegation, assertive communication and mutual respect. They know how to give a great report, how to make the most of their performance review and how to work together with nurses as a team. Consider presenting this information to your CNAs and your nurses for a real boost to nursing teamwork.

5.  Practice Time Management Skills

Why are some CNAs better than others at completing their work on time? Nursing assistants who strive for excellence have learned how to avoid time wasters like procrastination, a lack of focus and a negative attitude. Help your CNAs become time savers by teaching them about setting goals and priorities and providing them with practical tips that help them work efficiently—whether they work in a facility or in clients’ homes.

Try incorporating a few of these topics into your current inservice schedule and see what happens.  (If you’d rather not “reinvent the wheel”, give us a call at 877-809-5515 or visit our store.  We have inservices on all of the above topics.)  Remember…when inservice education goes above and beyond the norm, it spurs critical thinking, enhances the quality of client care, and encourages professionalism on the part of your aides.

Happy Teaching!

Linda

Linda Leekley BS, RN

It’s a new year…and time for a fresh look at how you present your CNA inservices.  Are you making the most out of your inservice meetings?  Do your nursing assistants come away from your inservices knowing more about their clients and excited to put that new knowledge to use?  If not, here are a few quick tips to help you develop a top-notch team of CNAs in 2010:

Convey your passion for nursing during inservice presentations. If your nursing assistants sense that you are excited about client care, they are more likely to be enthusiastic, too.  On the flip side, if you seem bored while presenting inservice materials, your CNAs are likely to be bored by you and the inservice!

Help your CNAs bridge the gap between learning and doing. It’s great to present an inservice full of important facts, but how does that information translate to the “real world” at your workplace?  For example, you can teach your nurse aides that they should observe for the signs and symptoms of depression, especially in older clients.  But, what do you want them to do with their observations?  Go beyond the facts and have your CNAs practice documenting and/or reporting their observations.  Get a discussion going about what resources are available if a client is depressed.  By thinking outside the box, you’ll do more than teach; you’ll develop CNAs who think critically and follow thoughts with actions.

Listen when your CNAs voice their opinions. Some of your nursing assistants may have worked in health care longer than you have!  Show them that you respect their experience by encouraging them to voice their opinions about client care.  For example, you may feel like “tuning out” when an aide says, “In my previous workplace, we did it this way.” Instead, take notice.  Ask the CNA what makes the “old way” better.  This opens a discussion and creates an atmosphere where you both might learn something.

During your inservices, make use of real-life situations—with the names concealed or changed to protect client confidentiality. For example, when teaching about diabetes, prepare an example of a current or former diabetic client.  Give a scenario that calls for action from a CNA and ask for suggestions as to how they would handle it.  As you discuss each response, relate it directly to the information in the inservice.

Have a system for following up. To ensure that your aides retain what they learn during your inservice meetings, come up with a simple way to “test” them on what they know.  For example, at each inservice meeting, start out by asking three or four key questions about last month’s topic.  Offer a small prize or treat for the right answers.  This will ensure that your CNAs come prepared to answer your questions!

How do you make the most of your inservice meetings?  Do you have some tips to share with fellow educators?  We’d love to hear from you.  You may make a comment below or email me at lindaleekley@knowingmore.com.  Thanks!

As a nursing supervisor, you know that your nursing assistants must meet their annual inservice requirement.  In most states, this is a minimum of twelve hours of inservices per year—although that number jumps to 24 in some states.  But, how do you make the most of the time you spend on CNA continuing education?  How do you ensure that your inservices are helping to develop top-notch nursing assistants?  And, what do surveyors look for when they review inservice records?  Here are four basic guidelines that will keep you on track:

• Any inservice you give should contain “portable” information.  This means that the knowledge your nurse aides gain must serve them in any job—not just at your workplace.  For example, if you review how to take blood pressures and instruct your CNAs on the importance of documenting vital signs, that’s an inservice.  Your nursing assistants can put that knowledge to use no matter where they might work in the future.  But, if you pass out a new vital signs flow sheet and teach your aides how to fill it out, that knowledge is workplace-specific and would not count as an inservice.

• Inservices should consider the learning needs of your CNAs.  Have you asked your aides lately what topics they would like to learn more about?  Have your quality improvement studies uncovered a “weak area” that needs attention?  What about annual performance reviews?  Are there specific issues on which you should focus to ensure quality client care?  It’s not enough to pick twelve topics each year that sound interesting.  Surveyors want to see that your education plan targets specific, identified learning needs.

• When planning your inservices for the year, you also need to take your clients into consideration.  Do your aides have the knowledge they need to care for their clients?  For example, if your CNAs work with a large number of diabetic clients, they should be well-educated about how diabetes can affect their daily work.  They need to know the signs of hypo- and hyperglycemia; what a diabetic client should be eating; how exercise affects blood sugar levels…and so on.  Because Alzheimer’s disease and other dementias are on the rise, many states require an annual inservice on how to work with cognitively impaired clients.  Be sure to analyze your client population and take their needs into account as you create next year’s inservice calendar.

• Make sure that a registered nurse oversees all CNA inservice training.  You may enlist the help of office staff, therapists, LPNs, CNA preceptors or guest speakers, but the overall responsibility for inservicing your aides must fall on an RN.  To satisfy state surveyors, your CNAs must be made aware of which registered nurse they can go to if they have questions about what they are learning.  And, that nurse has to be available, either by phone or in person.

Your nursing assistants play a vital role within your nursing team. Let’s face it…they probably deliver up to 80% of the hands-on client care! When you consider that aides have the least amount of pre-employment education of any clinical employees, it’s clear that their ongoing on-the-job training is crucial.  By following these four guidelines, you will be on your way to giving your CNAs the continuing education that they deserve.  When you make each inservice count, your team, your clients and your organization all reap the benefits!

If you’d like assistance in planning your 2010 CNA inservice calendar, feel free to contact me at lindaleekley@knowingmore.com or by calling our In the Know offices at 877-809-5515.

Happy Teaching,

Linda

Linda Leekley BS, RN

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)

We’ve all seen it in the news: the CDC has issued a state of emergency due to the outbreak of swine flu. In an effort to spread the word to nursing assistants about this issue, we have created a free Swine Flu Fact Sheet. Be sure to download it here…and feel free to share it with all your nurse aides.
Take care,
Linda Leekley

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