Be In the Know!

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

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

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

Give your CNAs a "thumbs up"!

There is nothing more uplifting for a CNA (or any employee for that matter) than when they are recognized for a job well done.  Many employees feel that their boss is quick to point out any deficiency or mistake, but feel that getting positive reinforcement is difficult and infrequent.  If your nursing assistants are deserving of recognition, here are a few ways to show them that you appreciate it…without spending a dime!

1. Send them a handwritten note. A CEO of a Fortune 500 company frequently handwrites “thank you” notes on $2 bills.  In more than 3 years of doing this, only one employee has asked if the bill could be spent.  This tells us that instead of spending the $2, the employees prefer to keep it as a positive memento
2. Share the love. Ask each employee to write something down about an exemplary aide who has earned their respect and admiration.  Put all of their comments into a small picture frame and give it to the aide.
3. Up-front parking. Create a sign for the best parking space at your office or facility.  The sign should read: “Employee of the Month,” or something similar.  Make the right to this parking space competitive, and you won’t believe what lengths your aides will go to in order to win the competition, and the parking space.
4. TGIF. Allow a deserving CNA to take off early on a Friday afternoon.  This may not be possible due to client care responsibilities, but if you feel that you can get along without the aide for the afternoon, offer him or her the rest of the day off.  Naturally, you’ll want to treat these few hours off as time “on the clock” as a reward for this employee.
5. Well days. Many people can relate to this:  You need a day off.  You may have something really important to do, or you may not.  So you decide to call in “sick.”  Most of the time this makes you feel guilty about missing work, right? Reward a job well done by allowing your employees to earn “well days.”  These are days off when an employee can do whatever they need or want to do, but does not have to fib about feeling ill.
6. Rank and Title. It may or may not come with a raise in pay, but if outstanding aides continue to show that they are responsible and accountable, offer to add “Senior” or “Shift Leader” to their title.  It is amazing how much pride your new leaders will take in this small gesture.
7. Go public. Create and distribute a company-wide newsletter detailing an employee’s exemplary performance.  This will honor that particular nursing assistant, while creating motivation for the rest of your staff.A quick “thank you.”  The most cost effective way of acknowledging hardworking employees is to simply thank them…and it only takes a second.  Everyone appreciates being appreciated.

If one or more of these rewarding gestures appeals to you, give them a try with your staff.  Then, come back to this blog and let everyone know what the response was to your show of appreciation.  We would love to hear from you!

Thanks for reading,

Evan

Evan Leekley

evanleekley@knowingmore.com

Check out this information from the Eldercare Workforce Alliance:

By 2030, one in five Americans will be age 65 or older, 75% of whom will have one or more chronic conditions. Many older adults and those with chronic diseases do not receive the care they need because of an inadequately trained healthcare workforce, clinician and faculty shortages, and poor working conditions for direct-care workers (such as nursing assistants, home health aides and personal care aides).

6. Provide training and support for direct-care workers and family caregivers.

If you would like to support the above health reform measures, please click here to visit the Eldercare Workforce Alliance and LET YOUR VOICE BE HEARD!

You can call or email your Representatives and Senators so they know how you feel about better education, pay and working conditions for direct-care workers.

All of us at In the Know will be making our calls and sending our emails, too!

Best wishes,

Linda

Linda Leekley BS, RN
In the Know, Inc.

Have you ever hired nursing assistants and, after HR paperwork and a quick tour of your facility or agency, sent them off to a full day’s work? Does orientation seem like a waste of time with CNAs? After all, many of them don’t stick around long, so why bother? Well, here’s a tale from my past that spells out the problem with that theory:

When I started my first job as a new nursing graduate, it was on a busy hematology/oncology unit at a big teaching hospital. I was green, intimidated and in need of a good orientation. Did I receive it? Nope…instead I was thrown into a full patient assignment. (There was a preceptor assigned to me, but she was busy with her own caseload.) When I expressed my concerns to my preceptor, she said to me, “Look, we know an orientation would be nice. But, you’re a warm body to fill a spot on this shift. Just do the best you can because none of us have time to help you.”

What happened? Well, thankfully, I avoided causing any harm to my patients! But, my stress level went sky high; I felt alienated from my co-workers; and I spent my days off worrying about work. Before long, I developed strep throat and walking pneumonia. After a month, I transferred to another oncology unit where the staff was willing to orient me.

So, guess what? Once again, the heme/onc unit was short staffed! Their neglect of my learning needs was shortsighted and cost them another “warm body”. And, as time went on, I found out that the cycle continued; very few nurses wanted to work on that unit. Their attitude about orientation harmed everyone: the supervisor, the staff and the patients!

It’s the same with nursing assistants. If they are not oriented properly to their role within your workplace, they are likely to become stressed, overwhelmed and anxious to move on to another job. This vicious cycle is part of why CNA turnover is so high across the United States.

There is good news. Studies have shown that, on average, when an organization institutes a high quality orientation, their turnover rate decreases by 50% within two years! That’s one reason why we developed a complete CNA Orientation Program entitled, “Getting Off to a Good Start”. We wanted to help you with your aide retention rates AND provide the tools and support that nursing assistants need when they begin a new job.

“Getting Off to a Good Start” includes information on professionalism, communication, teamwork, patient rights, infection control, time management, stress management, personal wellness, customer service, cultural diversity, quality improvement, documentation and LOTS of practical client care tips. And, the program gives the learner SIX hours of inservice credit…right off the bat!

If you want more information on our CNA Orientation Program, please feel free to give us a call at 877-809-5515. We’re happy to answer any questions you have and/or email you a preview of the program.

Happy Hiring!
Linda

Linda Leekley BS, RN
www.knowingmore.com

Today, you can read about our final group of nursing assistants who were selected by their supervisors and all of us at In the Know to be honored for being outstanding on the job:

Miranda M., who is a real team player at Dependable Home Healthcare in Martinsville, Virginia

Linda L., a top-notch CNA at Carolinas Medical Center-Union in Monroe, North Carolina

Josephine A., a real star at Good Samaritan Lutheran Health Care Center in Delmar, New York

Nita W., who believes in the mission of the Area Agency on Aging of West Central Arkansas in Hot Springs, Arkansas

Marie S., who excels at her job at the Jerome Home in New Britain, Connecticut

Supervisor, Fiana P., told us that she is so glad to have Miranda on her team. She has been able to please some of their most challenging clients. The agency stands by its name, Dependable Home Healthcare, and Miranda is ALWAYS dependable! Miranda has chosen a career as a nursing assistant, but it’s obvious that nursing is in her heart.

At CMC-Union, Kathleen R. reported that Linda is an extraordinary person. She is always so friendly and courteous to both patients and staff. Linda is always willing to help. She has been working for the hospital for a long time and knows everyone. You can always expect a lift in your spirits when you see her in the hall. Linda’s patient care is outstanding!

Supervisor, Marjorie H., told us that Josephine is always doing all the little extra things that make a resident’s day. The residents confide in her; if they are grieving, she cries right along with them. And, if they need a “lift”, all she has to do is show them her beautiful smile. Josephine’s co-workers are all glad that she is part of their team!

Missy M., Director of Health Services, reported that Nita has been working with their Agency for many years. Even though she has since earned her LPN degree, Nita continues to work full-time as a CNA because she believes in the mission of the Agency to help seniors lead independent, meaningful and dignified lives. Nita sees clients in their homes on a daily basis and always goes above and beyond to see their needs are met. She is the eyes and ears of the Agency and they feel so lucky to have her. The quality of their clients’ lives is so much better because Nita is looking after them!

At the Jerome Home, Kathy F. told us that Marie is an outstanding CNA. She works the 3-11 shift on their dementia unit. Marie is faced with challenging behaviors every day. She has learned to respond with a caring tone–which is sometimes all that is needed. Marie is always striving to improve her education and skills by participating in many of the classes offered at her facility. Recently, she was selected to take part in a phlebotomy training class so that she can draw blood as needed for her residents. Marie is a star employee!

We also send special recognition to all the CNAs at Washington County Hospital in Nashville, Illinois. Your supervisor, Clara S., told us that she is fortunate enough to have outstanding CNAs on every shift…and there was no way she could nominate just one. So, congratulations to all of you!

WOW! Such amazing stories of personal and professional growth! We send a big thank you…to Miranda, Linda, Josephine, Nita, Marie and all the thousands and thousands of other hardworking CNAs who bring so much of themselves to their jobs!

CONGRATULATIONS from the Team at In the Know!

Here is another group of outstanding nursing assistants who were selected by their supervisors and all of us at In the Know to be honored for their professionalism:

Kathy H., who loves working on the Skilled Nursing Unit at The Northwest Florida Community Hospital in Chipley, Florida.

Deborah A., an enthusiastic CNA at St. Peter’s Nursing and Rehabilitation Center in Albany, New York

Tywand V., who treats her residents with love at Rockynol Retirement Community in Akron, Ohio

Antonia Z., who goes above and beyond at Gulfside Regional Hospice in New Port Richey, Florida

Vera O., who is a pleasure to work with at Mayview Convalescent Center in Raleigh, North Carolina

Kathy’s supervisor, Diana F., told us that Kathy goes above and beyond every day at work. She takes pride in her work and all her coworkers appreciate her. The residents love her, too, and she really cares about them. Kathy spends time listening to and talking with them. She comes in early, stays late and comes in on her scheduled days off if the unit is short. Her cheerful demeanor and smiling face play a part in making the unit warm and homelike. Kathy is a big part of why the residents enjoy living at NFCH!

Supervisor Stephanie G. bragged to us that Deborah always seems to have a smile on her face. She is enthusiastic and energetic while at work. Many patients have commented on how nice she is to them. Deborah is always available to lend a helping hand and does it with a true concern for all involved. If Stephanie were a patient, she says she would want Deborah to take care of her! Deborah has a very demanding job but she always acts like a true professional.

Tracey N. believes that Tywand exemplifies the words “top notch” every day in her work. She also exemplifies the mission statement of her workplace. Tywand has been a nursing assistant at Rockynol for 5 years. She started as a floor CNA and is now the scheduler for the entire nursing department. Even though her main duty is scheduling the staff, Tywand continues to make the residents a priority throughout her day. Regardless of her own work, if a resident has a need, she is out there meeting it! She truly loves all of the residents and her daily actions demonstrate this. The residents love Tywand’s caring attitude and all her coworkers respect her hard work and dedication.

At Gulfside Regional Hospice, supervisor Sheilah R. told us that Antonia concentrates on making her dying clients comfortable, improving their quality of life and providing opportunities for them to meet final life goals. Antonia is a professional, empathetic, responsive communicator who facilitiates hope and exhibits a non-judgmental attitude in her care of both patients and their families. She achieved CHPNA status by passing the Hospice and Palliative Care Certification Exam. Antonia demonstrates excellent customer service and is loved and respected by her patients, families and coworkers.

Supervisor Ellen J. told us that Vera is a CNA of few words but her actions show genuine concern for her residents. She has a keen eye for knowing when something is wrong with them and has no problem informing the nurse. Ellen appreciates having Vera on her team and says she is a pleasure to work with. She communicates assertively and respectfully. And, she is a team player. For example, she is the first one to start passing trays at meal time…not just to her residents, but to all the residents. Vera knows what needs doing and she does it so well!

There is nothing to say but WOW! And, thank you…to Kathy, Deborah, Tywand, Antonia, Vera and all the other dedicated, hardworking CNAs who make such a difference in the lives of their clients.

CONGRATULATIONS from the Team at In the Know!

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