CAREGIVER BLOG - (CNA, STNA, PCA, HHA)

Posted: 2/27/2021 2:35:40 PM

Riding the Tide of the Gray Tsunami



In the US, the older population or those who are 65 years old and above has increased rapidly since a decade ago. The U.S. Census Bureau recorded a 34.2% increase or an additional 13,787,044 people in this age group. In the year 2018-2019 alone, there were 1,688,924 people who reached 65 years old. This trend is due to baby boomers who were born between 1946 and 1964 reaching retirement age.

By 2030, all baby boomers will be older than 65 years old. In that year, 1 in every 5 Americans will belong to this age group. For the first time in US history, there will be more older people than children.

This projection will bring about drastic changes in many ways that Americans live, including changes in national policies, programs, and many more. Healthcare providers are well aware of this surge in the older population and they have actually made the preparation their 'main business'.

The expected increase in retiring baby boomers is the reason why the "gray tsunami” or “silver tsunami” was coined. The gray tsunami refers to the big wave of the older population that will affect many aspects of the US as a country as a tsunami would.

Nursing assistants must be prepared to tackle this challenge as it is already happening.

Here are things to ponder on as well as some useful information to help you in your career:

1. You will be caring for many more older people.

Year after year, there will be a larger number of older patients to take care of and you should be able to adapt to this change. It will help to go back to your nursing concepts every now and again for a refresher just to keep your patient care at par with current standards.

Keep in mind that although people live longer nowadays, it doesn’t necessarily mean that they are healthier. Many will have healthcare needs in their advanced years. Older patients will need assistance as they slowly lose their independence.

2. There will be more career options in the care of older people.

The changes will bring about many job opportunities in the care of patients who are in their retirement age. The government will allot more resources, and that means more institutions with different services will pop up.

As of now, there are many types of facilities that cater to older people. There are retirement communities, assisted living, sheltered housing, continuing care facilities, nursing homes, among others. Hospitals, clinics, and nursing facilities are for those with more complex medical attention. Because of the growing needs and demands for these institutions, expect that there’ll be more versions of each or stand-alone services that will meet a particular health need. It will be like a career menu where CNAs can conveniently choose from.

3. You have to see the difference between caring for older people and that of younger adults.

Older patients, especially the old-old, may have different signs and symptoms of an illness than younger adults. For example, if it's common knowledge that a person with flu will have a fever, for the old and frail patients, this may not be so. Instead of fever, their body temperature may even drop lower than their usual. Confusion is also a symptom that should alert you that something may be wrong.

Older patients usually have more than one long-term illness, and they take so many medications. The signs and symptoms of their chronic illness or side effects of their medications may mask new health problems.

For this reason, it is good to be always alert for new complaints and for even for small changes in their condition. Keep in mind that aging can affect the way the body can fight and respond to diseases and injuries. And just as important is safeguarding their independence because older patients see independence as a very big part of their quality of life.

4. Those with Alzheimer’s disease will increase in number.

Today, some 5.8 million Americans already have Alzheimer's disease. By 2050, this number is projected to more than double (13.8 million). Currently, Alzheimer's disease is the fifth leading cause of death in this age group.

What do these numbers mean to the CNA? A lot of things. Firstly, chances are you'll be caring for many patients with Alzheimer's disease. Secondly, you have to be knowledgeable about the effect of this condition on a person's independence as well as on their physical and mental wellbeing. Lastly, be aware that these patients have unique needs brought about by the changes in their brain and bodily functions. Anticipate possible behavior problems, too.

5. Expect changes to senior living conditions.

The demand for senior living arrangements will definitely increase. There will also be changes in the style and manner that people will want to be cared for. Be prepared to care for those with the simplest needs and those who would still like to continue their luxurious lifestyle amidst their health issues.

6. Brace yourself because there will be more technological advancements.

Imagine what technology has brought us in the last 30 years. What do you think can technology bring to the table for older people in the next decade or so? Nursing assistants like you must be able to keep up with this kind of progress. High-tech equipment and gadgets will surely be useful especially if there would be fewer workers willing to take on the job of caring for patients.

There is no stopping the gray tsunami. The only way to cope with it is to ride its tide and welcome the accompanying changes, and you can be a valuable asset to this change.


Posted: 2/15/2021 2:48:31 PM

A CNA’s Dedication Deserves a Million Thanks



Nursing assistants are one of the few people who devote their lives to the wellbeing of others even if the job pays very little and the work is exhaustingly back-breaking. A CNA’s dedication to their work is remarkable and indeed commendable.

Not everyone who embarks on this journey stays for good. In fact, in the healthcare industry, CNAs take the no. 1 spot for having the highest number of turnovers. According to the 2019 National Health Care Retention & RN Staffing Report, hospitals have a hard time retaining CNAs. The turnover rate for nursing assistants is 31.9%. This number means that about 32 in every one hundred nursing assistants quit during a certain period of time.

As a CNA, you are such a valuable member of the healthcare team, and for that, you are worthy of all honors just for staying on the job. You deserve the undying gratitude of everyone - the patients themselves, their family, and those who need care one way or the other.

Please take time to love yourself and be proud of what you do. Here are some reasons to continue your chosen career:

1. You are a selfless giver.

You are human and so you get tired like everyone else, but you still give it your all. That's the hero in you. In fact, it's likely that you even feel embarrassed to complain.

Missed lunchbreaks are nothing new to you. You eat whatever you can grab while on the go, running from one room to the other, as long as you meet your patients’ needs.

You do the extra mile even if those additional hours are unpaid, and your efforts are unrecognized. You are a fountain of kindness. You feel happy and fulfilled that you can help the weak, the sick, and the old.

2. You touch people’s lives.

In an internal newsletter by Penn Medicine, Mary Rogers, MSN, Director of Nursing Operations, emphasized CNAs' priceless contributions. Quoting her, she said, “You impact patient outcomes by performing primary patient rounds or demonstrating good listening skills addressing needs.” According to Rogers, nurse assistants earn the patients’ trust, which, in turn, positively affects the way they feel about the care they receive.

And yet, not everyone is keen on recognizing a CNA's importance as part of the healthcare team. In the poem “Only” a CNA?, author Dawn Mazzola, a nursing assistant, writes about how undeserving CNAs are of this kind of belittlement.

Mazzola describes how unique a nursing assistant’s job is and how profound the way that they touch their patient's life. She powerfully urges CNAs like you to be proud of who you are and what you do. You are significant. Let nothing and no one tell you otherwise.

3. You are instrumental in improving the patient's quality of life.

Whether it is the patient's recovery process or just their everyday progress in a home or facility, the services you render contribute to their quality of life. You always do for them what they cannot do for themselves to perform activities of daily living. Every patient under your care who gets discharged will be part of your success story, and every recovery story will include you as well.

4. Nurses need you.


Let’s face it. RNs are admirable workers, too. But they already have a lot on their hands, and without you to help them, they won’t be nearly as efficient.

You are a nurse’s ‘muscle worker’ or ‘miracle worker’ to put it in a better perspective. Other than taking on the physical demands of the job, you also give them emotional support. Your service as their assistant is just as important.

5. Your job is in high demand.

You will always have work waiting for you in the near and distant future. The US Department of Labor says that a nursing assistant career has a good outlook and a much faster growth than other professions. This projection means that job hunting would be easier for many years to come than in other fields.

You also have a variety of options when choosing your place of work and working conditions. For example, if you think that hospital grind is too much for you, there’s always a doctor’s clinic with much more predictable tasks and work hours looking for an assistant.

CNAs face daily discomforts, but they always leave a part of themselves smiling and still giving to help a patient in need. It is not easy being a CNA, and this is exactly what makes this job a noble career. So as you put on your scrubs today and look in the mirror, tell yourself, “You are precious, and your selfless service is invaluable.”


Posted: 2/8/2021 1:27:22 PM

What You Do to Keep Patients Safe Matters



Patient safety is vital to healthcare, and it is the foundation of quality patient care. In essence, it is preventing errors and accidents that can harm the patient.

As CNAs who frequent the bedside and assist patients in their activities of daily living, patient safety is well in your hands. Alongside doctors and nurses who also have a fair share of this responsibility, CNAs like you are expected to keep patients from harm’s way in all possible ways.

Although many factors, such as understaffing, poor communication, and burnout, affect the way the staff can keep their patients safe, there are ways to prevent mishaps from happening and achieve favorable patient outcomes. The tips below should get you started.

1. Infection Control.

Did you know that nearly 1.7 million patients develop some form of infection two or more days after receiving care from a hospital or facility?

Healthcare-associated infections occur several days after admission, and this means that somewhere in their treatment timeline, there have been breaches in infection control protocols by staff. The sad part is that more than 98,000 of these patients succumb to these infections and die. And these tragedies don't have to happen.

Studies show that simply practicing universal precautions, the most basic of which is thorough handwashing, can lower these numbers, shorten hospital stays, lower healthcare costs, and ultimately save lives.

a. Practice hand hygiene.

To prevent healthcare-associated infections, handwashing and the use of hand sanitizers are vital to patient safety. These procedures significantly reduce the transmission of microorganisms and keep infectious diseases at bay.

Wash your hands thoroughly with soap and water for 30-40 seconds. Clean all surfaces including the palms, the back of the hand, the sides and tips of the fingers, and the wrists. Rinse and then dry your hands with a paper towel.

If, for some reason, you cannot wash your hands, use hand sanitizers that have at least 60% alcohol. Use an amount that is enough to cover all of your hands' surfaces and let it air dry completely.

Perform hand hygiene before and after seeing a patient, after using the toilet, before and after meals, and after handling contaminated materials.

b. Use a mask when you have colds.

When you still need to go to work even if you have a cough or a runny nose, you must wear a mask. A mask serves as a barrier to prevent the direct spread of microorganisms.

Remember that patients are somehow more vulnerable to infections because of their poor health condition. You can protect them and keep them safe by wearing a mask.

c. Help patients perform hygiene measures, such as bathing and grooming.

Bathing and other hygiene measures help control the spread of bacteria and viruses that cause infections. Encourage the patients to wash their hands frequently, too.

d. Clean your surroundings and disinfect surfaces.

As a nursing assistant, one of your primary responsibility is to keep the patient's immediate environment clean always. Give particular attention to visibly dirty items because they are highly contaminated. The toilet and frequently-touched surfaces must be cleaned and disinfected as well.

2. Anticipate your patient's needs.

Knowing your patients well can be your ticket to keeping them safe from falls and other accidents. If, for example, you have a patient who drinks a lot of water after meals, schedule toileting about half an hour later. This strategy prevents them from tripping and falling as they hurry to get to the toilet.

3. Communicate effectively.

Many errors happen because of poor communication among staff and between the healthcare team and the patient. If a request is unclear, or if you have doubts about it, do not hesitate to verify it first before carrying it out.

Also, part of effective communication is listening. Listening and paying attention to patient concerns can promote patient safety. Allowing the patient to speak up encourages them to say if something doesn't feel or look right. Comments such as these are red flags for possible errors and signal that you need to probe further.

4. Use checklists.

Checklists are the healthcare team's universal language for task completion. It simplifies what still needs to be done, especially if things get complicated during a shift. Checklists help ensure patient safety by preventing harm caused by missed or repeated procedures.

5. Take care of yourself to avoid burnout.

Constant stress and exhaustion weaken one's decision-making abilities and open doors for mistakes while providing care. Studies show that burnout significantly compromises patient safety, so it is important to take care of your physical health and your mental and emotional wellbeing, too.

As part of the healthcare team, your contribution to patient safety truly matters because you are with the patient most of the time. If you have a keen eye, you'd see potential problems even before they happen. Knowing how to keep a patient safe at all times says that you are highly competent and responsible.


Posted: 2/3/2021 3:31:13 PM

What to Do When a Coworker Breaches Safety Protocols



Patient safety is always a top priority. It gives meaning to the essence of healthcare. There is no quality care to talk about if a staff’s carelessness puts a patient in harm's way.

All healthcare workers, nursing assistants included, must always follow protocols that pertain to safety because breaches in these rules have drastic consequences. Overwhelming evidence shows that patient safety issues lead to more hospitalization days, injuries, and even death. It is for this reason that maintaining a culture of safety is vital to achieving quality patient care.

Performing patient care procedures safely is your responsibility, but it is also just as important to be mindful of coworkers who fail to follow the rules. And the first step to this awareness is to know common scenarios of how this usually happens, such as these below:

1. Infection control breaches.

Due to the enormous pile of tasks to complete in a single shift, some CNAs skip seemingly trivial procedures, such as handwashing. This bad practice is particularly alarming during this COVID-19 pandemic, when the coronavirus that causes the disease is especially brutal to the vulnerable patients, such as the older ones and those with chronic conditions.

You might also encounter a colleague who has a cold casually going from room to room without a mask. Other times, you might see another drop the dirty linens on the floor and then pick them up, contaminating their scrubs in the process.

Some CNAs who are responsible for cleaning, disinfection, and sterilization of devices and equipment do not follow procedures to the detail. They may also mishandle already disinfected equipment.

2. Working under the influence of alcohol or illegal drugs.

Providing patient care while drunk or high on drugs is a major breach of safety protocols. It can easily endanger a patient's life. An intoxicated staff member will behave and think differently and dangerously; hence their decisions become unreliable, and their actions can lead to patient harm.

3. Doing procedures that are beyond their scope of practice.

CNAs must always be aware of what their license allows them to do. Doing more and beyond one’s scope of practice is dangerous and illegal and can put one's career on the line.

4. Failure to follow falls prevention protocols.

Did you know that patient falls in healthcare settings happen frequently? Yet this type of accident is easily preventable. According to the Agency for Healthcare Research and Quality, there are 700,000 to 1 million hospitalized patients who fall each year. The same is also true for half of the 1.6 million nursing home residents. As simple as failing to raise the side rails as needed can lead to patient accidents and injuries.

5. Improper use of cleaning materials.

Safety issues can arise even from the incorrect use of cleaning products, such as bleach. As a general rule, bleach should not be mixed with any other products or else it may give off toxic fumes and cause breathing difficulties and skin and eye irritation not only to the CNA who's using it but also to the patient who's in the same room as them.

Have you seen any of the above scenarios happening in your workplace? If you did, what did you do?

When a coworker is breaching a safety protocol, you might be torn between just minding your own business or calling their attention to it. If you are unsure of what to do next time, here are some tips to help you deal with such a situation:

1. Protect the patient first.

If it's between protecting your patient or your coworker, your patient comes first. It's not ratting out or snitching on your colleague. It's doing the right thing.

If, for example, you smell alcohol in a coworker and see them help a patient transfer from the bed to the wheelchair, will you intervene? Yes, you should. If you don't, the patient may fall.

Your colleague who is under the influence is not fit to care for patients. Stop them from providing care and report to the nurse or supervisor immediately.

2. Follow safety rules and agency protocols.

Protocols are in place to prevent accidents and injuries to both patients and staff. It dictates the behavior needed to ensure quality care. If your agency has guidelines on reporting erring coworkers, it would be best for all concerned to follow procedures.

3. Communicate openly and respectfully.

Learn how to give feedback. It takes skill to do so without sounding mean. No shaming whatsoever. A workplace where people criticize mistakes and embarrass others is unhealthy. It encourages the erring staff member to hide future errors.

The goal of proper communication is to prevent accidents and improve quality care. Use words that mean to assist and not to criticize. "Let me help you put up the side rails" is calling the staff's attention to the potential problem. It serves as a reminder that they can prevent an accident from happening if they secure the patient in bed.

Maintaining a culture of safety is of utmost importance to ensure that patients receive the best quality care possible. While it is vital to ensure patient safety yourself, helping coworkers prevent patient harm is your duty, too.


Posted: 1/18/2021 1:24:17 PM

Tips for Encouraging Your Patients to Speak Up



According to a study, as many as 30% of hospitalized patients are hesitant to speak up about their care. And this results in poor patient experience as well as safety issues. Patients need to know that they can reach out and talk to someone who is willing to listen and help.

Nursing assistants play a crucial role in bridging communication gaps between the patient and the healthcare team because the rapport is already there and they spend the most time with the patient.

However, there are still some reasons why patients hold back. They sometimes think it’s pointless to do so, or they just don’t know how to bring the subject up. In case you feel that your patient has something to say and still hesitates to talk, these tips below should prod them to share their concerns with you:

1. Establish trust.

Show sincerity when you care for patients. Be approachable and kind. Offer to sit with them. When patients see that you genuinely want to help them, it will establish trust and make it easier for them to open up and talk. Trust is the foundation of great patient care, and without it, the patient will likely keep to themselves and be frustrated.

2. Give them your undivided attention and make eye contact.

For patients to verbalize their feelings comfortably, you must find time to stop everything else and talk to them for a few minutes. Look at the patient in the eye and smile because this signals that you are there for them.


If, for example, they tell you something important while in the middle of a procedure, finish up and then ask them to tell you more about it. You’ll be able to communicate more effectively when you are both not busy and undistracted.

3. Listen intently.

Listening is an important and effective part of communication. When you listen attentively, it conveys that you are willing to understand the patient's situation. Give them time to talk uninterrupted. And when you respond, begin with a summary of what they said. Recounting what the patient has said shows that you listened, and it's an efficient way of encouraging patients to open up more.

4. Ask them directly.

When patients speak up about their concerns, it opens opportunities for improvement. It is the first step to finding solutions. One of the best ways to encourage them to talk is to ask them directly.

Use these below as great conversation starters:

‘Do you have any concerns?”
“What’s on your mind today?”
“How are you feeling?”

These questions make conversations more meaningful because it allows the patient to discuss their feelings and worries freely. The use of broad openings or open-ended questions focuses the conversation on them.

Use the following questions to help them elaborate if they find it difficult to provide details.

“Can you tell me more about this concern of yours?”
“What would you like to happen?”
“Do you have any suggestions on how we can make this possible for you?”

5. Reach out to their family.

Some patients may find it hard to talk to staff but not with their loved ones. So, alternatively, you may ask the family instead. Check, also, if having a family or friend with them in the room would make them more comfortable speaking up.

Both strategies are helpful when the patient is confused or has trouble communicating. Family members who know the patient best can speak on their behalf. You can confirm with the patient later on, if possible.

Once the patient says what's on their mind, be reminded that it doesn't end there. The next step, which is just as important, is to be prepared to meet their needs, or else it would seem that everything that the patient has said has fallen on deaf ears.

Share the patient's concerns with the healthcare team so that together, the staff can find solutions to improve the quality of care and patient experience.

When CNAs help patients speak up, they become instrumental in achieving patient care goals.


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