Posted: 3/16/2018 4:09:12 PM

Your Voice Matters

Certified nursing assistants make up part of the healthcare industry's front-line employees, and they spend the most work hours with patients. So, what they have to say matters, whether it’s about their patients or their working relationships.

Feedback is giving information or a reaction regarding a person's performance or a workplace issue, for the purpose of improving overall patient care. What can effective feedback do? Think of it as oil for a squeaky machine. Without it, it is hard to move forward smoothly, achieve patient safety goals, and reach the organization's objectives. If done correctly, feedback can also boost employee morale and support careers. Additionally, it encourages collaboration within teams.

How would you rate the impact of CNAs’ voices within your organization? If you are a CNA, how do you give and receive feedback?

Here are a few questions to find out where you are on the road to improvement through feedback. Give each question a score from 1 to 5. Assign a score of 1 if you strongly agree and 5 if you strongly disagree.

1. I do not hesitate to talk to the nurse supervisor regarding important patient safety issues.

2. When the nurse and I talk about patient care, they ask me for my opinions and suggestions.

3. When I comment constructively on a colleague's behavior, I do not get harassed for doing so.

4. Providing feedback is encouraged in our unit.

5. I voice my opinions and contribute to the group when attending huddles and meetings.

6. When I give feedback, my colleagues listen and acknowledge my ideas and suggestions.

7. When my colleagues point out areas of improvement in my patient care, I listen and do my best to improve my services.

8. There are effective ways of giving feedback in our organization, other than simply verbal communication.

Add up your scores. A total of 28 or higher indicates that the feedback mechanisms in your workplace may need changed for the better. Remember that, as a CNA, your suggestions are indeed valuable.

Here are some ways to boost your feedback power:

1. Check your intent.

Is your purpose to encourage positive behavior? Is your criticism constructive? Do you have a hidden agenda to put a colleague down or criticize them personally? When you share information, your aim must be to provide safer and more efficient patient care or to improve working relationships.

2. Avoid labeling the feedback.

Feedback is neither positive nor negative if done in the right manner and through the appropriate channel. To avoid appearing too negative, focus on the behavior and not on the person. Stick to the facts and avoid getting personal. Explain how the behavior affects patient care or the teamwork.

Say, “I noticed the equipment is not properly washed with soap and water as it should be,” rather than, “She just washes the equipment under running water for a few seconds, and she does this all the time.” The first statement gives information and discusses the behavior while the second focuses on the person and ends with a vague and judgmental comment.

3. Do not hesitate or wait for “the right time,” especially if the issue is about safety.

Give responses immediately, as this is the right time. Waiting until the nurse or chief nurse becomes available or is in the right mood is not practical and allows for errors. The same must be done when giving feedback about a colleague. Did you notice that another CNA took extra time to stay longer with a grieving family? This is a positive behavior worth recognizing! Inform the colleague that you saw their effort and tell them how inspiring it was. You might just make their day.

4. Always make sure that you have understood what was said and that you've been understood in return.

Sometimes, information can be misinterpreted, especially if it is unclear. Repeat what has been said and ask if it is correct, or ask the person receiving the message what they understood, so there is no grey area.

5. When receiving feedback, consider the information regardless of how your co-worker said it.

Your colleague may sound judgmental and overcritical for many reasons. Instead of taking it personally, use the opportunity to learn and work toward your own improvement.

Feedback is a powerful tool in the healthcare industry. It helps build effective teams and reach organizational goals. Learning how to both give and receive feedback is critical to your success in the long run.

Try reviewing the course material on active listening class from our course library.

Posted: 3/9/2018 12:55:27 PM

How Large Patient Loads Affect CNAs, and Ways to Cope

Certified nursing assistants are known to be bedside warriors, but they are no Wonder Woman or Superman, with extraordinary strength and speed. Neither do they have an extra pair of hands to better multi-task, or a hoverboard to fly across the hallway without having to run. If they had these advantages, then caring for twenty highly dependent patients might seem easy!

In reality, most CNAs take on huge patient loads, resulting in burnout and high turnover. When CNAs leave their jobs, this cycle just continues. Frequently having large patient loads leads to overfatigue, and when CNAs can’t stand it anymore, they quit. Those who stay on the job must absorb their responsibilities while waiting for their colleague's replacement. After some time, others working with large patient loads resign, too. And the story repeats itself.

What is the ideal CNA-patient ratio? Well, there is no definite answer, because it depends on the setting, shift, and individual patient cases. We do know that without proper coping strategies, handling twenty patients each day can get the better of you if you do nothing about it.

So, what happens when the patient load is too large? How does it affect the CNA and their job?

Well, firstly and most importantly, when there are too many duties to carry out in a given day, patient care suffers. For example, CNAs tend to forego handwashing because it is a “waste of time.” Every procedure and conversation is done so quickly that their job becomes centered on finishing tasks, and not helping patients get better or feel more comfortable. Some procedures, such as mouth care, are skipped because they are not on their list of priorities. Errors also happen more frequently.

CNAs feel the burden, too. They become stressed and exhausted. They forego meals and rest periods, and delay going to the restroom in order to complete all needed tasks. They react and communicate negatively with patients and coworkers. Soon the stresses pile up, resulting in burnout.

This burnout is the very thing that we do not want! Exhaustion kills the passion for serving others and prevents a positive outlook at work. Although reality bites, those who cope well are those who will reap the rewards of the job in the end: a stable career, lifelong learning, and a true connection with people.

Here are effective ways to cope:

1. Develop a system for doing things and stay organized.

The idea is to continue looking for ways that work best for you, and soon enough most everyday tasks will be done automatically. For starters, figure out how to lessen the number of your trips to the station, the supplies room, and the bedside, how to multi-task, and the best methods for you to remember instructions.

2. Know your patients and anticipate their needs.

If you cannot keep complete mental note of their needs, write them down. Cluster activities as you see each patient. Doing so saves a lot of time and energy.

3. Invite your colleagues to work as a team.

A lot can be said about the power of teamwork. Great achievements are often the result of teamwork. The saying, “Alone we can do so little; together we can do so much,” can be especially true in healthcare. Some tasks and responsibilities can be rearranged to make life easier for everyone. Let one person take charge of restocking supplies, while another cleans and replaces equipment. Bank on everyone's strengths so that they can perform their duties effectively.

4. It is ok to involve the patient’s family in their care.

If your patients have loved ones staying with them, motivate them to help, emphasizing the bonding moments that become possible when they help with care. What can they do? Start with small tasks such as hair grooming, mouth care, and positioning.

5. Practice proper body mechanics at all times.

Your spirit may be strong, but your body won’t be forever. Don't let a recurring back pain from all that lifting and twisting get the best of you and your career. You know better!

6. Speak with the supervisor.

Yes, you may, and you can! Sometimes, all that is needed is accurate feedback. Tell them how the huge patient load is affecting your health and the way you care for patients, and then work with them to find a solution.

You chose this career because of your love of caring for others. Don’t forget to care for yourself so you can be the best CNA possible.

Try reviewing the course material on body mechanics class from our course library.

Posted: 3/2/2018 11:24:05 AM

Do Not Make HIPAA Violations Your Personal Courtroom Drama

HIPAA violations are the unauthorized sharing of patient health information in ANY form to others who are not directly caring for the patient. It is a direct violation of a patient's privacy and it is a breach of confidentiality. It is certainly a serious issue, to the extent that some cases would be great inspiration for a courtroom drama movie. As a CNA, you do not want to be part of this drama!

Here are some interesting facts for you:

1. A breach of patient confidentiality happens every 62.5 hours.

2. More than half of confidentiality breaches are related to disclosure of patient information to personnel not directly related to the patient’s clinical care.

3. An estimated 46.7% of breaches are severe and happen in public areas or within hearing distance of others who are unrelated to the patient’s case.

Now that we’ve gotten your attention, let’s emphasize that a HIPAA violation is clearly not just about you. Primarily, it is about the patient whose health information was exposed. It is a clear sign of disrespect to the patient, who usually suffers horrible consequences such as damages to something they hold dear, like their relationships and dignity as a person.

For those who intentionally or unintentionally fail to follow the HIPAA law, the consequences come in varying degrees of severity. Violators may be asked to attend rigorous HIPAA compliance training and receive other disciplinary actions. First-timers who were unaware that they made a breach may be required to pay a fine from as low as $100 to as high as $50,000. Those who intentionally commit a violation, such as those who receive payment in exchange for information, may have to pay a sky-high fine of up to $250,000 as well as face criminal sanctions and jail time. The journey back from this kind of mistake would certainly be very stressful to the violator.

In what circumstances can a CNA be charged with a HIPAA violation?

1. Discussing a patient with someone who is not proving direct care for the patient. For example, while having lunch with a fellow CNA who is cares for a different set of patients, you told them about your patient's “accident” with their ostomy.

2. Discussing a patient's health status with someone without express permission from the patient or their legal guardian. For example, you excitedly announced a patient’s positive pregnancy test results to her husband.

3. Relating information within hearing distance of others who are not related to the patient's case. For example, you told the nurse about your client's depression while you are in the elevator with other people.

4. Reading the hospital records of a patient who is not under your care. For example, a family member made a complaint to your employer after they saw you read the records of the patient on the other side of the unit.

5. Taking a photograph of a patient and sharing it on social media without express consent from the patient or the legal guardian. For example, you took a picture of a young burn patient and uploaded it to Facebook without asking permission from the child's parents, in the hope of raising awareness to fire hazards in the home.

6. Willfully using a patient's information for financial gain. For example, an unknown person asks you for the results of a patient’s DNA test and you give them the information in exchange for some cash.

7. Exposing a patient's medical records or hospital chart. For example, you accidentally left the patient's charts in the waiting room and people in the room looked at the contents of the chart.

8. Improper disposal of medical records. For example, the supervisor asked you to throw away some hard copies of patient information and you threw the papers, which were not shredded, in with the regular trash.

Do not let a HIPAA violation affect your career or cost you your job. It is important to keep your institutional policies in mind and always handle your patient's health information with the utmost care and professionalism.

Try reviewing the course material on hipaa class from our course library.

Posted: 2/23/2018 10:09:02 AM

Saying “No” to Your Patient Won’t Kill You

The healthcare industry abounds with stories of heroic acts where healthcare workers save the day. Hats off to these workers who make headlines because of their bravery. But not all stories of courage are that extraordinary.

Every day, healthcare staff, such as nursing assistants, show how brave they are when they have to say “no” to their patients. How hard can it be to refuse a patient's request? Other than raising a few eyebrows, you risk building up the patient's frustration, anger, and resentment, having them give you a poor rating in the patient satisfaction survey, or worse, causing them to file a lawsuit.

Yet, saying “no” to a patient is sometimes necessary. When you feel that you should refuse a patient, you need to both exercise critical judgment and keep in mind institutional policies. Here are some scenarios where CNAs must stand firm and hold their ground.

1. You’re doing your rounds and one of your patients, Mrs. Winters, keeps pushing the call button. You go to her room and she demands that you look for the book that she “lost.” You find her book under one of the pillows on the bed. As you are about to see the next patient, the same call light flashes again—this time, Mrs. Winters needs a cup of water. She has a cup and pitcher by the bedside and is without any restrictions in her movement.

As much as you want to help patients get well under your care, you may respectfully explain to this patient that you cannot oblige their every request because you have to attend to other patients’ needs as well. You may ask the nurse for assistance in this matter and have them note the conversation you had with the patient.

Another helpful strategy is to assist them with whatever they need while in their room, and then remind them that you are not able to be back for another half an hour or so. A nursing assistant must encourage independence and self-care in patients, as long as their abilities allow.

2. Ms. del Mundo, a resident at a nursing home, demands to know the results of her roommate’s most recent laboratory tests. She says she is so worried about her friend and wants to know the information to help her roommate get through difficult times.

It is very tempting to say yes to the patient in this situation, especially if you have witnessed their friendship. But a CNA should not disclose any private information of another patient regardless of how pressing the “need” is. It is a HIPAA violation and disrespects the patient whose privacy was violated.

3. Mr. Cane, a male patient in his late forties, is charming and witty. Although in pain, he never fails to make the staff smile. Mr. Cane shows particular interest in you and asks that you see each other on a date after his discharge.

You might think that dating a patient right after discharge does not cross professional boundaries because your service to that patient has ended, but no—it is still prudent and proper to refuse their invitation at this time because of the possibility of caring for the patient again on a return check-up.

4. Eva is 56-year-old patient at a skilled facility who is verbally abusive to the staff. She is also aggressive at times, throwing supplies and equipment during care procedures. During one episode, she yells at you, throws her food tray, and demands that you come that instant.

Understand that abuse is never okay. Be firm and tell them that their behavior is unacceptable. Have a colleague standby silently to witness the hostile behavior. Keep calm and do not take it personally. And when it gets worse, do not hesitate to call security.

When refusing a patient is absolutely necessary, brave it out and be firm. Saying no won't kill you, but it will save you from stress and burnout.

Try reviewing the course material on gentle teaching no 1 class from our course library.

Posted: 2/16/2018 11:45:53 AM

A CNA Who Smiles Wins Hearts

"A smile can change the world," or so they say. Is this just a cliché?

Smiling is a natural instinct. As babies, we smile for every positive experience, whether it is the pure delight of seeing our mothers, watching a hanging mobile toy turn, feeling full with milk, or just because we have no worries at all. Parents seeing their baby grin for the first time are filled with emotions that make them want to do anything to protect them from the harsh realities of life.

As we grow older, our smile remains a powerful gesture that can cheer someone up, if we manage to wear one even when we don’t feel great on the inside. At work, where nursing assistants care for people who struggle with their health, while dealing with difficult colleagues, a smile can make a huge difference!

A smile is a reflection of positive feelings. It is contagious. Those who can smile in a room full of tired, weak, or sick people can instantly lift the atmosphere and lighten everyone’s mood.

In their difficult moments, patients could use a smile because it triggers a reward mechanism in their brain. Here's where it gets interesting: Science says that when you smile at someone, the other person feels as if they are receiving a box of chocolates or even cold, hard cash. Imagine that! A smile is like giving a patient a meaningful gift.

Nursing assistants can, therefore, use smiles to their advantage as part of providing care. Uncooperative patients respond better to health workers who are sincere and inviting, and who are ready to put on a happy face and speak with a gentle, motivating tone.

Older patients who may feel lonely because they long to be connected with their family, will always appreciate a CNA who greets them with a smile every time they enter their room. The gesture invites conversation, such that which might help them reminisce about happy memories.

Children, most especially, become less anxious if the people who provide their care smile at them. Young patients participate in care procedures without a fuss because they trust a friendly CNA. They even forget their pain when they smile back or laugh at a joke.

The advantages of a smile do not end here. The giver also benefits—big time. Whether genuinely given or just made in an effort to feel good about yourself during stressful times, the positive effects are amazing. It makes the brain release more “happy” hormones which lower heart rate and blood pressure and help the body fight stress. This means that when you smile and think positively about a situation, however bad it is, the body naturally becomes attuned to finding solutions, seeing hope, and feeling that everything will be all right.

Here’s another compelling truth about smiling: It makes you look more attractive, more confident, and better able to deal with problems. So, there's a very good chance that your colleagues will treat you differently, in a positive way. They might even think that you are up to something. Not bad at all!

A smile has powers. Scientific and social experiments already prove that, so the next time you go to work, start your shift with a smile and spread happiness and good vibes all around.

Try reviewing the course material on beginner class from our course library.

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