Posted: 8/19/2019 2:53:54 PM

CNAs and Nurses: A Powerful Partnership

As a nursing assistant, how do you see your nurse supervisor? How well do you work with them? What do you think makes a healthy partnership?

These questions help describe a CNA's working relationship with their nurse, who acts as their leader. This is an interesting topic because research says that teamwork and nursing staff engagement yield positive results. Patient fall rates decreased, and collaboration improved. It also resulted in fewer nursing staff resignations. Like Batman and Robin, CNAs and nurses can achieve more as a team than alone.

Amidst the known benefits of their teamwork, nursing assistants and their nurses do not always see eye to eye, and this creates barriers to achieving patient goals. CNAs sometimes feel they have no voice in healthcare, leading to poor partnerships with their nurses.

Here are some common sentiments we hear:

"I feel that my nurse doesn’t trust me enough. They don’t take me seriously. I wish we could work better together. I am willing to learn more, if only they would teach me!”

"I don't like to be treated like I'm some kind of robot, only following orders without a chance to give feedback or say our opinions."

"I don't mind being corrected as long as it's done with respect, even better if they also see and recognize my efforts once in a while."

Here are some ways nursing assistants can enhance the CNA-nurse partnership:

Be kind to your nurse. You may have a ton of things to do, but you can take the initiative and ask how their day was and greet them properly with every encounter.

Go the extra mile. Because nurses take on bigger responsibilities, their challenges at work are also more complicated. So, a helping hand willing to do more is greatly appreciated. "Let me help you with this," goes a long way to build stronger teams.

Send feedback. It may be scary to get your voice heard or you may feel that your opinion is unwanted, but your ideas for approaching tasks and your observation of the patient is valuable. Be confident when you approach your nurse. Your confidence will get their attention and help them listen. Remember that two-way communication is important to prevent errors, and there's no harm in taking the first step to open communication channels.

Be willing to learn. There are times when nurses' words sting. If you keep an open mind to why they said what they did, you're less likely hold it against them and feel resentful. Put yourself in their shoes. Maybe they were anxious over a potential error that could cause trouble or exhausted after working a double shift.

Show appreciation. Say thanks for every learning opportunity. If you know it’s a special day for them, congratulate them. Recognize their hard work, too.

Collaborate and work with them. Collaboration is working together to achieve a common goal. To collaborate successfully, be an active participant in every patient huddle. Don't be afraid to ask questions. Have the confidence to voice your opinions and bring your ideas to the table when the matter calls for it. Listen to suggestions and follow the care plan meticulously.

A CNA is a nurse's second pair of hands, eyes, and ears, and a valuable ally in achieving patient goals. When CNAs and RNs team up successfully, the work becomes more rewarding and something to look forward to every day.

Posted: 8/12/2019 1:17:58 PM

Eight Steps to Turn Mistakes into Golden Learning Opportunities

Being a nursing assistant means never a dull day at work. Most days, you have so many tasks at hand, all begging for your attention at once, that you unknowingly make mistakes.

Can you remember a time you stopped in your tracks at work because you suddenly realized you made a significant error? What instinctively came to mind? How did you react and what did you do about it?

Let’s take the case of Samantha:

Samantha is a new CNA finishing her second month in hospice care. Sam is showing great potential as she performs her duties with enthusiasm. One day, she overheard a nurse discussing the importance of elevating the head of the bed when feeding patients, and maintaining the elevation for a half hour after meals.

This came as a shock. She remembered that, in her fourth week on the job, a frail elderly patient suddenly had difficulty breathing a few minutes after Sam fed her. She was rushed to the hospital and soon passed away.

Sam distinctly recalled helping the patient sleep flat on her back right after dinner because she had asked to turn in early. It hit her like a bolt of lightning—did she cause her patient to end up in the emergency room?

She quickly realized her mistake. She should not have allowed the elderly patient to sleep on her back right after a meal, because the risk of aspiration (breathing difficulties from food substances entering the lungs) is so high in this situation. Although she couldn’t be sure there was a connection between her mistake and her patient’s death, shivers ran down her spine. Now she knows better than to let her patients sleep flat on their back after eating, especially if they are weak or have swallowing problems.

If you find yourself in a similar nerve-wracking situation, what should you do to turn things around and find the silver lining?

1. Acknowledge your mistake. Before anything can be done about it, there must be an eye-opener that acknowledges and identifies the problem. Accept the reality that you made a mistake so you can start corrective measures and your healing process.

2. Don't play the blame game. It is human nature to want to blame someone or something else when errors were made, to make it less humiliating and guilt-ridden. But, you can only look into your faulty decision-making and the circumstances that led to the accident.

3. Follow protocol for reporting errors. In healthcare, mistakes are not taken lightly since the patients’ safety is at stake. Whenever errors are recognized, there is a procedure that must be strictly followed, whether or not the patient sustained an injury. This protocol helps in research and devising ways to reduce similar incidents in the future.

4. Accept the consequences. When a patient is injured or likely harmed because of a CNA’s mistake, there will be consequences. These can range from a simple reprimand or memo to lawsuits and the revocation of your license. Braving out the negative effects while providing patient care is a difficult but necessary journey to ensure justice, and of course, that no similar incident happens again.

5. Forgive yourself. Perhaps the hardest thing to do is to let go of your own guilt, especially if the patient was harmed because of your mistake. Learning to move on can be very challenging at this point, so much so that you simply can’t expect to find peace overnight. Take it one day at a time until you gain back your confidence.

6. Ask, “What can I do to prevent future mistakes?” Ultimately, before you can carry on with your job as a nursing assistant, you need to put back the broken pieces by learning your lessons the hard way. You must think of ways to prevent such accidents from happening again.

7. Share the lesson with others. Because mistakes are life's greatest teacher, share your experience with others so they can also be wary and cautious when dealing with similar situations.

8. Move on and do not repeat the same mistake. Don’t let your error prevent you from doing what you love most—caring for others. Pick up the pieces and carry on. Just be sure to not make the same mistake twice.

Mishaps teach you golden lessons you can learn from and treasure in the long run. Do everything in your power to prevent one, but if you find yourself in a sticky situation due to a mistake in patient care, get back up, reflect on the lesson, and then overcome.

Posted: 8/5/2019 2:58:56 PM

When the Patient’s Family is Difficult…

For nursing assistants, dealing with tough and uncooperative patients is part of the job, but it can be seriously irritating. It’s understandable that they might make irrational demands or seem to complain a lot—they’re sick, uncomfortable, and in pain. But when a patient’s family members are the difficult ones to deal with, we somehow run out of reasons why we should put up with them. All the same, dealing with a patient’s difficult family members is also part of a CNA's day-to-day reality.

You’ll know you’ve met one when they:

Are controlling and overly demanding - Difficult family members micromanage everything and are into all the nitty-gritty details. They notice your brush strokes when you perform mouth care. They’ll want their loved one’s soup at the perfect temperature and consistency, and that means reheating it numerous times to their satisfaction. They also take the most time to interact with since they question every procedure. Everyone scrambles to their feet just to satisfy their demands.

Are argumentative - Because nothing goes unnoticed by a difficult family member’s eye, they can make a problem out of the smallest issue, which can easily escalate into a full-blown shouting match. They tend to insist on what they want, even when it’s against policies or safety protocols.

Take advantage of your compassion - They are well aware that you are a dedicated nursing assistant with a soft spot for sick patients. So, they take advantage of your kind heart and demand back-breaking tasks in short order “for the patient.” They may also continue to use up your time even after your shift has ended.

Are impossible to please - Difficult family members will make you feel you are incompetent and incapable of delivering quality work. They seem to complain constantly, and even your best efforts are somehow never good enough for them.

Are abusive - Abusive people do not think twice before being disrespectful to others. They hurl expletives without blinking. They also get physically abusive. They often don’t hesitate to shove, push, or kick.

Recognizing difficult family members is the easy part. What should a CNA do when you encounter one of them?

Give them some space - Understand they act the way they do because they are stressed by their loved one's health condition. Their behavior may be the result of anxiety, fear, or guilt, which they unknowingly project outward. Or sometimes, being hard on everyone is just part of their personality!

As a nursing assistant in the caring industry, have the patience to let go of small annoyances. Listen carefully and fulfill demands as long as it doesn’t compromise your license, your sanity, and most especially, patient safety.

Keep your calm - Let’s be realistic and accept that staying calm while being cursed at is very hard to do. But this tip is for your own sake and peace of mind. It takes self-discipline to practice calm, even while the other person is pushing all your anger buttons at once.

Set boundaries - Setting limits is a lifesaver for CNAs fighting burnout and emotional distress brought about by controlling relatives. Being at the bottom of the food chain, so to speak, does not make you anyone’s doormat! Firmly but respectfully say that your shift is almost over and you'll gladly make aware the incoming staff. Tell them that you are there to help and doing the best you can.

Stop abuse early in its tracks. When a patient’s family member goes too far, tell them directly that their words and behavior is abusive and needs to stop.

Seek support from a supervisor or manager - Many times, you need reinforcements to make a family member understand the situation. Don’t hesitate to call back up, like your nurse or manager, for example.

Dealing with a patient's difficult family member is part of any CNA's everyday challenges. The best advice is to maintain professionalism especially when the going gets tough!

Posted: 7/22/2019 4:25:58 PM

How to Protect Your Patients and Your CNA License

The revocation of their license is one of the harshest consequences in a CNA’s career. When you are stripped of your license, you’re technically not a CNA anymore and cannot work as one. Other than the headaches and heartaches you endured before the Board of Nursing (BON) arrived at this decision, the future becomes not so promising, too. Since it is a symbol of safe practice and trustworthiness, a nursing assistant who lost their license looks like they’ve let those good qualities go.

Once your CNA license is revoked, it will be hard to convince the certifying Board of Nursing that you did not mean to cause harm or damage, or that the unfortunate event does not reflect you as a person.

And they rarely reinstate licenses. Most of the time, the decision is final or you need the help of a lawyer. It’s also difficult to re-enter the nursing field due to your marred work history. It will be challenging to convince future employers that what happened was either an accident or single occurrence. “I’m sorry, it won’t happen again,” doesn’t cut it.

The consequences do not end there. Your ego, source of income, and other opportunities are damaged as well.
Of course, no one wants to end up in this situation and it doesn’t have to happen to you! Be aware of the following behaviors that can lead to the revocation of your license:

Lying, cheating, falsifying documents, or omitting vital information when applying or reapplying for certification - Dishonesty and falsification are grave offenses that can strip you of your license in a flash. These offenses mean two things: 1) You do not meet the minimum requirement to safely practice as a CNA, and 2) you intentionally deceived the certifying body, the Board of Nursing, and disregarded patient safety. Examples of this offense are providing false training documentation, getting licensed illegally, or failing to disclose previous criminal charges or prior disciplinary actions in your application or recertification.

Performing procedures beyond your scope of practice - Even if you’ve seen it done so many times, you think you can perform a procedure with your eyes closed, do not do it unless you are certified to do so.

Working under the influence of alcohol or illegal drugs - This precaution is for the obvious reason that patient safety is at stake when your brain is foggy because of mind-altering substances. Under the influence, your decision-making is faulty, so you are likely to make mistakes or cause accidents, prompting patient injury and potential legal problems for you and your employer.

Also, diversion, or stealing medications from a patient and using them yourself, is a serious offense. Be aware that you don't need to use illicit drugs to get into trouble. Mere possession of illegal substances can lead to the loss of your license as well as your job.

Mishandling patient information - "What happens in Vegas, stays in Vegas" can apply to your interactions with patients, too. Whatever happens with a patient should not be discussed with anyone unless they are part of the team that provides their direct care—even if the patient is famous or known to the person.

Never take pictures of patients without their consent or share their photos or information over social media. When you do, you don’t just disregard the patient's right to privacy, you can cause them great inconvenience and damage to their reputation.

Patient abuse - Every now and then, we hear horrific stories of CNAs who abuse their patients. Abuse is never right, whether you’re a CNA or not. This type of wrongdoing will not only strip you of your license but also put you in jail for a very long time.

Criminal acts - Intentionally harming patients or stealing from them are just some examples of crimes committed while working as a CNA, and they are sure ways to end your career as one.

Negligence leading to patient critical harm or death - Patients’ lives must be protected at all times and if you fail in this regard as a nursing assistant, it's like throwing away your license for good. Not all negligence cases lead to this consequence, but it is a likely scenario if a patient's legal counsel has strong evidence of your oversight. So, always keep patient safety a priority.

Every CNA license comes with pride in the fact that nursing assistants do awesome work caring for patients. It is proof of competence and safe practice. Treasure your hard work, career, and commitment to patients, and protect your license!

Posted: 7/15/2019 5:37:13 PM

Night Shift Hacks that Actually Work

Are you a night owl CNA who prefers the graveyard shift? Or maybe the manic day shift is too much for your inner peace?

Whatever your reason for working nights, you should know there are a few downsides. By nature, the body is programmed to rest from sunset onward. During sleep, the body undergoes healing, repair, and restoration. But patients need care round the clock and there must be staff like you to care for them during this time.

So, don’t let the disadvantages of the night shift drag you down. Be assured that you can still have a great experience as a nursing assistant, if you’re prepared to face the challenges and get a step ahead by working on coping skills early on.

To help cope, here are some handy life hacks you can follow to get the most out of your night job:

Trick your brain - The body follows a 24-hour rhythm that coincides with day and night, perking the body up for activities during the day and waning down energy at night to prepare for rest. You want to mimic this by keeping the nurses' station brightly lit as you work and use sunglasses to curtail the brightness when you go home in the morning.

Eat a healthy breakfast - Pack your “day” with enough nutrients to provide the energy you need for work. An empty stomach likely signals to your body that you’re ready for bed, so eat up to boost your wakefulness and stamina.

Avoid stimulating foods and activities before bed - This includes nicotine from smoking, which is a stimulating substance that can keep you awake. Better yet, stay away from this bad habit altogether. You also need to cut down on caffeine such as in coffee, tea, and chocolate before bed, since they keep your brain active. Heavy exercise can likewise give you an energy boost, so schedule it away from bedtime.

Don’t make alcohol your sleep tonic - Alcohol can make you drowsy, but it causes poor quality sleep. Ditch your shot glass and drink some warm milk before sleep, instead.

Maintain a consistent sleep schedule and number of rest hours - When you work at night, you’re going against the body’s natural rhythm. The least you can do for your health is give the body a pattern to recognize. If you sleep at the same time each night, you'll likely have less difficulty falling asleep and feel properly rested upon waking. Also, maintain at least eight hours of sleep to fully recharge your body.

Keep yourself busy - Check on your patients and make sure they are sleeping comfortably. If they have scheduled vital sign measurements, do them while being very careful not to wake patients fully. You can restock supplies, sanitize surfaces and equipment, fold linens, and organize the station. Being busy also prevents you from feeling drowsy and out of focus.

If your patients are mostly stable during the night, use this time to bond with other staff - One of the greatest perks of the night shift is that you’ll have time to get to know your coworkers better and appreciate them as people. There are fewer reasons for misunderstanding because the atmosphere is easier and more relaxed.

The graveyard shift can be advantageous in many ways, if you know and practice healthy work routines. Follow the above hacks and you can have a wonderful experience working at night.

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