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

Posted: 11/17/2017 1:25:02 PM

Continuing Education for Career Advancement as a CNA

Certified Nursing Assistants have a bright future in their careers, not only because the healthcare industry will certainly need more of them in the future, but also because they have a lot of choices when it comes to advancement through continuing education (CE).



To continue working as a CNA, most states require that your license is renewed before the end of your second year of practice. According to a federal rule, a CNA must have at least 12 hours of continuing education per year to renew their license. Some State Boards of Nursing require a total of 24 hours of CE courses in two years, and some, even 48 hours per year. Whatever the case, CE courses are necessary for several important reasons.

1) Continuing education keeps you up-to-date with concepts that are necessary for safe and fully-informed practice. The quest to continuously improve the way we care for patients means there may be certain standards of care, information about care procedures, or even normal values that change over time.

2) CE programs provide important information about current issues facing patients and healthcare workers. If there is an emerging disease or a prevalent illness, then CNAs get information about it through continuing education.

3) Continuing education also gives you information regarding safety, an important concern when working in a healthcare setting. Patients' lives and your own safety are at stake. How do you prevent from being infected with certain diseases? What are the best practices for proper body mechanics? These are just a few of the safety concerns which CE courses discuss.

Continuing education courses cover a variety of topics. Here are some examples of CE courses available for CNAs:

1. Workplace safety as defined by the Joint Commission

2. Ways to reduce medical errors

3. HIPAA

4. Age-specific care

5. Care of patients with:

a. Alzheimer’s disease
b. Latex allergy
c. Dementia
d. Stroke
e. Suicide
f. Depression

6. Infection control

a. Blood-borne pathogens
b. HIV/AIDS
c. Air-borne pathogens and tuberculosis

7. Task-related concerns

a. Medication administration
b. Documentation

8. Issues in practice

a. Professionalism
b. Ethics
c. Patient’s rights
d. Domestic violence
e. Bullying
f. Legal issues

9. Advancement in medicine

a. Caring for patients with pacemakers

10. Skills

a. Personal care skills
b. Basic nursing skills
c. Emergency procedures
d. Communication and interpersonal skills
e. Basic life support
f. Transcultural care

Continuing education courses are pre-approved by State Boards of Nursing, and there are many ways to make it happen.

Big hospitals often provide in-service training or training that is relevant to providing care in their particular hospital. If you are working in a big institution, this may be the best method of completing your CE hours, because you will have the chance to improve service through courses in that hospital.

Nursing schools are also an excellent provider of CE courses. Look into the same school you received your nursing aide training. They will also have CE courses for you to check out.

The Red Cross is another institution that can provide the hours you need. The courses offered are usually about life-saving methods such as cardiopulmonary resuscitation and basic, to advanced, life support.

The newest way to complete approved CE hours is through online institutions. This is one of the best advantages of living in the modern tech world. These courses can even be taken in the comfort of your own home.

Whether renewing a license or changing career paths, continuing education builds confidence in care provision and prepares you for whatever lies ahead. Nursing assistants are required to complete 12 hours (or more) of these career-boosting courses in a year, and all of them will be worth your time and money.

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


Posted: 11/10/2017 4:40:47 PM

Where Will Your Happy Workplace Be?

There are currently more than one and a half million Certified Nursing Assistants in the U.S. today. You might be one of them, or soon to be joining this workforce. About 40% of CNAs work at a nursing care facility. So where do the other 60% find employment?



Right now, you may be considering all your employment options or just wanting to find your “happy place” in this career. Whatever your reason, look no further. Here is a list of possible settings in which a nursing assistant works:

1. HOSPITAL – The hospital is a fast-paced work environment, so if you are looking for action and are up for a challenge, this is the place for you. A hospital CNA must be able to quickly adapt to changes because there are many in a short time period.

You will work closely with the healthcare team, especially the nurse. You will care for patients who often come into and go out of your care, as new admissions and discharges happen frequently. Your work will be full-time in three possible shifts, including weekends and holidays.

Other than regular CNA tasks such as vital signs measurement and bed-making, you will be required to enter data into a computer as well as answer phones and call lights. With special training, you might be given the tasks of watching client monitors, performing ECGs, gathering specimens, and alerting the staff to any problem that arises with a patient.

2. NURSING HOMES – these places provide nursing facility services such as skilled nursing, rehabilitation, or long-term care round the clock. A CNA's job here is focused on vital signs measurement, assisting clients in their activities of daily living (ADL), and helping clients achieve the best possible quality of life with their chronic disease or disability.

Clients are typically older persons who are chronically ill and adults with disabilities who require more complex care than simply their ADLs. If you value the bond between a healthcare worker and their client, then this is the place for you, because most clients stay long-term for their care. Your best friend and closest associate is the nurse.

3. ASSISTED LIVING FACILITIES – As nursing assistant students, you have most likely received training in these facilities. They cater mostly to older people who are stable and mobile. Clients maintain some independence but cannot live on their own because they still need assistance with some aspects of their care.

As a CNA, this means that you will perform care procedures that the client cannot do on their own or finish tasks that they cannot complete. The work will be lighter in the sense that most clients can independently go to the toilet and clean themselves.

4. ADULT DAYCARE – As the name suggests, this work setting is where you will find adults with disabilities or older people who cannot be left alone in their homes when their primary caregiver or significant other is away at work.

As a CNA, your job would be to help provide meals and meaningful activities to your clients and to supervise them until their relatives pick them up at the end of the day.

5. HOME CARE – If you like working in different home environments with some traveling required, then this job is for you. You will provide care directly to clients in their own homes.

Home care work requires experience because you will primarily be working independently, unless you work in homes with a nurse. Your interaction will mostly involve one to a few clients, whom you visit each day.

6. HOSPICE – To work here, you must be emotionally tough to handle the death of clients as well as their grieving families. Hospice is a place where healthcare workers provide care to clients who have less than six months to live.

If you think that this must be a sad place to work, think again! Where death is common, you may begin to appreciate life more. This work setting will remind you to value the most important things in life.

Other than these six most common workplaces for CNAs, there are others where you can put your skills and knowledge to use. These include clinics, dialysis centers, same-day surgery centers, and even prisons and mental hospitals. You can also work as private duty CNA, where you would care for one client, 24/7.

Each work setting has its own rewards and challenges, and it is up to you to decide where you would be most comfortable and productive. I hope this guide helps you find your happy (work) place soon!

Try reviewing the course material on professional behaviors of the nursing assistant from our course library.


Posted: 11/6/2017 5:32:45 PM

Eating Issues in the Elderly

Nutrition is one of the most basic needs for a person to be healthy. People have to eat the right kind of food, and they have to drink enough water to have the energy to move around, to repair and heal the body, and to fight diseases.



For most people, mealtime is something to look forward to. Just thinking of one’s favorite dish would be enough to improve one's mood.

But to older people, eating and having proper nutrition is not as easy. It could even be a burden or a very difficult task to some. Nursing assistants must be prepared to assist their elderly patients in any way they can.

Here are some issues seniors face that CNAs must be aware of:

1. FORGETTING THE TIME FOR MEALS AND HOW TO EAT

Patients with dementia may forget that it is time to eat so they miss meal times. Some, on the other hand, demand to have something to eat because they could not remember that they have already eaten. Those with advanced dementia have brain changes that even make them ‘forget' how to eat altogether. The result is they cannot chew or swallow when eating.

Nursing assistants must remind the forgetful patient that it is time to eat. Those who have already eaten but insist on having a meal may be given a light snack. CNAs should limit distractions during meal times so the patient's focus is only on eating. Televisions or radios should be turned off and replace that noise with some light conversation.

Sometimes it may be necessary to tell a patient with dementia what foods are on their plates and what the utensils are for. For those who have forgotten how to chew their food, the CNA may have to demonstrate the act for them by making chewing motions themselves. Most importantly, patients should be given enough time to eat.

2. DIFFICULTY SWALLOWING

Patients who are weak or those who recently had a stroke may have difficulty swallowing, putting them in danger of choking or aspiration. A nursing assistant must ensure that the patient’s foods are soft and cut into small pieces. Thin liquids must be avoided and they have to serve thickened soup and pureed foods instead.

3. POOR APPETITE

Having no appetite is not a part of healthy aging. But many factors cause a loss of the desire to eat in the older adult. Physical changes in their taste buds can dull the flavor of foods. Medications that cause dry mouth or a metallic taste can also discourage an older person to eat.

CNAs can make the patient’s food tray appealing. They can help patients choose foods that are packed with nutrients so even if the patient eats only a small portion, they are getting the nutrition they need. A patient whose appetite is poor may be offered food more frequently.

4. TOOTH LOSS, ILL-FITTING DENTURES, AND GUM DISEASE

Many older people become prone to gum disease that cause toothaches and tooth loss. In this case, they cannot chew food properly. Nursing assistants must ensure that the foods these patients eat are soft, and prepared either ground or finely chopped. Eggs, cheese, yogurt, and other similar soft foods are ideal for these patients. Most importantly, helping them perform mouth care can help prevent gum diseases and cavities.

5. DECREASED SENSATION IN THE MOUTH

Patients with diabetes and those with advanced dementia may not be able to tell if their food and drinks are hot or cold. CNAs must check the temperature of the foods and drinks before offering them to the patient, making sure that they are not too hot to cause burns.

When eating is an issue in the older patient, nursing assistants must have the patience to help them overcome the difficulties of having proper nutrition due to their health conditions. They must go out of their way to be creative in thinking of ways to make meal time a pleasant experience.


Posted: 10/28/2017 10:09:07 AM

Bluer than Blue: Caring for Patients with Clinical Depression

During your nursing assistant training, you were taught that clinical depression is more than just feeling sad. People, the healthy or the sick alike feel down at times, but having an overwhelming feeling of sadness and hopelessness and feeling no pleasure in anything that they do every day are clear signs of depression.



There is a high chance that as a certified nursing assistant, you may be caring for a patient with depression. In 2015 alone, more than 16 million adults or those aged 18 years old and above, have had at least one major depressive episode, and one in every four Americans aged 65 and above has depression. The numbers show us that this mental condition is a huge problem.

CNAs should know how to deal with depressed patients. Let’s take a look at one scenario below:

John is a 70-year old retired teacher who has diabetes and is battling heart and kidney complications because of his diabetes. His wife had died three years earlier, and their only daughter had settled in Europe after she married there. John is always quiet, teary-eyed, and never says a word to the staff. He refuses to eat and bathe. He does not participate in any activities and doesn’t want to take his medications. He lies in bed all day but does not seem to have a good night’s rest according to the staff who are working the night shift.

John is a classic example of a patient with clinical depression. Nursing assistants who spend the most time doing bedside care are challenged when they do not get a positive response from the patient. CNAs must use therapeutic communication and keen assessment skills because they would need to measure vital signs and get the patient to perform activities of daily living as well as to take their medications.

When caring for a patient with clinical depression, nursing assistants can use these helpful tips:

1. Never think that depression is part of aging. Although a lot of depressed people are older, it does not happen naturally in old age.

2. Be sincere and genuinely show care. Do not appear falsely cheerful. Let the patient know that you care.

3. Do not give any negative comment or pass any judgment.

4. Spend extra time with the patient. Even just sitting with them will mean a lot.

5. Encourage the patient to talk by asking open-ended questions but do not press them for answers.
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6. You may talk even if you do not get a reply.

7. Use therapeutic touch to show your care.

8. If they refuse to bathe, ask permission to comb your patient’s hair or to give them a back rub.

9. If your patient doesn’t talk, listen carefully and note every detail and the meaning behind their words. Motivate your patient to express their feelings.

10. Invite the patient for a walk.

11. Ensure that the patient takes all their medications on time.

Most important of all, CNAs must be all eyes and ears when caring for patients with depression because the patient’s hopelessness and extreme negative feelings may drive them to think of hurting themselves and commit suicide.

Report any changes in the patient’s behavior, especially if they have a sudden burst of energy to do something purposeful such as carry out a plan. Be wary of responses such as “I have it all figured out now,” “I just want all this to end.”

Depression and suicide are very serious matters that must be handled with care. CNAs and the health team must have the determination to help patients overcome negative feelings. More importantly, nursing assistants must do some reflective thinking and examine themselves in these situations because it is only with empathy that we could reach out to these patients.


Posted: 10/22/2017 1:01:16 PM

Care to Look at the Care Plan?

A certified nursing assistant’s life is not an easy one. It’s more like juggling thermometers and BP apps, and assisting patients here and there while you’re doing the running man challenge.



When you see a patient, you start planning in your head what the patient might need and build your mental to-do list. Not even halfway through your shift, you feel overwhelmed with your tasks, only to know you were not able to do some the most important functions that are written in the CARE PLAN!

"So, what happens now?" you ask yourself. Well, for starters, you may have to repeat procedures because you missed getting the required information the care plan says you should. Second, you just realized that you made a mistake. Your brow starts to sweat because you emptied the patient’s urinal when the care plan says to collect all the patient’s urine.

What is a nursing care plan? Your nursing assistant school surely taught you a very good definition of it. But to stress its importance, let us look at it in these practical ways:

1. THE CARE PLAN IS AS IMPORTANT AS GOOGLE MAPS ARE TO TOURISTS.

With the use of navigation apps like Google Maps, you can never use 'getting lost' as an excuse to being late to your destination. Care plans are no different. They give direction and purpose to your day. It tells you the things you need to accomplish and why. You cannot make an excuse of saying you missed doing your task if it is written in the care plan.

2. A CARE PLAN IS EVIDENCE THAT YOU ARE WORKING WITH A TEAM.

CNAs work closely with nurses who developed the care plans. It is like a one-stop shop for many team members across different shifts. The care plan shows who does what so that expectations are clear. In the end, when the patient improves, the team efforts have prevailed.

3. A CARE PLAN TELLS THE STORY OF HOW THE PATIENT WILL GET WELL.

Perhaps the most important reason why care plans should be followed is that the patient's health and wellness depends on it. The care plan contains information about the patient's problems, the goal to make them better, the duties on how to reach the goals, and how the patient is doing after all the tasks have been performed. It mentions communications with the patient and among members of the care team. With the healthcare team’s effort, it could be a success story on its own.

4. THE CARE PLAN IS A DOCUMENTION WITH LEGAL SIGNIFICANCE.

Remember that what has not been written down did not happen. Not only does a care plan need to be followed to the letter, whatever task is done must be documented in the patient’s record. If the nursing assistant does not perform the tasks indicated in the care plan, they may be held liable in any case where the patient sues.

More than all the above reasons, a nursing assistant must follow the care plan because it reflects their professionalism. It says a lot about the quality of their work and their performance. In the end, those who stick to the plan will reap their rewards. They will pave the way toward their career success.


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