We’ve all been assigned to cranky, demanding rude residents/patients. You know them: Mean, belittling people who have elevated themselves above all others in level of need. Not just pillow fluffers, these residents demand strict attention to minute details not because the attention is necessary but because the resident believes they are entitled to it. Resident families can be just as hard to work with. I’m not sure who is worse: The demanding resident or the demanding family member. Regardless, here are 7 tips on working effectively with the Mrs. Cranky’s of the world:

1) CHECK IN
Check on the demanding resident 1st thing: Once you know you’re assigned to Mrs. Cranky, go to her room and check with her right away. Let her know you’re her aide.

2) DISCUSS PLANS and ADJUST WORK FLOW
Ask her if she has any special requests for today: Perhaps she wants her bath later in the morning; or she isn’t feeling well and would like to skip breakfast. Or maybe she has guests coming and would like to wear the hard-to-don red dress. By asking her what her plans are for the day, you are giving her a real say in how her day will go. Based upon her feedback, schedule your workflow to accommodate Mrs. Cranky’s needs. This does not mean you neglect your other residents.

3) SHARE YOUR WORKFLOW PLAN
It is perfectly acceptable to let Mrs. Cranky know that your other assigned residents have the same needs as she does. Make it clear that you are responsible to others and that you cannot cut back on time they need. You can say all this in a polite, professional and caring manner. Even further, I would let Mrs. Cranky know the order in which you will tend to her care. Give APPROXIMATE time frames. By doing this, you are alerting her that you hold your other residents’ needs just as high as hers.

4) ANTICIPATE NEEDS
Unless she is your first resident, check in with Mrs. Cranky every so often. Anticipate her needs. Use your knowledge of her demands as a tool: If you know she usually rings the bell at 10am for bathroom use, be one step ahead of her and show up in her room at 9:55am to see if she needs the toilet…

5) TALK!
When performing actual cares for Mrs. Cranky, listen to her if she speaks. If she is rude or insulting you, let her know that this offends you! Tell her that her words hurt your feelings. By doing this, you put her on notice that you won’t stand for rude remarks and the like. Try to find some common interests to talk about- this shows her that you do have a genuine interest in her. Ask her about pictures she has; ask her where she has traveled in her life; ask her questions about HER LIFE in an effort to show your curiosity. If she answers your questions positively, GOOD! Keep aiming for this positive energy. If she continues to gripe and complain, remain quiet. Don’t ignore her, but ignore the negativity and by doing so you are not giving her audience.

6) ASK POINTED QUESTIONS
If Mrs. Cranky seems upset or angry, while doing her care, ask her if something is bothering or upsetting her. Sometimes people are uptight or nervous about things and take it out on the nearest person. If she expresses sadness let her know she can speak with you about those things and offer to pass on her concerns to others as needed. Let her know she can trust you. If she is angry at her family, offer to speak with the nurse to see about a family meeting. If she is mad at other staff, listen but don’t give any feedback. Give her attention for her positive words and say little about her negative words.

7) FOLLOW UP! OFTEN!
During the shift, after her care is completed, check in with Mrs. Cranky. Again, ANTICIPATE her needs! When you take a break, let her know. By doing this you are letting her know you care about her. At the end of the day, if appropriate, check in with Mrs. Cranky one last time. Ask her if she needs anything. Ask her how she thinks her day went- and what could be done to make it better. When we ask people to help us with planning schedules and work flows, it’s amazing how much feedback we get! It’s always appropriate to say goodbye and other polite remarks.

 


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1 Compassionate: A compassionate CNA is valuable. She respects what her residents/patients are experiencing; she has a knack for knowing what to say, just when to say it too! She advocates for her patients/residents- she gives detailed reports and updates to the nurses on changes in condition.

2 Patient: This CNA does not allow her job demands to get in the way of resident care. She does not **do** the tasks for the residents in order to get it done quicker; she encourages her residents to take their time with tasks. This CNA does not rush her residents thru meals and toileting.

3 Work-oriented: The CNA who loves his job is evident to all. This aide rarely uses her cell phone while working; when this aide arrives at work, she is ready to work; she focuses on her assignment and residents; she has little time for small talk.

4 Enthusiastic: The CNA who is upbeat and positive is rare. He will have a “Let’s get this done” attitude with a smile. He will not let others’ emotions and negativity affect his day.

5 Reliable: A reliable aide is one who shows up for work, on time. She gets her assignments completed in a timely manner and importantly, residents have become comfortable knowing this aide will take good care of them.

6 Punctual: On time, every time. Whether its arrival time for work, or getting residents to activities and meals, the punctual aide is an asset.

7 Hard-working: The hard work CNA’s do is what we are (in) famous for. A well respected CNA isn’t afraid of this work- she doesn’t mind all the lifting, pulling, tugging and moving. She won’t complain when she misses a break occasionally. She will offer to work an extra shift to cover a call out. She doesn’t blink when confronted with confused and scared residents with Alzheimer’s disease.

8 Flexible: One of the truly most important traits of a good aide is whether he/she is flexible…flexible to float to other units, to swap out shifts to cover openings, to swap assignments when needed…to help a coworker who is running behind.

9 Self-disciplined: It’s getting harder and harder to find nurses and aides who are more in tune with their residents then themselves. Self-discipline relates to one’s ability to maintain control of their emotions and feelings. It also relates to staying totally professional when at work. Not too many aides can do this these days. The skills needed however, can be taught and modeled.

10 Focused: Are you totally, 100% focused on your residents and their needs? Do you plan your assignment to fulfill resident desires and ensure you schedule enough time for each resident? Do you carry your cell phone with you? Do you get caught up day dreaming?  Do you tend to get involved with other aides’ problems and gossip? The answers should be YES, YES, NO, NO and NO.


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CULTURE:

Definition: The predominating attitudes and behavior that characterize the functioning of a group or organization.

Maybe you have heard a lot about workplace culture lately. It has been a buzzword for the past few years and much of it is geared towards the corporate world rather than the nursing home setting. However, every place of employment DOES have its own culture and within the LTC setting a bad culture is devastating to staff and residents.

Signs of a “BAD” Culture include:

  • High turnover and absenteeism
  • High amount of agency staff use
  • Uptight unsmiling staff
  • Grouchy residents
  • Backstabbing, gossipy groups
  • No teamwork
  • Hostilities between shifts
  • Too many cliques

Causes of a bad culture include the actions, or lack of action from management, charge nurses and YOU the CNA. You have a huge impact on the culture of the unit you work on. Your attitudes and ability to be positive all have a large role in whether the place you work is seen as a good employer.

Everyone has a set of personal values they go by; also, everyone has morals. Knowing these can be a first step towards changing your attitude and therefore becoming more upbeat.

Many of the reasons/causes of an unhealthy culture are not the fault of the CNA, and these areas must be addressed by the Administrator and DON. Some tips for them would include:

  • Hold regular staff meetings with ALL staff
  • At these meetings seek input and advice from staff, and ACT on items that can be acted upon. Explain why others cannot be followed through.
  • Break up negative cliques and do not allow little gossip groupings
  • Examine reasons for shift wars and implement methods to stop them
  • Have a mission and SHARE it with all staff better yet have all staff help with developing the mission statement
  • Maintain a positive attitude and make all decisions based up the mission statement.
  • Catch staff doing things the right way and give them credit for doing so (Gone with the mindset that “They should be doing it this way in the first place”)
  • Hold staff accountable for policies and procedures breaches (attendance)

Many things are within the control of you the CNA, when it comes to creating a positive culture. You have to look at things differently though, and this can be hard work for old timers not used to change. Having the mindset that people are lazy and will take advantage of others, for example, will get you nowhere. You will always been seen as a negative force.

Your attitude might be why you are so unhappy at work. No one likes to be around someone who always finds fault with others with their work, their uniforms, and their lifestyle.

Negative people drain energy from others. It is hard work to remain negative it amazes me to see how some CNA’s can be so miserable for so many years. It does seem that these miserable aides end up having more health problems as they get older, they LOOK so much older than they are, and they are just as unhappy at home as they are at work. The old saying “Misery likes company” may have some truth, but what I think really occurs is “Misery infests others”.

Things You Can DO, Right Now:

  • Try not to get involved with gossip; stay away from groups of staff who tend to share stories about others. If you are approached with a statement like “Did you hear” say NO and say “I DON’T WANT TO KNOW”. Walk away.
  • Don’t be a part of the “Call in Queen Club”. Show up for work, on time. And have a smile on your face.
  • Have a personal mission statement/vision if management cannot pen their own. A simple motto will work something to the effect “I will give the best care I can and I will be a good coworker to my peers.” Live by this. You will quickly become known as someone everyone likes to be around.
  • Don’t keep old baggage on your back. Forgive others for past mistakes and issues. Move on. Talk with them; tell them they have another chance with you. Stand up taller, take the higher road. You will feel so much better, like a burden has been lifted.
  • Use your manners. Saying PLEASE, THANK YOU, EXCUSE ME and I’M SORRY go so much further in the culture you create, then saying things like Nope, I can’t, or doing things like rolling your eyes, sighing heavily, murmuring under your breath.
  • Instead of having that “Us vs. Them” mindset, why not have “Its US”? All of “us” shifts, including housekeepers, cooks, nurses, residents, etc. We are working together, not against one another.
  • When you are training new staff, be kind and gentle to them. Just because they are CNA’s doesn’t mean they should be treated poorly. And don’t expect them to know everything no one knows the little tricks with residents until they get the training you can give. Model decent behaviors and talk about being positive. This will make a lasting impression.
  • When agency staff are utilized, don’t be rude to them. It’s not their fault they are there. More than likely it’s partly the facilities’ and YOUR fault! It all rolls back to culture if a place is full of negative people who refuse to help one another, who call out frequently and where there is management that condones these practices. Folks are not going to work there. People will quit or call out. Face it– a vicious cycle can occur here.

When you treat agency staff poorly, they talk. They tell their bosses and they tell other aides in other facilities we have all heard about HELL HOLE nursing home its hell because of the staff usually. I have heard some stories about agency staff being treated so badly by aides at certain nursing homes I would NEVER consider working at. And that is bad for you: Aides who might consider getting a job where YOU work, so you are not working short all the time won’t even give your employer a chance. And you might wonder WHY you don’t have enough staff.

The same cycle occurs when we mistreat new staff who quickly quit on us. They find employment somewhere else, and talk to others about their experience at your facility. The facility has reputation that has bad culture and is terrible to work at.

Help the culture at your work. Do your part: Smile, stay positive, help coworkers, train new staff well and ask Management to help create a workplace culture that helps with retention, and then in turn, recruitment.

Hopefully management can assist with this because it will take some enforcement on their part to make this work.


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So, you’re brand new and a little nervous? That’s okay and natural. Being a CNA is a rewarding career, but there are LOTS to learn and lots of cover in those first few days at work! Don’t be surprised if you feel a bit overwhelmed and anxious. Someday–soon- you will be an “old pro” at this stuff. The first part of this is for the new CNA…

I remember my first few weeks as a CNA- it was hard to get to know all the residents as well as staff as well as the facility policies and procedures. I was very overwhelmed and looking back now- there were certain things I should have done that would have made my life much easier then! Live and learn….

First, it is a good idea to bring a little notebook to work with you. In here you can write down info you need about everything from phone numbers to resident issues. Jotting down info is a way to remember it! At periodic times during the day check the little book to see if there are things you still need info about. When you think of questions and no one is around to answer them- write them down. Later you can refer back to the book.

 

OK, now onto more things every new CNA should be aware of. It’s always a good idea to know the facility policies and rules before we start a new job. Sometimes this isn’t possible. You should make it a point to find out where to go to get this info if it isn’t provided to you. Again, looking back there were things that I wasn’t clear about and I had to re-learn basic policy stuff. If I had asked in the first place:

1) Holidays/weekend pay differentials? Are there any?

2) Overtime pay: After 40 hours or after 80 hours?

3) Attendance/Tardiness: What are the exact limits/percentages?

4) Pay increases: Based on merit? Or length of service?

5) Performance reviews: When, how often, are raises included with them?

6) Uniform policy: Assistance with purchasing?

7) In service Hours requirements: Does facility offer enough hours to meet mandated 12 hours?

8) Phone numbers to call: For when you need to be out. Time limits?

9) Benefits: What is offered? When do they go into effect? What will cause termination of benefits?

10) Staff meetings: Times? Are the mandatory?

 

These are basic policy things every employee should know, and know well. Once you have this info, you can make choices about what you need to do- and when. Knowing this stuff will make your life a lot easier and will prevent surprises down the road.

For those ever important first few days, there are several things I recommend you get done, if possible. First off, find out which residents you will be working with on a regular basis. Why? You want to read their care plans as a tool to help you get to know them. Knowing what you are expected to do as far as nursing care is the reason you are there! Knowing what is in the plan will help you care for these residents in a safe and appropriate manner. You may not understand some of the things in the plan, if this happens then ask the nurse in charge of the unit. Nurses write the care plans, and they depend upon us to carry out the objectives to meet the goals in the plans. The nurse is an excellent resource for CNA’s.

In your little book you may want to write down things about your residents- from the care plans. It will be awhile before you can actually place a plan with a resident! This takes time- getting to know them and what rooms they are in, never mind their care needs. Hopefully someone will be mentoring you; while being trained it is a good idea to relate what you are being shown to how it is worded in the care plan. Ask questions and learn. Your mentor has experience and can teach you much.

Watch how your mentor works- directly and indirectly with residents and staff. You should learn much just from observing. The next thing I recommend is that you check with the nurse at the beginning of the shift about what is expected of you:

Do any of your residents need VS, baths/showers, weights, or other care? When are VS needed by? Also ask about special snack/drink requirements. It is so much better to know this stuff ahead of time rather than ten minutes after they were due. Communication is vital in nursing homes- with nurses, peers, residents. Also make sure you find out where you are supposed to document your care? Ask about paperwork and where it is. It is very important that you get the paperwork done every day.

After a few weeks, you will know which residents work well together; you will figure out how to prioritize your care to meet everyone’s needs. It takes practice and hard work. One thing that is very helpful is taking a few minutes at the beginning of the shift to plan your assignment– who gets done first, who gets showers and weights and what not. Gathering all your supplies you need before entering a room is a great time management skill all CNA’s have. Carry around a pocketful of gloves too. Check with the nurses, in most facilities you can bring in your own thermometers as long as you don’t bring them home for use. Having your own tools saves time- I have my own B/P kit too.

 

The next sections are what this page is really all about: Timesavers and tips CNA’s everywhere use to get their work done. Some things are pretty elementary and others are really cool. Try them.

 

Being Prepared:

Always be ready with a basic work kit: A waist pouch is a good thing to have- with a pen, tape measure, extra gloves, permanent marker, if possible your own B/P kit, watch and extra elastic hair things.

Keep a mental checklist of what you need before entering a room- linens, clothing, etc. Be ready.

When changing bed linens, roll all dirty linen into a ball within bottom sheet; this is easier to remove than several pieces of linen.

Type a copy of abbreviations to a little card, then get card laminated. Keep in waist pouch.

Plan your work day- check with nurse about nursing priorities and go from there.

 

Personal Care Tips:

A cool idea for shiny, soft hair: Get a little spray bottle; fill with one part conditioner to nine parts water. Spray in after shampoo and leave; this detangles as well.

Another use for little spray bottles: Fill with water and add a few drops of bath oil; after shower/bath spray a little onto resident’s skin. Make sure you mark these bottles with what is in them!

Bath oil can also be used in showers- small amount rubbed into your hands & onto resident’s skin. Also, add a drop or two into a wash basin during rounds….just be careful when disposing the oily water. Don’t drain in the tub/shower area- someone might slip at the next shower.Find residents slipping out of their chairs? A piece of rubber-type shelving liner works well to keep them upright.

For SUPER stubborn, glued on caked on BM, get several wipes or washcloths wet with hot water and lots of soap…add in a little shave cream –this works wonders with cleaning. Use sparingly as the cream can be drying. Apply a little lotion after.

 

Meal Tips:

For residents who have thickened drinks- and who don’t like the taste of the thickener, adding flavor drops helps. Thickened water taste terrible. Some say that adding a few drops of lemon juice takes away the bad taste.

It may sound elementary, but do add salt & pepper to foods if it ok; also butter & margarine. Many elderly are used to these condiments being in their food.

If food gets cold, the wise CNA will take plate to a microwave oven to re-heat it.

Residents may eat better if they start with a clean mouth: Provide oral care right before meals.

Remember that meals are supposed to be a fun time; don’t force feed your residents; allow them time to enjoy their meal! Same with drinks- don’t force them down. Allow the resident to determine when they are ready.

Residents who feed themselves may have trouble keeping their plates on the table. Use the rubber shelf liner under the plates.

You can build up a utensil by wrapping a washcloth around the handle and securing it with a rubber band. After each meal remove the cloth for washing.

When feeding a helpless resident- remember to tell them what you are doing, what you are feeding them- before each bite. If they constantly spit the food out, think that maybe they don’t like the certain food and offer an alternative. Or maybe it’s too hot or cold. Ask the resident. Look for cues. During this feeding time, talk with the resident about current events or something like it. Don’t just sit there and stay quiet. Engage with the resident, make this as social a time as possible.

Foods you know the resident likes should be made known to whoever is in charge of meal planning. This is a way for you to advocate.

Documenting meal consumption is a part of every CNA’s job. Be realistic when figuring amounts eaten. Look at serving sizes and look at what wasn’t taken in- look at what was lost via drooling, spitting out…Check the clothing protector/bib!

Also, some residents like to hide their food…know this and keep an eye on it.

Remember that residents don’t always appreciate being made to wear a bib; ask them if they would like to. Don’t force it upon them.

 

Mentoring a New CNA:

First, recall your first few days and weeks as a CNA. Have some empathy. And remember, the new CNA will watch everything you do and say. Be a role model.

Don’t expect the new CNA to know everything; yes- they have been certified but this doesn’t mean that they have hands on experience. Your job is to teach them this!

Be respectful of the new CNA’s questions. Answer them all as best you can with a smile; if you don’t know an answer either find out or direct the CNA to someone who does know.

Allow the new CNA to observe you for a day or two. Let them see how you work; how you handle your residents. This is called role modeling. Don’t assume that it is ok to have them make your beds and get your supplies. One of the things you should be striving for is to teach them how to be prepared and how to work best to get it all done.

Plan your work and your day with the new CNA. Show them how you prioritize things. If you have questions for the nurse, bring the new CNA with you so she can see how you interact.

While you are working, explain every little thing you are doing. You want to be certain the new CNA understands why you are doing certain things in a certain order….or to please certain residents. Allow the new CNA time for care plan reading. This is vital.

Allow the new CNA break times. They might need more than you think!

If your facility doesn’t provide one, make a checklist of things you want to teach. This way you will cover everything.

No matter what, NO SHORTCUTS should ever be shown to a new CNA! They might think these cuts are ok on a daily basis, which they are not. Show them the right way!

Remember that you are a person who the new CNA looks up too; you are IT. So act it. Be professional, but friendly. Be there for those moments of self-doubt and fear. Be a person who is positive and encouraging. NEVER rebuff a new CNA’s ideas or observations: After all, they see things from a view point you haven’t seen for a long time.

The way you interact with the residents is very important during the mentoring period. Go over Resident Rights, and when the time is right use what you are doing as an example of honoring rights.

 

Peer Relations Tips:

Treat others how you would like to be treated.

Using manners can leave a positive impression to just about everyone.

If you get your work done early, offer help to others who aren’t done.

Don’t backstab and find fault with your peers. Instead find the good – and offer praise.

When working short, it may be a good idea to “buddy up” with a partner. Doing things together is easier when we are stressed.

Always let your partner and nurse know where you are- even if you are only going to the rest room. This is true when you are doing care- if you know you will be awhile with a resident- say so ahead of time.

Be considerate of your peers: Don’t abuse your break times or meal breaks. Be prompt and on time.

Tell your family & friends that unless it is an emergency- not to call and text you at work.

 

Dealing with Residents who have Dementia/Alzheimer’s:

Keeping a sense of humor helps a lot.

Being positive is another trait that should be touted. Don’t assume something bad is always going to happen.

Once a struggle has begun, try to remain as professional as possible; don’t get into words and accusations. Don’t be the perpetrator of a power struggle. It’s not worth it. Make sure you report all behaviors to the nurse.

If a resident has become combative, your goal should be to protect the resident, other residents and of course – you. Try to act as a shield between the other residents, but don’t put yourself in a line of fire.

Sometimes it is better to walk away while a resident is having a hard time.

If you feel you might do or say something you could regret— LEAVE the room. Get someone else to take over; recognize your limits and respect them.

If you notice an increase in behaviors, ask the nurse about a special meeting to address your concerns. A team approach is always best. Now your good documenting will come in handy.

 

Documenting

When writing notes, be clear, concise and to the point. Be objective. Don’t write what you think happened or what you think caused an incident. Only write what you know.

Timely documentation is vital. If you take a set of VS and see that a resident has a fever, let the nurse know right away. Don’t wait until the end of the shift, or even wait until you’re done with this resident.

If your facility uses flow sheets, make sure you’re initials can be easily read.

Getting to know the particular types of paperwork you are required to do can take a little time; it is always better to ask before you sign your name to anything.

Never sign off anything you didn’t do. Never sign off something someone else has asked you to sign. Only document care YOU have given.

Being a witness to something and being asked to sign that you witnessed- this is another story. Just make sure you write that you witnessed….

Use pens with facility approved colors. Don’t use pencils or markers. (KEEP IN MIND: Colored inks do NOT show up on copies- only B/W does)…

When using EHR systems, never share your login info/password with another staff. For any reason. Ever.

 

Taking Care of Yourself

Don’t go to work sick. Ever. On the other hand, don’t call out over a simple hangnail either. Be respectful of giving enough notice when you call in. Also, never call to say you’ll be late and then call back to say you’re not coming in at all!!

Do some stretching before work! Really- it helps loosen up all those muscles we use and this helps prevent back injuries.

Eat right- right is different for all of us. Make sure you are getting enough calories in daily to do your job as well as your home life.

Drink a lot of water. CNA’s don’t always think of themselves when it comes to fluid intake! Eight 8 oz. glasses a day is the least we should be bringing in; more is cool. If permitted, carry with you a covered water bottle at work. Drinking enough water may very be one of the best things we can do for ourselves! The other end of this is using the bathroom when nature calls. Don’t wait and hold it in. Go when you need to go. Find the two minutes it takes.

Lift people and objects properly. Use good body mechanics: Lift with your leg muscles, not your back muscles. Keep your balance and always work in conjunction with a partner during lifts.Get enough sleep. Again, this is a personal thing, each individual has different needs. Whatever your need are, tend to them.

If you find that you are always getting upset about work, if you feel outraged at things- you need a break. Take a vacation. If this is not possible, then take a mental health day. I don’t condone taking time off that isn’t vacation – but there are those times that we all need a break. Especially right now when the nursing community is changing so rapidly.


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When we accept a job, anywhere, we are expected to act in a professional manner. In health care it is vital to be a good worker, to respect our resident’s rights and dignity and to respect ourselves. After years of seeing certain things and traits of people, I have come up with a few things specific to us, Nursing Assistants.

Appearance
Number one, no matter what ANYONE says, is how we look. Nursing staff are supposed to be clean and neat- in order to prevent infection. All too often we see CNA’s wearing clothing, uniforms- that are wrinkled and dirty looking. Stains and holes are just plain tacky looking.

If we want to project an image of being professional, we must be willing to dress the part. I have heard many a CNA state- “I don’t make enough money for decent uniforms” …This is true for many of us. No one is saying one needs tons of uniforms, just that the uniforms we do have be kept in good shape.

Wear clean clothes to work that are ironed or at least wrinkle free. Wear underclothing that is decent and not too colorful. We all like to wear perfumes and colognes. However, many residents and patients have sensitivities to our scents. Sometimes we drown ourselves in cologne- and it is plain disgusting. Don’t wear it to work.

Next, think about make-up and nails. Have you ever seen women who paint their faces with lots of colors and wear their hair “BIG”? They remind us of clowns. Well, when we go to work wearing lots of makeup, we too look like clowns!

It isn’t good to have too much eye color, blush and mascara on while we are going about our daily duties. Often, the makeup runs and we look awful. We work hard and move around a lot- we get hot and sweaty. Nothing looks tackier than nursing staff with mascara running down the cheeks!

Nails should NOT be long. They also should be real. Many Government and Nursing Professional Groups have positions about artificial nails on nursing staff: Bacteria find a wonderful medium for growth under these nails. Many a patient has been scratched and infected with long unclean nails. It isn’t a matter of looks anymore so much as a matter of safety.

Work Ethics: Attendance, Tardiness
This is an issue of discontent for so many of us. We seem to always be working short. Daily we see others calling out. Some more than others, but it is a constant in our line of work. I would like to spend a few moments talking about this.

Missing a lot of time from work is bad for you. It can really ruin your reputation. If you need to be out for a legit reason, then so be it. People have different ideas of what “legit” means- this is a very individual thing.

Missing a lot of time really affects your co-workers ability to respect you too. No matter what they tell you to your face- they are not pleased that you call out a lot! After all, they have to pull harder loads, do YOUR work for you. If you tend to miss A LOT of time, you might notice that your peers really don’t talk to you much and they don’t ask you how you’re feeling! Don’t be mad at them- try to realize what burden you are placing upon them.

Perhaps some “standards” should be set and I am going to put them here. I personally never call out unless I am ill. “Ill” means- fever over 100, vomiting, diarrhea. I don’t call out for headaches- I take Advil or Tylenol which calm most aches and pains. If I’ve had a single episode of vomiting or other stomach upsets I generally won’t call out. I’ll take Pepto Bismol or Imodium to help.

I TRY to make myself better so I don’t call out. Too often I see CNA’s call out because they had a fever from something other than an infection; when asked if they took anything to make it better- they always say NO. I don’t understand this- why would anyone want to be sick??

In this day and age there are many options for medical care: In almost every town and small city there are walk in clinics that charge 35.00 for a quick exam for simple concerns such as sore throats, earaches, UTI symptoms as well as sprains, fractures and other minor medical needs. These places are open 15 hours a day 7 days a week.

Many of us have children- young ones who do get really sick. They can be the main reason so many of us need to be out so often. My thoughts about this are twofold: On the one hand I see a need for women, Mothers, to be home with their young kids when they are ill. On the other hand, I see many Mothers USE their kids’ illness’s as an excuse to be out. Working Mom’s should have pre-set arrangements made in cases of illness of children. Many private sitters WILL take a child who isn’t dreadfully sick, but not well enough to attend their school/daycare. That, or find another field of work because healthcare does not have funding capacities to employ lots and lots of back up staff to cover call outs. In the end it is often your coworkers who have to pick up slack and take on your assignment when you are out. They work short staffed.

The same talk is true for tardiness, to a lesser degree. In our work, the bulk of what we do on day shift occurs in the am hours. Especially in that hour or so right before breakfast. We call it hustle time! If someone is late, this becomes all the more energy draining for those who show up on time.

I know there are times that everyone is late. It happens. But there are things you can do to keep it to an absolute minute amount. First: Make sure you set the alarm on your cell!

If you work for an agency or employer that employs more than 50 people you might be eligible for FMLA. Ask your HR department about this. FMLA is wonderful for people who truly need it and who don’t abuse it. Sadly, many people do abuse it and miss lots of work without any true accountability. Originally FMLA was set up to help people take of themselves during serious illnesses such as cancer, heart disease and the like. Now, people can claim they have anxiety or headaches and be approved to call out up to 12 weeks each year.

No matter why one is out, and no matter if it is FMLA approved or not: It is unprofessional to miss so much time at work you’re not an effective member of a team. You have to be at work to be effective.

Next-go to bed at a decent hour. Don’t stay up all night partying when you know you have to work the next day. This is just plain dumb.

Listen to the weather channel or local weather reports if you live in areas known for their winters. If you hear snow is coming, set that alarm clock for even earlier than usual. I know this might sound very inconvenient, but it is YOUR responsibility to get to work on time.

I work with a girl who has pulled this: She calls 10 minutes before the shift begins to say she will be a little late. Then half hour later she calls to say she isn’t coming in after all. This is very bad and really rotten. When we asked her why she does this- she said she sleeps through the alarm and wakes late. Hmm. We told her to turn the alarm UP loader and move it far away so she HAS to get up (we even advised her to remove her remote device so she cannot turn it off)These things worked for her, maybe they can help you if this sounds like you.

If you really are sick or cannot make it to work for whatever reason, call in way ahead of time. Not within an hour! Most places require at least two hours, some four.

If you find yourself being out a lot due to these slight ills, perhaps you should think about what the real reasons might be that you’re sick. Maybe you don’t like where you’re working; maybe you’re unhappy with your coworkers and team. Whatever the reason, take responsibility for yourself. If this means finding employment somewhere else, then so be it. If it means getting out of nursing, then do so. Your residents depend upon you being professional. Missing too much time is not helping them.

Work Ethics: Honesty, Integrity
I can tell you without any hesitation that lying is the single biggest thing anyone can do to ruin their professional life. Telling tales is just not acceptable in any situation, in any circumstance and especially has no place in health care. A lie will always come back to bite you. It might take years, but it will catch up with you.

More importantly, in our work, being honest about what we have done is vital to patient safety. We are responsible for providing hands on care and often times we are rushed, short of staff and we forget. Sometimes we just cannot get it all done. It is much wiser to tell the truth, to admit a mistake, than to try to cover up.

An example might be- you forgot to get a weight and you just write in last month’s weight. Seems simple at first but what if the resident lost weight? No one would know and no interventions could occur to help the resident. Another aide checks the weight next month, and two things can happen: The other aide could forget to get that weight and do what you did; or the weight is truly gotten and the loss is noted- if it is BIG loss- they will question why it wasn’t noticed last month. The first thing they will think about- DID YOU REALLY CHECK that weight??? Your integrity will be questioned.

Some people try to justify telling those little white lies. I guess this is a very personal issue that only you can decide upon. With your friends/family, this might be ok once in a while if NO harm can ever come of it. But I would not tell even a white lie because it will come back to me.

When we speak about honesty, integrity always pops up as well. Integrity is when others know we mean what we say and say what we mean. It means we are always a well-valued person who has no agenda that is questionable. It means we are a person who can be counted on to tell the truth. Wouldn’t you like to have some integrity? It’s a good trait and one we should be proud of.

Attitude
I always hear about so and so’s bad attitude. This is another issue that is defined by each of us in our way. To some, a bad attitude is when we see/hear others complaining all the time. For others, it might mean constant bitching about management.

For me, it means something very different. I think a certain amount of complaining, done in the right places with the right people, can be a healthy thing. It can be a stress reliever and a way to think of solutions.

A bad attitude is defined by me as one of being disrespectful towards peers and supervisors, towards residents/patients, of being short and curt with others. A bad attitude can always seeing the negatives and not looking for the good. Spreading rumors- especially about leaders is not a good thing and shows me a rotten attitude. Giving everyone or just a few a hard time- not helping with lifts, not answering call bells, are all things I roll into a group I call ATTITUDE.

Having a good attitude will make others LIKE working with you. They will seek you out and seek your thoughts and opinions. They will respect you and they will talk good about you. Isn’t this better than being spoken poorly about??

Work Ethics— Using Employer Resources
When I talk about using your employer’s resources- I really mean ABUSING these resources. I am talking about the phone, the fax machine, the computers and maybe the supplies on hand for the residents.

I know many CNA’s who are always using their cell phones while working. When doing this, you are in effect stealing time from your employer. You’re being paid to work; to provide personal care and comfort to residents; to engage with them; not to be on your phone playing Candy Crush or texting your 14 year old daughter who doesn’t know what to eat for a snack. Many agencies and organizations do not allow cell phones on the premises; other do allow and CNA’s should never take advantage of this. It’s becoming a huge problem for residents- who need care but who come second to staff’s phone time. Ideally we would leave our cells in lockers or ask the charge nurse to hold onto the phones in the med room. Staff can grab them at break time.

The same applies to fax machine and computer use.

As to using resident supplies- this is not only unprofessional and unethical it is also illegal. It is called fraud and a CNA can go to jail for this. Don’t do it. Ever.

If you find yourself being out a lot due to these slight ills, perhaps you should think about what the real reasons might be that you’re sick.


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