10 Traits Of Well Respected CNAs

 

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 it’s 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 co worker 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.

Question Of The Week: Consistent Staffing or Flexible Scheduling?

One of the best things we’re seeing from the Culture Change movement involves how CNA’s are assigned to the residents they care for. The consistent staffing model has gained some popularity over the past few years. Research shows how this model benefits residents and aides.

Fast forward a couple years and some challenges are presenting themselves.
In my region, hospitals, nursing homes and other health care facilities have faced a shortage of nurses and aides. In order to attract these skilled professionals, most facilities up here are moving away from the standard nursing schedule model to a more flexible one. Gas prices and travel time play into this.

Instead of scheduling staff to work the typical 4 days on, one day off, every other weekend model, where I work we have staff working all sorts of different hours. Many are choosing to work two double shifts and one 8 hour shift per week. Others have opted to work three 12 hour shifts per week. Not all of these positions require weekend work either since we have a group of staff who work two 16 hour days each Saturday and Sunday.


This means different aides working every day.
So, consistent staffing is almost impossible to achieve. Rarely does an aide work two days in a row. Nurses are doing the same thing.

Many of my co workers travel from distant towns to my facility to work the weekend only; they stay at a small local hotel (paid for by my work). The benefit of this for my co workers is using far less gas which is expensive. My employer is happy knowing the units are staffed for the weekends. Other than the weekend staff, no one is expected to work two 16 hour days in a row. Nurses are offered the popular Baylor program: Work the 32 hours each weekend and get an 8 hour bonus which equates to 40 hours pay.

Facilities have to make tough choices. Either keep the strict medical schedule model and have a shortage of nursing staff, or, offer flex hours and have adequate staffing each shift.

How does this all effect residents in nursing homes and assisted living facilities? They don’t have a core staff. There is NO one CNA who is assigned to them on a daily basis.

My own schedule has changed at my request, due to the price of gas. I was spending a quarter on my earnings filling up the gas tank, just to get to work five days a week. Now I work two double shifts and one 8 hour shift, a week. Five shifts in 3 days. I have saved a respectable amount of my income by making this change.

I like the schedule in many aspects:
-I have four days a week off to be with my family and tend to home and hobbies. I’m not nearly as stressed and tired as I was when working the 5 day schedule.
-I’m saving gas, for sure- but also wear and tear on my vehicle.
-When I am working, I keep the same assignment for the long (16 hour) day. Those residents I assist with getting am cares done, I also assist with doing the pm cares as well. If we don’t get the bath done in the morning, we know to fit it in at night. My assignment is consistent for the entire two shifts and my residents and their families really like that. We haven’t seen an increase in falls or skin issues.

This week we ask the Questions:

What kinds of schedule options do others have? Is flex scheduling allowed? If so, what kinds of shifts and hours are typical?

What’s more important? Having enough staff who may be working flexible shifts, or not having enough staff who always work the typical nursing model schedule?

Question Of The Week: Falls & Responsibility

Question:
At work today I got into trouble because one of my residents’ fell. This man is independent and never needs our help. He can do his own care- showers, dressing, walking, meals, toileting…the works. As far as I know he has never fallen before. I was busy with one of my other residents who requires total cares. I was in the middle of bathing her when the nurse came in to tell me the man fell and why wasn’t I with him? After I finished up with my lady’s care, I was told to fill out a report which wanted to know what I COULD HAVE DONE to prevent the fall; THE LAST TIME RESIDENT WAS TOILETED; THE LAST MEAL consumed- all things that had nothing to do with this fall!!

Later, I was written up for the fall. I told the DON that everyone is responsible for ALL the residents on the hall I was working. Yes, he was assigned to me, but when I am busy with other residents, my co workers should step up and cover for me. What do you think of this?

Answer:
You should not have been written up, in my opinion.

Every resident must be assigned to a CNA. It’s law. No way out of that. Every aide accepts their assignment and therefore responsibility for the residents on it. Each CNA is responsible for her assigned residents and the unit, as a whole, cannot do this.

It’s tough when bad things happen to good aides, though.

Did you read the man’s care plan? Are you absolutely sure he is independent in his cares? If so, did you check in with him to see if he needed any help, with anything? I think sometimes we assume these residents who are able to do their own care never need ANY help- and this isn’t always the case. When doing this check in, it’s always a good to ask when they’re planning to get up; what they’re bathing plans are and the like. This way, you can have some awareness that Mr. Smith is going to be up and about around 9am, and might need someone to just peek at him.

Of course this is where team work comes into the picture. Every time an aide is going to be tied up for awhile with residents, its always a GOOD thing to let as many peers know where you’re at. And include the nurse with this info as well. If you’re so inclined (and I would be) I would ask peers to keep an eye and ear out for your other residents…especially if I was going to be tied up for a longer period than usual with the other resident. A good charge nurse would make sure your other residents are covered as well. It’s a balancing act though: Asking every aide to cover the others’ residents every time personal care is being performed is just not practical.

As for the report: It’s called an Incident Report. The questions asked do indeed have everything to do with the assessment of a fall. By asking you what you could have done to prevent this fall, the answers you provide are supposed to be helpful to prevent a repeat in the future.

Did you know most residents fall because they are trying to get to the bathroom? If they’re hungry they might be trying to rush out to a meal. Usually there are other questions too on these reports- about all sorts of things. Often we don’t know the prior condition of any resident when they have fallen without a witness.

It’s very important for CNA’s to answer these things honestly…however….when we’re written up it takes away the desire for CNA’s to have any respect for these reports. These things should never be used as a means for punishment. When independent residents fall, it is NOT the direct fault of the aides. It was caused by something else. It IS up to management to figure out why the fall occurred- but by placing blame on the aides they are short changing this process. This is another example of autocratic management style- which isn’t helpful. And, I have to wonder if nursing homes with high fall rates have these kinds of managers.

I’m sorry you got written up. Of all the things CNA’s don’t have control over, the FALL tops the list. The work loads alone should tell all that it’s impossible to be everywhere at the same time- or even once an hour. A good fall prevention program begins with a trusting environment where no one is disciplined for falls unseen. Once that is in place, true prevention