Category: Question of the Week

Question:
I work at an assisted living community- in the dementia unit. Many of my co workers are from other countries; many do not speak English well, or simply refuse to speak English. I have been a mentor for CNAs for over 15 years now and I’m having a hard time mentoring these people. They can’t read English. They can’t write in English. Trying to teach them I & O charting, for example, is very difficult. Trying to explain care plans is another extremely difficult task for them. They are all CNA’s- brand new aides with no experience. This is their first job as aides. I think this is a serious problem: How do these people pass the CNA exams?? I don’t think it’s safe to employ them but my DON said I am being biased and not open to diversity.

 

Answer:
You have very legitimate concerns. Your DON is a moron to be totally blunt. He or she is placing the residents at great risk by taking such an attitude. Diversity is great; we need it in today’s world. The purpose of diversity in the workplace to have a strong representation of the community our employer is part of. Diversity brightens prospects for this community and it helps keep the local economy strong. Diversity also has drawbacks. In order to work well, the people seeking jobs must match the skillsets required by employers. Sometimes, employers lower standards and hire in people from other countries in hopes that these people will learn skills and rise up to standards.

In nursing this creates professional problems. While we want to open up opportunities for foreigners who want to learn, we have to be careful with patient safety issues. When a nursing employee of any rank cannot read such basic materials like care plans, or Care Cards, or assignment sheets, they should NOT be permitted to work. Even if this employee has passed the state CNA exam and is **certified** I believe employers must go a step further in ensuring that ALL employees can function in their hired roles. So, a test should be part of the employment application process. Potential hires should be required to read a sample care plan and explain to the hiring people, what they just read and how they interpret it. The key to such employment practices is that they be evenly applied- to ALL potential hires and not just those from other countries or who speak with accents. DOing so is fair.

My advice for you is to go back to your DON and speak again to your concerns. Ask the Administrator to join this meeting. Then, keep a log book with you at all times and note when you trained who on what…and whether you believe they understand the training. Alternatively you can ask to step down as a mentor- this is a tough choice but you might go home and sleep better knowing you had no part in this unethical practice. If you know a resident has been harmed by a employee who cannot understand English and therefore provided substandard care, you have an obligation to report it.
I’m sorry that your employee chooses to place you in such a bad position.

Question:
I work PRN at a healthcare facility. They recently hired a new CNA, full time. She is a nice person, but has no experience as a CNA. She’s been working there for a month now and still not up to speed. The problem is, I cannot work with her as my hall partner. I like her, she is a nice person! But the issue is liability if she can’t do something correctly. Other CNAs have told me they can’t work with her, either. She is very, very slow. She waits to be told what to do, instead of just doing it. She walks into the patient’s room with me and just stands there with her arms folded across her chest. I tell her “look, we have to do this together. You cannot just stand there”. Also she doesn’t know what a Hoyer lift is. She acts hesitant to touch or handle the patients. There are 30 people on the hall and I cannot do it all myself!! I need a reliable partner.

Answer:
This is a burden to experienced CNA’s for sure! Brand new, unseasoned aides seem to be more troublesome than ever before. We need good strong aides who can take initiative to get the work done as independently as possible. Unfortunately, this situation leads me to believe she had poor training in her CNA course. In this situation, I would offer her assistance during shift report if possible. Help her identify priorities. What does she need to do first? When should she ask for help? Gently correct mistakes. If possible I would meet with her after the shift ends, off the clock even. This investment in time may well pay off in terms of a smoother running unit with a capable partner. I also recommend that all of these concerns be brought to the charge nurse. She might have some options and advice as well. Another possibility is to go to the DON and ask for help with this aide. Maybe she needs more training. Maybe she needs more confidence. Maybe she needs a kick in the butt to get moving quicker…no matter what you do, don’t continue to do her work for her. You’ll burn yourself out trying. Instead, when she asks for help with lifts and transfers, tell her you will assist her when your assignment is complete. Sadly you may have to work independently from this aide if she can’t get her act together. Good luck!

Question:

My mother was a CNA for many years. My sister is a nurse. I have an interest in working in healthcare, but I’m not sure yet. Is there a way for me to try out nursing without spending a lot of money with training and/or education?

Answer:

Great question. I wish everyone who has aspirations to be a nurse could think things through a little better. Nursing is hard work. It’s not an easy way to make money. It’s not a white collar job. I see far too many people have an interest in doing this work for all the wrong reasons; once they get the training and education and degrees, they realize they are in the wrong profession. They’re left with staggering education bills. I’ve seen many RN’s practice for a year or so before realizing the work isn’t for them. Too bad! There are a couple ways to”test run” this line of work before committing to it. I would suggest applying for a job as a Resident Assistant at an assisted living facility first. Because assisted living facilities do not have specific requirements for nursing staff, the role of the RA was developed as an alternative to more costly CNA’s. RA’s so basically the same things as CNAs- and are paid roughly a dollar less per hour. Doing this work for a good 6 months to a year should give you an idea whether nursing is the right career choice. You will experience hands on personal care, assisting people with ADLs, observing nurses doing their work and perhaps work side by side with CNAs.

Second, there is no harm in taking a CNA course. Of all the options, the CNA training is the cheapest and takes the least amount of time. For about $1000.00 a person can go through the classes, get certified and work as a CNA in nursing homes, hospitals and assisted living centers. Few doctors offices and schools hire CNAs. Working as a CNA will certainly give you hands on experience you would need in order to make an educated decision about your career. Many nurses started out as CNA’s- it really helps them understand the demands of the work throughout their careers. Good luck in whatever you decide to do!