In the Know
Do your CNAs distinguish between objective and subjective observations? When was the last time you reminded them that for information to be objective, they must be able to see, hear, feel or measure it, or have it confirmed by another person? If the reports from your nursing assistants tend to sound like opinion instead of fact, they may need to brush up on this skill.
As you know, one of the primary roles of the nursing assistant is to collect and communicate information. The information is collected by observing clients and communicated by reporting to the nurse and/or documenting in the client’s chart. So, how good are your CNAs at observing and communicating important information about their clients?
For example, do they know the difference between information that is urgent, important or significant? And do they communicate these three types of information appropriately? For example, urgent observations are those that are immediately life threatening. If your aides consider a client going one day without a bowel movement urgent information, you might want to give them a review of this topic.
Do your CNAs distinguish between objective and subjective observations? When was the last time you reminded them that for information to be objective, they must be able to see, hear, feel or measure it, or have it confirmed by another person? If the reports from your nursing assistants tend to sound like opinion instead of fact, they may need to brush up on this skill.
In both acute and long term care, things can change fast for your clients. Your nursing assistants need to be knowledgeable about what is normal so they can recognize what is abnormal. This applies to vital signs, mental status, elimination, the skin and so much more. While most CNAs learned the “norm” in school, it is helpful to give them a refresher on once in a while.
Here are some inservice ideas to help your CNAs hone their observation and reporting skills:
- Spend an hour giving an overview of the human body. Review each of the body’s miraculous systems…and discuss how important each one is to a person’s overall health. Then, your CNAs can use what they learn to help their clients live healthier, longer lives.
- Present an inservice about basic human needs. Remind your nursing assistants that they aren’t caring for bodies, they are caring for people. And, all their clients have very basic needs, including physical and psychological needs–fundamental needs that are the same, regardless of where or how they live. Review the five levels of Maslow’s hierarchy of human needs.
- Teach them about the normal aging process so they know what to expect when working with elderly clients. For example, do your aides know that the elderly have fewer sweat glands, so they have trouble keeping their body temperature stable? Or that the heart muscle becomes less “elastic” so it pumps with less force? To make up for this, the heart beats more frequently.
- Give your aides a vital signs update. While many organizations rely on technology to measure vital signs, your CNAs should never lose the basic skills of taking a client’s temperature, pulse and blood pressure. And, since pain is considered the fifth vital sign, be sure to provide information about pain management.
- Review reporting and/or documenting client care information. During this inservice, remind your nursing assistants that if they are providing care for clients without documenting thoroughly and carefully, your organization may not get reimbursed for their work. Or, if they are documenting care that they did not perform, your organization may not get reimbursed, and could possibly be fined for the false records. Both situations result in a financial loss. And, a loss for the organization is a loss for you, your CNAs and your clients!
If you don’t have the time to put together inservices on one or more of the above topics, remember that, at In the Know, we have done it for you. You can click on the links throughout this article to see what we have to offer. And, if you have ideas for inservices that you’d like our team of nurses to write, please send an email to [email protected]. We’d love to hear from you!
