By: Cindy Quisenberry

Ways to maintain good relationships with your employer  Be on time for work.  Be open-minded and flexible in accepting your assignment(s).  Ask questions about things you do not understand.  Make sure you understand what your supervisor expects of you.  Be patient when you need the supervisor’s help.  Report any patient changes immediately to your supervisor. (and document that you reported them in the patient’s chart)  Talk about any problems or concerns you may have.  Be accountable and honest.

Ways to maintain good relationships with your co-workers  Offer to help co-workers.  Be supportive and available to help when needed (as long as it does not interfere with the care for your assigned patients)  Go to lunch together (if scheduling allows)  Share ideas about caregiving (but maintain HIPAA)  Call in sick only if you are ill.  Attend in-service education classes together.  Be honest and reliable.  Be open to learn about and accept cultural differences.  Respect others’ opinions and beliefs.

In-service  Educational programs taught to staff while on the job.

Questions to ask your supervisor prior to administering care  Do any patient have special needs today?  Do I need help form the supervisor at any time to give my patient a treatment?  Does the supervisor want any particular things done first?  Do any patients have any special appointments today? (applies more to long-term care)  Never try to do anything you have not been taught to do.

Types of Nursing Care  Team Nursing  Functional Nursing  Primary Nursing

Team Nursing  The charge nurse is the team leader and makes assignments based on the needs for the shift. The team cares for a whole group of patients on a unit or a wing.  The charge nurse assigns team members to specific residents, but you work with others as a team to give care.

Functional Nursing  Individuals are assigned specific tasks rather than specific residents as the focus of care. For example, you might have the responsibility of helping with all the showers one day, while another person makes all the beds., another gives all the medicines, etc.

Primary Nursing  A registered nurse or licensed practical nurse has the primary responsibility for patients’ needs. Nursing assistants work with the nurse and care for the same patients each day. Together, you area responsible for patients’ care 24 hours a day. On other shifts, other staff members carry out the plan of care (POC) that has been set by the nurse, the nursing assistant, and the patient.

Factors that influence patient care  The Patient’s Needs  Always ask “Is this what this patient needs or wants?”  Philosophy of Caring  Set by the DON – ideas about how to do things  New Treatments and Equipment (ie: wound care, etc.)  Federal and State Regulations (OSHA, Patient’s Bill of Rights, etc.)  Staffing

Job Description (Nursing Assistant)  General Purpose  To perform direct care duties under the supervision of nursing personnel and to assist in maintaining a positive physical, social, and psychological environment for the residents/patients.

Job Description  Qualifications  Pass the national certification examination.  Be a state registered Nurse assistant in good standing according to all applicable federal and state certification requirements.  Be at least 16 years old.  Be able to read, write, and follow oral and written directions, and have successfully completed elementary education.  Speak and understand English.  Have a positive attitude toward the elderly.

Job Description  Essential Job Functions  Personal Care Functions  Duties - assist residents with daily bath, dressing...  Physical and Sensory Requirements – walking, reaching, lifting, grasping, fine hand coordination, distinguish smells..  Nursing Care Functions  Duties – Provide nursing functions as directed by supervisor, including perineal care, cath care, VS’s, review care plans, report changes in resident conditions...  Physical and Sensory Requirements – bending, lifting, communicate with residents...  Food Service Functions  Residents’ Rights Functions

Job Description  Essential Job Functions  Food Service Functions  Duties – prepare residents for meals and snacks, assist resident with feeding, perform after meal care...  Physical and sensory requirement – lifting, recording intake, fine hand coordination...  Residents’ Rights Functions  Duties – Maintain confidentiality, treat residents with kindness, dignity, respect, report all resident complaints...  Physical and sensory requirements – ability to communicate with resident and remain calm under stress

Job Description  Other Job Functions  Support Functions  Safety and Sanitation Functions  Staff Development Functions  All Other Duties As Assigned

Job Functions  Recognize patients/residents as individuals.  What are their likes and dislikes  Get to know THEIR routine (ie: How do they like to start their day? What do you need help with? Do you like to nap during the day?)  Learn about their culture (influences food preferences, personal care practices, clothing, etc.)  Learn their values – come form a person’s family, upbringing, religion, education, individual experiences. (ie: being useful, making a lot of money, practicing religious beliefs, respecting persons with authority, etc.)

Job Functions  Promote the patients autonomy (self-determination).  Encourage patients to maintain their highest level of functioning  Involve patient in all decisions about their care  Maintain privacy, respect their rights, support their choices

Job Functions  Provide mindful caregiving.  Watch for any changes in their attitude or behavior and report any changes  Develop trust.  Make sure the resident feels safe  Listen to what residents tell you to do and how they want things done  Be clear to the residents about what you can and can not do for them  Be honest and open with residents  Be consistent  Dress professionally

Job Functions  Be a good employee.  Be reliable  Healthy  Considerate, cooperative, efficient with time and supplies  Dress appropriately  Follow policies  Do not use drugs or ETOH

What are Common tasks or nursing assistants, dental assistants, & physical therapist assistants?

What are Common tasks or nursing assistants?  Assist with personal care  Assist with mobility  Assist with meals  Provide physical comfort measures  Provide emotional support  Maintaining the resident’s environment

Factors That Influence Care  The resident’s needs – always the primary focus  Philosophy of caring – set by the DON  New treatments and equipment – (ie: wound care, back protection devices, etc.)  Federal and state regulations – provide a framework for caregiving  Staffing

Taking Care Of Yourself  Coping with stress  Make a list of what you need to do, start with most important first.  Explain to the patients why you cannot spend more time with them.  Exercise and get a good night’s sleep.  Eat a balanced diet.  Do something relaxing for yourself.  Talk to someone about your job and how you help others.  Talk to your supervisor – may need to take some time off.

Taking Care Of Yourself  Coping with your emotions  Talk about your feeling with co-workers or family  Take time to think about why you miss that person and what they meant to you  Let yourself feel sad.  Sometimes when you’re feeling sad or stressed, you need to get away form the situation for a while.  Talk to your supervisor.  Talk to your pastor, priest, rabbi, etc.  Remember that although you need to talk about your feelings about a situation, all patients have a right to privacy