November 2012 Vol. 10, No. 11 Teamwork Teamwork is a vital component of a CNA s job. A CNA must consistently work with and exchange information with residents, fellow CNAs, nurses, and supervisors in order to ensure the proper care and safety of the facility s residents. In this lesson, CNAs will learn to recognize the skills necessary for team building, such as setting goals and good communication. CNAs will learn what is expected of a team member and examine the traits of an effective team leader. They will also learn the four keys to successful team building: planning, education, monitoring, and troubleshooting. Poor communication skills are a detriment to any team. In this lesson, CNAs will also learn specific tips to improve communication, and how to communicate a problem. They will also be able to identify the most common reasons why CNAs do not communicate problems with coworkers or supervisors. Have a good day of training, and stay tuned for next month s issue of CNA Training Advisor, which will cover mental illness. n Program time Approximately 30 minutes Learning objectives Program Prep Participants in this activity will learn how to: Identify the four steps to a successful team Describe the requirements for effective leadership Recall tips to improve communication skills Illustrate the proper way to communicate issues of concern Preparation Review the material on pp. 2 4 Duplicate the CNA Professor insert for participants Gather equipment for participants (e.g., an attendance sheet, pencils, etc.) Method 1. Place a copy of CNA Professor and a pencil at each participant s seat 2. Conduct the questionnaire as a pretest or, if participants reading skills are limited, as an oral posttest 3. Present the program material 4. Review the questionnaire 5. Discuss the answers What is a team? Being part of a team can mean something different to everyone. Promoting the same team vision is essential for the long-term success of a facility. As a group, share your thoughts on the key components of a team. What is the facility doing that is aligned with this feedback? Are there areas of concern that need to be addressed? Quiz answer key Your shortcut to compliant documentation The Long-Term Care Clinical Assessment and Documentation Cheat Sheets is the ultimate blueprint for how to provide resident-centered care. This electronic-only resource provides nurses with a thorough list of what to check and what to document during every shift, based on the specific circumstances of a given resident. Best of all, the new electronic format of this content enables long-term care clinicians to easily search for the condition they need to treat and access the appropriate checklist within seconds. 1. b 2. c 3. c 4. d 5. a 6. c 7. b 8. d 9. c 10. b For more information or to order, call 800-650-6787 or visit www.hcmarketplace.com/prod-9750.
Page 2 CNA Training Advisor November 2012 CNAs are just one segment of the greater clinical team within a longterm care facility and often look to nurses for immediate leadership, to establish assignments, and to maintain continuity on the floor. Nurses can and should provide these things, but they rely on CNAs too. Without consistent and thorough communication from CNAs regarding the care of residents, nurses lack information that is necessary to make critical decisions. Barriers in and communication between CNAs and nurses or other staff members can have extremely detrimental effects on residents. To create a successful clinical team, facilities must eliminate those barriers, improve communication, and promote a mentality of collaboration among all staff members. The basics of A team is a group of people who work together toward a common goal. Members of a team combine their knowledge and skills to do a better job than they could do individually. A person can be self-reliant and independent, but in many situations, working with others can produce the best results. In a healthcare facility, people often work in teams to meet their patients needs. The members of a care team must be able to work together and share responsibility to provide the most appropriate and best care to their patients. In fact, getting along with your team members may be as important to your patients health as knowing proper care procedures. Team building is the process of enabling your team to reach its goal. Everyone on a team has a responsibility to help everyone else. The main goal should be the same for everyone, and all team members should agree on their purpose and the results they want. Relocating? Taking a new job? If you re relocating or taking a new job and would like to continue receiving CNA Training Advisor, you are eligible for a free trial subscription. Contact customer serv ice with your moving information at 800-650-6787. For a team to be as successful as possible, members should do the following: Agree on team goals and plans Develop good communication skills Work together to achieve goals Set a good example for others on the team Assess the strengths and weaknesses of the team Four steps to success A team must have clear goals, trust, willingness to assist each other, and good morale to do well. Each person must feel as though he or she contributes something important. Take the following steps to ensure your team s success: 1. Plan. Team members should work according to a plan established by the leader, the group, or the policies of the facility. Objectives and procedures should be clear. 2. Educate. A team should have all of the training and information needed to successfully complete a task before team members begin it. 3. Monitor. A team should observe progress through discussion, feedback, and review. Members should meet regularly to examine how well their team functions and to identify its strengths as well as barriers to its effectiveness. 4. Troubleshoot. Teams must deal with issues as they come up. Members need to determine whether a consistent problem is the result of a poor plan, improper facilitation, bad work habits, or another cause and find a solution. For example, imagine that your team can t keep up with chair alarms sounding in your facility when residents stand up. The interdisciplinary care team may need to readdress the necessity of chair alarms for each resident or create a new system to respond to them. Effective leadership A leader can make or break a team. You ve probably had many leaders in your life some good, some bad. Someday, you may be chosen to lead a task. A good leader, whatever the situation, should follow these steps: Delegate. No leader can do everything on his or her own. Recognize team members strengths and delegate jobs accordingly. Editorial Board Project Director: Elizabeth Petersen Editor: Melissa D Amico mdamico@hcpro.com CNA Training Advisor (ISSN: 1545-7028 [print]; 1937-7487 [online]) is published monthly by HCPro, Inc., 75 Sylvan Street, Suite A-101, Danvers, MA 01923. Subscription rate: $149/year; back issues are available at $15 each. Copyright 2012 HCPro, Inc. All rights reserved. Printed in the USA. Except where specifically encouraged, no part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro, Inc., or the Copyright Clearance Center at 978-750-8400. Please notify us immediately if you have received an unauthorized copy. For editorial comments or questions, call 781-639-1872 or fax 781-639-7857. For renewal or subscription information, call customer service at 800-650-6787, fax 800-639-8511, or email customerservice@hcpro.com. Visit our website at www.hcpro.com. Occasionally, we make our subscriber list available to selected companies/vendors. 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November 2012 CNA Training Advisor Page 3 In order to grow, team members need to be given responsibility, authority, and accountability. Anticipate the group s needs. If you know from experience that a team member has trouble with a particular task, make sure you re available for assistance if needed. If your team has been working especially hard, give team members a break or a small reward for their efforts. Build team members self-esteem. This is as simple as telling someone he or she did a good job. When people feel good about themselves, their attitudes are better and their work is more productive. Communicate. Clearly express what you expect from people. If they do not meet expectations, tell them why and how to improve. Ask for and listen to your team members opinions. Improving communication Focus on these tips to improve communication with other staff members within the facility: Listen. Don t assume you know what someone is going to say. Don t interrupt. Just as you want your supervisor to listen to concerns, listen to his or her response. If you re confused, say so. Try to see the point from the other person s perspective. Be honest. Suppose a piece of equipment broke when you were using it. You may be afraid of punishment and keep the information from your supervisor because you think he or she will be angry. Explain what happened. Don t leave it for someone else to discover. Be understanding. If nurses or managers don t respond to you immediately, understand that they are busy and may have other things on their mind. Although your concern may be important, they may have more pressing issues to deal with before they can address it. Don t be defensive. Suppose you tell your supervisor about a coworker whom you believe is mistreating a resident, but he or she responds abrasively or asks whether you can prove it. Because of this response, you think your supervisor doesn t believe you and get angry. It s common to become defensive when you think someone doesn t understand or believe you, or that he or she isn t listening to you. Stay calm and explain the situation again. Communicating issues of concern Something that could be easily overlooked, such as a wobbly table or a loose wheel on a walker, could seriously jeopardize the safety of a resident. Although such a thing may seem like just another worry in an already busy day, it s essential to the success of a facility to ensure constant communication. Some of the problems or issues CNAs should report include: Changes in the status or symptoms of a resident. If a usually cheerful resident suddenly won t get out of bed or a resident s blood pressure or pulse changes, a CNA needs to tell the supervising nurse. A change in demeanor or vital signs could be an indication of something serious. Broken or malfunctioning equipment. If you discover that a piece of equipment is broken or not functioning properly, report it immediately. In an environment where residents have limited mobility, fall easily, and rely on lifesaving equipment, everything must work correctly at all times. Additionally, speak up about shortages of briefs or linens, as these are important to quality care. Incompetent coworkers. If a CNA appears to be behaving recklessly doing his or her job incorrectly or without regard for the well-being of a resident his or her immediate supervisor should be notified. Imagine that one of your coworkers tells a resident to void in bed because he or she is too busy to bring the resident to the bathroom. You need to report this type of behavior. Abusive or inappropriate behavior. CNAs have an ethical obligation to protect their residents. Elder abuse can be physical, emotional, financial, or sexual. If a CNA overhears or sees a visitor behaving inappropriately toward a resident by abusing or otherwise taking advantage of that resident, he or she must inform a supervisor. Note that it s best to go to an immediate super visor with a problem. The charge nurse, the nursing supervisor, or (as a last resort) the director of nursing are your best bet. Don t go to an administrator or social worker first unless the issue directly concerns that person. This is because all members of a facility are busy with their daily duties, but your direct supervisor should be able to take the time to listen to your concerns. Communication problems In an ideal world, everyone would communicate freely and honestly, and there wouldn t be any barriers to getting information to the proper person at the proper time. In reality, though, there are several reasons why staff may not speak up about a problem or concern. The hierarchy of a facility including the relationship between CNAs and nurses can be intimidating and may not encourage open communication. Don t miss your next issue! 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Page 4 CNA Training Advisor November 2012 CNAs cite the following as major reasons for not telling supervisors about issues they are concerned about: Don t want to complain. Some CNAs are worried that their concern will sound like a complaint. Supervisors should let them know that it s okay to express their concerns and that they don t need to fear being negatively judged. Don t want to get anyone in trouble. Members of a facility s staff work closely together and often spend more time with each other than with any other people in their lives. As such, friendships form, and it can become difficult to objectively look at a situation involving a coworker. Regardless, it is the responsibility of CNAs to care for their residents above all else. Think their concerns are ignored. In some facilities, there is a clear power distinction between the CNAs and the nursing supervisors. CNAs may think that they are not respected or that their input doesn t matter. It s the job of management to create an environment that facilitates communication. Don t want to appear nosy or feel that it s none of their business. Nobody wants to look like a busybody. Some people keep their mouths shut because they don t want to create the impression that they are too concerned with other people s business. But CNAs are the eyes and ears of a facility if they don t speak up, no one will. Don t think anything will be done about it. Maybe in the past you mentioned that a resident s hearing aid has gone missing and nothing was done about it. That doesn t mean that no one listened. The day-to-day operations of a facility take many hours and many dollars. Some things require time or money that is not immediately available. Communicate your concerns to management anyway, especially about ill-functioning equipment and processes. Assume management knows. The nursing supervisor spends hours every day walking the floor and speaking to CNAs; he or she would know if something is wrong, right? Not necessarily. Just like a CNA, a nurse has a lot on his or her plate and may not notice something that seems obvious to the rest of the staff. Never assume that your supervisor knows about your concerns. How do you spell TEAM? To keep some key concepts in mind, just think of how to spell TEAM: T is for Trust: Teamwork requires open and frequent communication and feedback. Each member has individual strengths; appreciate them. Build mutual respect and support. E is for Education: Educate yourself and share what you learn with others. Mentor inexperienced members of the team and learn from them. Take advantage of on-the-job-training programs. A is for Assistance: Interdependence is when one team member depends on another to provide something that helps the team member do his or her job. When people assist each other, things go better and faster. M is for Morale: Maintain a good attitude. High efficiency can be achieved only if all members of the team cooperate and work harmoniously. n Questions? Comments? Ideas? Contact Associate Editor Melissa D Amico Email mdamico@hcpro.com Phone 781-639-1872, Ext. 3505 CTA Subscriber Services Coupon q Start my subscription to CTA immediately. Options No. of issues Cost Shipping Total q Electronic 12 issues $149 (CTAE) N/A q Print & Electronic 12 issues of each $149 (CTAPE) $24.00 Sales tax Order online at (see tax information below)* www.hcmarketplace.com. Be sure to enter source code Grand total N0001 at checkout! For discount bulk rates, call toll-free at 888-209-6554. *Tax Information Please include applicable sales tax. Electronic subscriptions are exempt. States that tax products and shipping and handling: CA, CO, CT, FL, GA, IL, IN, KY, LA, MA, MD, ME, MI, MN, MO, NC, NJ, NM, NV, NY, OH, OK, PA, RI, SC, TN, TX, VA, VT, WA, WI, WV. State that taxes products only: AZ. Please include $27.00 for shipping to AK, HI, or PR. Your source code: N0001 Name Title Organization Address City State ZIP Phone Fax Email address (Required for electronic subscriptions) q Payment enclosed. q Please bill me. q Please bill my organization using PO # q Charge my: q AmEx q MasterCard q VISA q Discover Signature (Required for authorization) Card # Expires (Your credit card bill will reflect a charge from HCPro, the publisher of CTA.) Mail to: HCPro, P.O. Box 3049, Peabody, MA 01961-3049 Tel: 800-650-6787 Fax: 800-639-8511 Email: customerservice@hcpro.com Web: www.hcmarketplace.com
November 2012 Vol. 10, No. 11 Teamwork Mark the correct response. Name: Date: 1. A team is a group of people working together toward. a. an end b. a common goal c. a cash prize d. personal recognition 2. Changes in a resident s symptoms should be immediately communicated to. a. another CNA b. the director of nursing c. the supervising nurse d. the administrator 6. When a problem arises, when should a team deal with it? a. At the annual meeting b. Never c. As soon as possible d. When it becomes too serious for team members to ignore 7. CNAs should be wary of how they voice concerns to nurses because they don t want to sound like they re complaining or whining. 3. What is one thing a good leader should do for his or her team? a. Do as much work as possible alone b. Don t bother the team with problems and issues c. Tell people what you expect from them d. Don t expect too much from people 4. If a CNA discovers broken or malfunctioning equipment, he or she should. a. fix it on his or her own b. cover it up so others don t blame the CNA for the damage c. ignore the damage; someone else will take care of it d. immediately report the damage to a supervisor 8. To improve communication within a facility, what should staff members do? a. Be honest b. Be understanding c. Listen d. All of the above 9. Which of the following is not something teams should do to be successful? a. Agree on the team s goals and plans b. Work together to achieve goals c. Ignore the concerns of other team members d. Assess the strengths and weaknesses of the team 5. CNAs have an ethical obligation to protect their residents from all forms of elder abuse, even if it means reporting inappropriate actions of a coworker. 10. The main goal of a team should be the same for everyone, but all team members don t need to agree on their purpose and the results they want. A supplement to CNA Training Advisor