Every Compliment is Precious

A friend of my Mom's just posted the following:

My mom has been a nurse more than 35 years. She's worked mostly in populations that don't come with a lot of "Thanks". I've seen her AMAZING work and then get yelled at because of something completely out of control. 

She's a LPN (Licensed Practical Nurse). This is the 1st nursing degree after being a nursing assistant. Many MANY RN's look down on LPNs because they have 1 less year of education. What many people don't know is that she has a 4 year education and had to drop out of her last quarter of college when her father passed away unexpectedly. She's smarter than most every nurse I know, but never flaunts it. My mom is the very definition of a classy nurse.

Am I shocked that she saved a life? Nope! She's done it hundreds of times before. I was surprised by the compliment.

My sister works in media. She is gorgeous and chatty and has an Emmy! When we get together she gets to chat all day about her very exciting and adventurous job. I stand there and say nothing. Why? Because legally, I can't say anything.

Those of us in the nursing profession (HCAs, NA-Cs, LPNs, RNs, etc) are not allowed to talk about what we do. We don't get to share the incredible and amazing work we do. We don't get to show off and our managers often use our mistakes as "learning experiences", but don't mention the amazing number of things we do right. It's really hard. 

Thank you Trisha for the compliment!! My mom is AWESOME! And she saves lives everyday. And the lives she can't save, she brings peace and comfort to. 

Thank someone giving care today. Compliments are few and far between and desperately needed. Thanks, Mom!

Some Things Need to Change

I've been thinking a lot lately. I've had some experiences that really upset me. Some things have hurt my feelings. I've been astonished at how others are treated. I really think it's time to shake up the nursing profession. I'm not convinced that those of us in nursing are quite the angels that the public makes us out to be. There is definitely some room for improvement. Here are some things rattling around in my head that I plan to start unpacking in the weeks to come:

The Nursing Hierarchy
I've had it with hearing about how "we" are "above" "them". We all have our roles to play. There are not a bazillion different kinds of nurses so we can pit one against another. Respect is where we need to start.

A Lack of Humility
I was sitting in a consultation and I heard about how another nurse told this family that the patient had pressure ulcers and how another nurse disagreed and thought it was just a rash. In this same day I heard a NA-C discuss how he was sure about a Bladder Infection and how a family member just did not understand Dementia. First: nurses don't diagnose. Second: The family usually knows more than us. Third: when we draw these snap conclusions, we totally shut our minds off to a myriad of other possibilities...including the possibility that we may be wrong.

A Lack of Kindness
We are not only unkind to other professionals, but to each other, other coworkers, families and often patients. This is so ridiculous. My boss asked me to clarify a mistake I made with another nurse (yes, nurses...good nurses even...make mistakes). That nurse not only did no clarifying, but spent 5 minutes telling me how I'd made her job so difficult (making me cry non-stop as I had agreed to cover a shift at the last minute and ended up working 12 hours straight). She didn't say "hello". She didn't say "goodbye." She just blamed. Who wants to work like that?

Begging to be Right
We spend way too much time trying to be right. Not solving problems. Not listening to what others have to say. Just determined to be right. I get migraines whenever I go into meetings. Meetings with the state, meetings with my job, meetings with family. I despise them. All people do is try to be right. We spend 20 minutes talking about how one solution or another won't work. There's little focus on the solution.

What I have written today and what I will write in the next few weeks will rumple a lot of feathers. I'm about to criticize a profession that adores it's angel image. But some things need to change. They need to change for sake of the patients, families and for, quite frankly, for ourselves. Nurses are burning out of this profession so much faster that we can keep up with. There is a Nursing Shortage with no solution coming anytime soon. If we don't figure out how to be solution-oriented-kind-humble-team-players. Nursing will die and lose it's angel image we've worked so hard to obtain.

Seahawks Giveaway!

Hey folks!

It's been awhile since I blogged, but that's going to change. I have a new book coming out soon and I have some things to talk about. Some things, you are going to be all "RIGHT ON!" and some things you are going to be "you have lost your mind" but I'm gonna throw it all out there because there are some things that we need to start discussing. Some things that have been getting under my skin & I am now on a mission to bring some change to.

In order to butter you up a little bit, I'm going to do a give-away. The Seahawks are headed to the Super Bowl, so we need to give away some Seahawks gear.

Our pastor's wife & her friend are these amazing gorgeous women. They have this small business called Bestie Bows. They make these hair bows that are just freaking adorable. They have been making Bestie Bows that are Seahawks bows. AWESOME!!!!

I'm giving away 10 of these suckers.
Comment on this blog = 1 entry
Like on Facebook = 1 entry
Comment on Facebook = 1 entry
Share on Facebook = 1 entry
Tweet = 1 entry

Sorry guys. This one is mine. :)

Delegation or Delegation

If you'd like to enter to win a $100 Gift Card to Amazon.com, read below and learn how to enter.

So I finished up the Medication Conference today that was put on by WHCA. It was cool & I got a lot out of it, but it wasn't meant for me. I wasn't overseeing medication staff. I'm not writing policies & procedures. I'm not doing Med Audits & I am NOT doing a med pass. I do training. At night I work for hospice and give meds in client's homes on a very individualized basis. I don't do anything near the definition of a med pass anymore (& if you know someone who does...take them a Snickers tomorrow...They work really hard).

I was sold on the invitation when I saw that they were going to be talking about Nurse "delegation" in the Nursing Homes.

Yep... The rumors are true. I've heard talk of this hear & there. Nothing official, just talk. In healthcare, there is talk everywhere & I work in 3 different fields of nursing (acute care, long term care & education) so I get talk from EVERYWHERE (and we all need to start being a bit nicer with our words, but that's another blog post)! So when I saw that someone from the Department of Health was going to be giving a presentation on this, I was sold and knew I had to go.

So why do I put the term "delegation" in apostrophes?

Well, anyone who knows me knows that I'm quite sarcastic. So yes, I'm being a bit sarcastic because that's who I am. But there is a bigger reason. When we talk about Nurse Delegation in Nursing Homes, we are misinterpreting the word. Let me tell you the difference:

Nurse Delegation: The Program

In Long Term Care (Assisted Living, Adult Family Homes & Individual Providers) we have known of Nurse Delegation as a DSHS Program. It's an alternate for our residents who need medication administration. It allows stable & predictable residents to get medication administration in their home without requiring them to move into an institutional setting or hire round-the-clock nurses. It's a good program & there is a good amount of data from other states that shows that Nursing Assistants who are properly trained & delegated have significantly lower med error rates than nurses. There are ALOT of requirements and ATON of paperwork.

Delegating Nursing Assistants: The Nursing Commission

 When we become nurses, we are instructed on our Scope of Practice & the expectations that come with our with our license. Nursing is becoming more & more everyday, an administrative/supervisory position. We are allowed to delegate nursing procedures to trained staff members. Nursing procedures include a lot more than medications. In Hospice we "delegate" our NACs to do bed baths, vital signs, nail care & (sometimes) housework. As part of our "delegation" we are expected to oversee their competency in these nursing tasks. In fact it is a Medicare requirement that we "supervise" (this means asking the family if they are getting their needs met) the nursing assistant every month. When we use the term "Delegating" is this respect, it isn't a PROGRAM, it's part of our SCOPE OF PRACTICE. In the same respect, we often "delegate" housekeeping staff to clean up hazardous waste & contaminated equipment. These are nursing procedures that require more than a knowledge of 409 & Dawn. They have to be trained Infection Control & know their safety risks. So "delegation" according to the Nursing Commission is not just with nursing assistants & not just with medications. It's much broader.

Medication Assistants Endorsed (MAEs)

So now, the Department of Health is offering a new program called MAEs. This is a new credential. When I've been hearing rumors of "Nurse Delegation in Nursing Homes", I saw today, that we are using the wrong terminology & it's leading to a lot of confusion. This is NOT an extension of the DSHS Nurse Delegation Program. This is a whole new credential. It's not a new REQUIREMENT. It's an optional program that facilities may utilize if they wish.
This is a good thing! This means that facilities have more flexibility in the way they provide care to the residents. It's another option and when we have more options, then residents get much better care.

I will talk more about MAEs in the weeks coming up. I hope to be able to offer the program (although I have a few hoops to jump through). I also am always interested in programs that give ur communities more options at great care & I think this may be one of them.

I am trying to wrap my head around what communities are looking for and how NAC's are feeling about adding this credential and education to their portfolio. I've put together a short & simple survey that I'd love your help in. Everyone who fills it out will be entered to win a $100 gift card to Amazon.com. If you share the survey, I will give you an additional entry. If you leave me a comment, I'll give you another entry.

Your opinion matters. Tell me what you think! Contest will go on for 2 weeks & end on September 11th at midnight.

http://tinyurl.com/MAECred

Gait Belt - 31 Days of Necessary Equipment for Caregivers

Series 31 Days of Necessary Equipment for Caregivers

Back in November, I wrote a diddy to my love of Gait Belts. I had recently been teaching a class where a student who knew everything (just ask her) loudly proclaimed to the entire class (of beginners) that Gait Belts were only used in Nursing Homes.

You probably remember the loud crack heard across Washington State as my heart broke.

The fact is that I don't teach any transfers or walking without a gait belt. There are 2 disease processes that I can think of where a Gait Belt is contraindicated, but they are so exceedingly rare that I doubt you would ever see them.

A gait belt is ESSENTIAL for every single transfer and every single time you are doing stand by assist. They:

• Give you something to hold onto
• Of note... If you are ever giving me care and use my pants to lift me and give me a wedgie...I will kick you very hard in the shins
• Also... If I am on a limited income and you tear my clothes because you are holding onto them to help me transfer, I'll fire you
• Gives security to your client. They feel supported and safe
• Protects your back if something starts to go wrong. You NEVER know when something might go wrong. Even our strongest consumers may:
• Trip on the rug
• Have knees that go out
• Fall during an earthquake
• Have an underlying infection you don't know about that would cause them to be weak
• could have a seizure
• etc, etc, etc

I also really believe that you should own your gait belt and not rely on your work to provide you with one. I think it should be worn as part of your uniform (you can wear it under your clothes) so that you have it immediately if you have to help someone up or someone needs to go somewhere.

The Cotton Webbed gait belts are the most common. They cost about $10.00. They need to be thrown into the wash every night for infection control reasons.

My favorite and what I personally use is a Nylon Gait Belt that has antiseptic imbedded in it. It's pretty (looks like the American Flag) and it's very easy to wipe down in-between clients with an alcohol wipe. It's much better for infection control. Mine also has a plastic clasp which I find easier to work with than those metal teeth things.

I do carry around gait belts when I'm doing classes and sell them at cost because I believe so strongly that caregivers should have them.

If your client doesn't like the gait belt used, try this:

• Explain the importance & safety. Focus the safety on YOU. Clients sometimes make choices they know will hurt them, but they rarely want you hurt. They depend on you. So let them know it is safer for you and they are much more likely to use it.
• Try getting a pretty design or color. Gait belts come in all kinds of colors & designs. I took care of a lady once who was part of the Red Hats group. When I brought her in a Red Gait Belt and told her it looked nice with her dress, I never had a problem again.

One last couple of tips:

• Never leave your gait belt at work. It WILL get taken.
• Always put your name on your gait belt. Otherwise it WILL get taken.

Do you use a Gait Belt?

Mentor - 31 Days of Necessary Equipment for Caregivers

Series 31 Days of Necessary Equipment for Caregivers

Day 1 - The Mentor

Every good caregiver needs a really good mentor. The nursing/healthcare world is a crazy, confusing, mixed-up, frustrating, amazing world. If we are to survive it, then we need someone who we can share the triumphs with and learn about the pit falls.

Things to look for in a Mentor

1. Someone who "gets" you ~ You need to be able to share your intimate feelings with this person, so they need to understand all your quirks and weirdness.
2. Someone with more experience than you. ~ You need someone who's been through the weirdness of healthcare and can give you some perspective in confusing times
3. Someone with a need for learning ~ You want someone who is constantly improving themselves. This will motivate you to improve yourself. Everyone should be continually learning.
4. Someone with a Positive Outlook ~ Healthcare is hard. Don't get bogged down in people who are full of drama. Find someone who enjoys problem solving and challenges and can boost your mood when you're struggling.

Do you have a Mentor? Who?

31 Days of Necessary Equipment for Caregivers

As I wind down another Core Training class, I have heard once again this statement from some students:

"We don't use that at our work. I need to talk with my boss to get one."

This is usually a Gait Belt discussion, but it also surrounds the Button puller & stethoscope.

I want caregivers to take control of their job and profession and really believe that there are some things that caregivers should have of their own and take care of.

Depending on employers to provide you with essential equipment is a recipe for disaster. Employers don't often provide 1 of everything for each caregiver which leaves you looking for items that other caregivers are likely using. If employer equipment gets lost or broken, you'll have to go without until they can reorder which puts both you and the employer at risk if someone gets hurt (you or the client).

So everyday in July, I want to talk about 1 item that I think Caregivers need to own for themselves and take care of.

Enter to Win

To celebrate the awesomeness of our caregivers and nursing assistants, I am giving away a $100 gift card to Amazon at the end of National Nursing Assistant Week. You can enter everyday and get some extra entries for doing some cool social media extras.

Contest starts tomorrow, June 13th and ends on June 20th!

a Rafflecopter giveaway

Be sure to thank a caregiver or nursing assistant today!

National Nursing Assistant Week!

National Nursing Assistant Week starts this week on June 13th and goes until June 20th. This year's theme is Nursing Assistants @ The Heart of Care.

To celebrate how awesome and integral our nursing assistants and caregivers are, I am going to raffle off a $100 Gift Certificate. You may enter daily starting on June 13th and ending on June 20th. The raffle will be available via:




Facebook www.facebook.com/EssentialTrain
Twitter @EssentialTrain
and this blog.

To enter, use the Rafflecopter app on Social Media. Bonus entries for those who comment and share this blog.

Please be sure to find and thank a Nursing Assistant this week. It's also OK to buy them a cup of coffee or take them out to lunch. Without skilled and kind caregivers and nursing assistants, health care would fall apart as we know it!

Happy Nursing Assistant Week!

http://cna-network.org/

I Was Cured Today... Were you?

I am absolutely fascinated by the study and treatment for mental illness. For several reasons. #1 being that I am a sufferer of mental illness. I struggle with Major Depression and Anxiety. When my husband came home from his nursing program last year telling me he had to write a paper on anxiety disorders, I jumped up & down and said "I can help with that. I've got most of them!"

I also became very interested in it when a friend of mine from high school took her own life in 1999. I felt absolutely awful because I didn't understand her illness and often did not give her the kind treatment that she so desperately needed. I watched her parents cry at her funeral and sitting in the pew 4 months pregnant thought "I pray I never have to go through this".

So today something really significant happened. We got a new diagnostic manual. Today was the 1st day that you could get the DSM-5 (I've written an extremely brief and over-generalized history of the DSM at the bottom if you're interested).

I've been really watching this book and it's development for awhile. I've been uber-curious about it. That was made difficult because those working on it weren't allowed to talk about it, so updates were few & far between.

I've also been very curious because of the tragedies that we've seen that I have felt have come one after another after another. While I'm not a fan of guns and won't have them in my house, I can't shake the feeling that we are completely missing the point when we are focused on guns and not of the mental status of those committing these horrendous acts. I thought for sure that with the new DSM book coming out, it would start more intense dialogue about mental illness.

Yep... I was wrong. We're still not talking very much about it.

So I was cured today of a mental illness. Shyness. Severe forms of Shyness used to be considered an anxiety disorder (medical speak is 'social anxiety disorder'). This wasn't really removed, so to speak, but was revised and additional criteria was added. So now I'm normal.

I find this fascinating, hilarious and infuriating all at the same time.

I have an excellent counselor that has really helped, but my Depression is chronic and today was a bad day. It's hard to describe how painful and crippling major depression can be. I thought I was doing fine and then out of the blue, I feel terrible low confidence, crippling sadness and tears poring out of my eyes. I sit in bed and use my "tools" to talk myself out of the negative thought patterns and focus on my blessings and health.

And as I do this, I become so angry that I truly have no answers for why I go through this and why treatments are so hard to manage. Medications for me always caused me to be worse and suicidal. Meds just don't work for me and there's a lot of evidence that show they don't work for a lot of people.

The reason I feel so angry is because since 1840 when "insanity" was recognized as a mental illness, we are really no closer to effective diagnosis and treatment. So yesterday I was mentally ill and today my anxiety disorder is cured because a bunch of REALLY educated people decided that I was 1 symptom short of ill. huh????

It's great that we keep trying to get a grip of mental illness, but I can't shake the feeling that we are still missing out on:
Prevention
Diagnosis based on biology (not symptoms)
Environment
Deep Research
Social Stigma
Cultural influences
and more...

Why is it that in my very blessed life (healthy body, healthy happy children, amazing husband, mortgage paid, good friends, etc etc), I am still trying to deal with a period of intense sadness and I still break out into tears. What's wrong with my brain? Chemicals? Electricity? Thoughts? Emotions? What??? The DSM 5 doesn't give me that answer. If I had diabetes, I'd have that answer. I'd know exactly what is wrong down to the individual cells involved. I'd know what chemicals are responsible and what organs are malfunctioning. I'd know exactly what to eat and what medicine to take. With my Depression or my parent's addiction or my patient's schizophrenia... I get none of those answers and for someone like me THAT HAS TO KNOW, I feel like all this DSM stuff does is add to my mental illnesses.

So if you see me walking by... would you give me a hug? I'll be doing more research and writing new programs and it's going to be hard for me to get through these changes. Guess it might be time for me to make another appointment and go back in to learn so new 'tools'.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


The DSM (Diagnostic Statistics Manual) is a book of codes and symptoms and resources to help diagnose mental illness.

The history of the DSM book is kind of a funny one. In 1840 "insanity" became an official illness. In 1917 the "Statistical Manual for the Use of Institutions for the Insane" was released and had 22 diagnosis.

The 1st DSM was released in 1952. This included 106 mental disorders and recognized "nervousness" and "personality disturbance" as mental illness.

The 2nd DSM was released in 1968 and had some minor word changes. It had about 180 diagnosis'. There was a reprinting of the DSM-II in 1974. This was really significant because of the emergence of gay rights and gay activism. The term "homosexuality" was replaced with "sexual orientation disturbance".

DSM-III came out in 1980. It included over 280 diagnostic CATEGORIES. Each category having several to many diagnosis'. In 1987 a revision removed "sexual orientation disturbance" and those wanting treatment for homosexuality were lumped into a category called "sexual disorder not otherwise specified." The focus at this time was not on homosexuality itself, but severe anxiety over one's sexual orientation.

The DSM-IV which is the manual we've been referring to up until today was released in 1994 with a revision in 2000. The DSM-IV started using "AXIS" system. Where patients are diagnosed on:
Axis 1 - All mental illnesses except 'mental retardation' (which has received a new name in the DSM5) and personality disorders
Axis 2 - 'mental retardation (again, so glad that name got changed) and personality disorders
Axis 3 - General physical medical condition
Axis 4 - Psychosocial and environmental factors
Axis 5 - Global Assessment functioning (which is a number scale that shows how someone is functioning with their disorder)

So today... We come to the DSM 5. We see a removal of the AXIS system and subsections of Schizophrenia added.

Book Club good for DSHS Approved Continuing Education

I read this book about over a year ago and it has completely rocked my world. It's an amazing fun story about David Ponder and how he goes from complete despair to complete success. I read it in 1 night and have read it several times since.

"Forty-six-year-old David Ponder feels like a total failure. Once a high-flying executive in a Fortune 500 company, he now works a part-time, minimum wage job and struggles to support his family. Then, an even greater crisis hits: his daughter becomes ill, and he can’t afford to get her the medical help she needs. When his car skids on an icy road, he wonders if he even cares to survive the crash.

But an extraordinary experience awaits David Ponder. He finds himself traveling back in time, meeting leaders and heroes at crucial moments in their lives—from Abraham Lincoln to Anne Frank. By the time his journey is over, he has received seven secrets for success—and a second chance. The Traveler's Gift offers a modern day parable of one man's choices—and the attitudes that make the difference between failure and success."

Cost: $55 - For the Book and a DSHS Approved Continuing Education Certificate for 4 hours (with successful completion of the course)

How it works: Read The Traveler's Gift by Andy Andrews. Follow the chat on my blog once a week for questions to discuss every week for 4 weeks.

This is an amazing book and you definitely won't want to miss it!

REGISTER here to join the club.

Be sure to email me with any questions or concerns!!

Are you Afraid? I am.

It's Time to Look at Workplace Violence

Did you see this event that happened on Monday? A resident at a Long Term Care Facility shot an employee in an altercation.

http://www.king5.com/news/Resident-at-Stanwood-senior-living-home-shoots-employee-189741271.html

While I am sad and, frankly, nauseous, I am not surprised.


Long Term Care has all the risks of hospitals:
>Visitors/Families under stress
>Confused residents
>Overwhelmed staff stretched very thin

But Long Term Care also has some additional challenges when it comes to worker safety:
>No formal security
>Employees and Residents have more intimate relationships and Professional Boundaries get blurred
>A Home-Like environment that sometimes encourages residents to bring in guns or illicit drugs (I once had to shoo out not 1, but 2 prostitutes with drugs when I served my time as Director of Nursing)
>Less restrictive visiting hours
>Doors that are not monitored

This is not a new problem. I remember being 12 years old and my mother coming home early from her job as a Nursing Assistant. She was crying because a resident had grabbed her in a completely inappropriate place, held on very tight and smacked her so hard, her contacts came out and tore. That was 14 years ago.

I also remember what her response was and as I look back on the situation, I am truly sad at her response. Not because of her by any means. My mother is the strongest person I know. Because her response had nothing to do with the violence. It was a response that workers still give today because noone has any answers to this problem.

As a single mother with absolutely no dispensable income, her response was to be thankful that the nursing home she worked at was going to replace her contacts and pay for the rest of her day off.

She didn't talk about how the administration was going to take steps to reduce this violence. She took no extra classes on how staff could protect themselves. She wasn't invited to take part in a Safety Committee that specifically focused on Workplace Violence.

And... She went back to work the very next day. Just like Healthcare Workers today do.

I don't have any easy answers. Answers to Workplace Violence aren't easy to come by. OSHA (Occupational Safety and Health Administration) does have some suggestions:
1) Employers and Employees should develop and maintain a violence prevention program as part of the facilities safety programs
2) A Worksite Analysis should be done. A Step by Step common sense look at the workplace to find existing or potential hazards for workplace violence
3) TRAINING To make staff aware of security hazards and how to protect themselves through establised policies, procedures and training.
I think a HUGE key to reducing workplace violence is to have Management Commitment to safety and Employee Involvement in the policies, procedures and training.

Whatcha Think? Comment Below and tell me how you feel.

Force the Right Brain to Work

I really think that negativity among the nursing profession is an epidemic. It's not just Nursing Assistants and Home Care Aides. It runs rampant among nurses and doctors as well. There is a reason this happens.

It is our Left Brain. Our left brain HATES stress and wants everything to be comfortable and normal. It's the Right Brain that encourages us to be weird and wonderful.

So when someone around us complains, we have a tendency to go with the complaint because commonality in peer groups is peaceful and comfortable. If we were to disagree, that enters us into conflict (mild to severe) and conflict is uncomfortable.

So we have to be mindful in order to be true to ourselves. We have to tell our Left Brain to SHUT UP and allow our Right Brain do what it does best. Our Right Brain is just aching to debate and discuss and come up with amazing solutions to problems, but we have to shut up the very loud brain and allow our right brains to work.

Right now, I am getting ready to run 42.5 miles in the next 3 days and this is the biggest part of training I have done. I have learned that when I become a bit uncomfortable and stress my body, my Left Brain starts to come up with fake pains and reasons to give up and just starts a whining. I have learned how to shut that off by using a mantra (mine is a bible verse "I can do all things through Christ who gives me strength". Yours might be "Shut it Left Brain" or "It's time to get to work Right Brain") and conscientiously switching gears and then switching your behavior.

This is the 1st of a 5 post series on negativity. I want to talk about and change negativity in 4 main areas:
Negativity towards ourselves
Negativity towards others
Negativity towards your employer
Negativity towards our profession.

I hope you'll come along with me on this ride. If you want more information on how to change your negative thinking, I suggest the following books (The running book will help you in anything because it explains so well why we think the way we do):

The Power of Habit: Why We Do What We Do in Life and Business by Charles Duhigg

Mental Training for Runners: How to Stay Motivated by Jeff Galloway

The Traveler's Gift by Andy Andrews
Look forward to a Book Club worth 4 hours of DSHS Approved Continuing Education in February

Take the Stairs by Rory Vaden
Look forward to a Book Club worth 4 hours of DSHS Approved Continuing Education in April

OMG LOL Finally! At Last! YEAH!

When I-1163 was approved, we knew that all Continuing Education would need to be approved. Since the application for Continuing Education came out in April, I have been working very hard to get BINGO and Book Clubs approved. It's been a long process and I've learned so so much. Although it was hard, it was a really great experience. I learned about writing curriculum, working with the state and making compromises. I'm not being sarcastic when I say that it was a really enjoyable experience and I learned ALOT. Sure it was long and sure it was a lot of work. But patience is definitely not a virtue of mine and it was a good opportunity to learn how to be patience.

BINGO has been approved

1. A flat 2 hours will be given for each game played
2. Students will need to pass a short test at the end in order to get their certificate (test and evaluation will be available online)
3. All students who wish to play must register (online www.EssentialTrain.net, by email essentialtraining@comcast.net or by fax)
4. Play the game for free, the certificate will cost $20
5. The winner will get $50 and the certificate for free

BOOK CLUBS have bee approved as well

1. A flat 4 hours will be given for each game played
2. Students will need to engage in the blog questions after each chapter assignment in order to get credit for the class
3. All students will need to pass a short test at the end in order to get their certificate (test and evaluation will be available online)
4. All students who wish to play must register (online www.EssentialTrain.net, by email essentialtraining@comcast.net or by fax)
5. Cost of the classes will be $50 and will include the book and certificate

Several other online classes have been approved as well and will be available online by the end of the month.

I'm SO SO SO excited. I hope you are too.

Classroom vs Online

There is a huge trend going towards online learning. It's flexible, its easy to do on your own, it's easy to meet employer requirements in the comfort of your own home. It's wonderful.

I personally love this move towards online learning and I love that anytime I have a question or want to learn a new topic, I can look something up online (often for free) and learn a new skill. It's actually what I've been doing a lot of to learn how to run a small business.

But I worry a little about online learning. Over the last week and a half, I've been teaching a group of awesome HCA's in a completely classroom environment and it's really rather awesome.

You get something from the classroom that you can't get with online learning. INTERACTION. You get to hear what others in your same situation are going through. You get to hear questions that you didn't even know to ask. You get to add your own stories and history to the learning and get immediate feedback from the instructor.

As a teacher, the classroom has been very revealing to me. Online, my students are in a whole other frame of mind, but in front of me, I get to learn about their challenges and backgrounds and experiences. This helps me to form new curriculum and learning techniques to reach more students.

The most effective learning technique for adults has shown to be a BLENDED approach. Most colleges have adopted a lot of classes this way. Part of the time is spent in the classroom and you get the interaction and the 1:1 with the teach and part of the time is done online in the comfort of your own space.

I'm a big fan of this.

What works best for you? Online - Classroom - Blended?

Ode to the Gait Belt

I so desperately want to write a poem, sing a song, enact a play that marvels at the benefits of a Gait Belt.

I was teaching a Individual Provider class last week. I came across "that" student. Every class has this student. The student who:
1) Knows Everything
2) Has been doing this for 20-30 years
3) Thinks this class is such a waste of time

It's OK. Every class has them and it's easy to humor this student. They don't bug me (well actually, they do, but that's my problem to work out). And that's not the point of this post.

This particular student announced to this class of 20 students that Gait Belts were only for NACs working in a Nursing Home.

If you remember a ear-splitting crack heard across Washington State, I'm hear to assure you that that sound was the sound of my heart splitting in 2.

Gait Belts are simple and easy ways of holding onto the client when doing a transfer or assisting to walk. They give the Home Care Aide a handle to hold onto. Even if the client is weight bearing and at relatively low risk of falling, you just never know when something may go wrong.
Their knees may suddenly give out
A cat may push them off balance (you know that cats do this on purpose, don't you)
An underlying infection may be brewing that would make them dizzy
Their blood sugar may be low
Their blood pressure may be high

Any number of things may be happening that you are not aware of that could cause even the most stable client to lose their balance and fall at any time.

PLEASE PLEASE PLEASE use a Gait Belt. They are your friend. They want to help. They want to be put to use.

BTW... If I ever need help and you use my pants to lift me and give me a wedgie, I'll kick you in the shins.

Use a Gait Belt!

HCA or NAC

On an almost daily basis, I get asked 1 question:

"Is a HCA a lesser version of a NAC"?

I may also hear:

"Are the HCA and NAC the same?"
"Is the HCA the 1st step to becoming a NAC?"
"What is the difference between a HCA & NAC?"

It's all different wording, but the implied message is the same:

'aren't they the same'?

The answer is a resounding "No."

The HCA (Home Care Aide) is different than a NAC (Nursing Assistant Certified). 1 is not a lesser version of another. 1 is not a "first step" to another. 1 is not better than the other. They are different. The focus of both is different and from one another. Both are very much needed in Nursing and a loss of one or the other would be devastating to Long Term Care.

Both have a shared set of skills:
Handwashing ~ Bed Baths ~ Transfers ~ Catheter Care ~ Fall Prevention, etc.

HCA's are much more focused on care in the home. Their role is not a highly medical one, but a highly supportive one. They support the person's strengths in the home environment (which may include Assisted Living or Adult Family Homes). They learn housekeeping, green cleaning and medication assistance.

NAC's are more focused on the nursing environment (which include Skilled Nursing Facilities and Hospitals). They support a person's recovery from a major medical problem. They learn Rehab Skills, learn how to work around medical devices (IV's, Tube Feedings, etc) and Vital Signs.

That's not to say that NAC's don't work in the Home Care Environment and HCAs never work around medical devices, but that is not the focus of their trainings.

In my experience, NACs struggle to adapt to the Home Care Environment and be less medical and HCAs need to learn more skills to go into the Medical Environment.

I think that the job of a NAC tends to be more physically demanding while the job of a HCA tends to be more emotionally demanding.

What other differences are there between NACs and HCAs?

My Letter to DSHS Department of Training

I have been getting so antsy to get approved as an instructor for the 70 hour CORE Training, that I decided to write a short email to the training department about my applications that have been turned in. It's not at all a popular opinion, but I believe my solution would really speed this process up.

Hi Paul!

I’m sorry if this is cluttering your inbox, but I would like to share my opinion with you (oh dear, I hear my mother in my head saying something not nice about everyone having opinions).

I really think that you guys should charge application fees. My view is not going to be a popular one, but I would pay you guys money if it meant you guys could get more staff and get my applications through faster. My application to be approved as an instructor for the already-approved CarePro curriculum was emailed 5-6 weeks ago and I haven’t heard a thing. I just submitted my continuing education stuff and I know that’s going to take even longer to get through.

 So here is my rationale:

1)      Everything else through the state has an application fee. My nursing license, facility licenses, facility beds, HCC will have 2 application fees, my car tabs, my registration, my kids birth certificates, death certificates. Everything else has fees and I get responses from those departments so much faster (I love you guys and believe your department is the sole place of sanity in the state, but you know it’s wrong when the DMV is faster than you ;-).

2)      If I (and others) had to pay a fee each time we submitted an application, we’d be more thorough about making sure those applications meet minimum criteria that you are looking for. I don’t want to pay a fee to have the application rejected. I’m sure you guys are tired of being the bad guys and rejecting applications left & right when they don’t meet criteria. I know that is the theme because every return email I get has something to do with being sure to meet minimum criteria including your new nifty automatic reply.

3)      I am a Community Based Trainer, which means that I will be charging students a fee to go through my programs. In the end, it isn’t costing me anything because I will be able to recoop these fees through the natural order of maintaining a small business. My ability to financially sustain my tiny little company is waiting on these applications to be approved. Maybe you don’t charge Facility-based Trainers, but only Community Based, but I think it’s fair that we pay the processing costs so that we can earn income, ya know. Maybe facility based trainers get an option for a paid fast-track or a free low priority.

OK. I’ll let you get back to reviewing applications and not reading the whining of RNs (we are an admittedly whiny group).

Thanks for all you do.

Mack

What do you think could be done to help out a very overwhelmed department in Olympia?

To Tweet or not to Tweet

The recent tragic death of Trayvon Martin has sparked an enormous amount of emotion, as it should. A few days ago, Spike Lee tweeted what he thought was George Zimmerman's address. It turned out to be an elderly couple with no relation at all to the Zimmerman's parents (he did apologized and offered to pay all the couple's expenses they incurred because they had to leave their home due to death threats). A few days later, Roseanne Bar tweeted George Zimmerman's parents actual address, but she promptly took it down. These 2 tweets (a comment 140 characters or less on Twitter) have sparked amazing news media blitz's about how celebrities should be using their immense influence for good instead of for vigilantism. But I thought it was time for a discussion of how caregiver's use social media.

1st and foremost - REMEMBER HIPPA

Social media has become a fast and quick way to share thoughts, but because it's become so fast (Jon Acuff says that 7 real days is equivalent to 43 Twitter-Years) people tend to not think about what they are putting out there. I'm here to remind you that HIPPA violations on social media sites are being watched carefully and prosecuted. Just get in the habit of NEVER EVER EVER sharing anything about work on Social Media sites if you are in healthcare. It's a slippery slope from putting photos of your new name tag to sharing photos of patients/client/residents, etc.

Few workplaces pay you to be on Social Media during your shift and supervisors ARE WATCHING. If you are doing something personal and are not on a break, you are stealing from the company. It is estimated that employers lose $10,000 a year per employee in lost productivity and they are looking for ways to get that money back. If they notice that you are on social Media sites (remember your posts are time stamped), your raise may not come this year.

A lot of employers are checking your account prior to hiring. If you post every frat boy party or Girls-only-dirty-trip to Vegas and that is the only thing on your site, you may not be hired anytime soon. If you have 30 tweets during the day about how much you hate your job. You probably won't get hired.

It is important to become vigilant about what you are putting onto your Digital Life. Your posts, shares, tweets, pins, etc say something about you. You should be sure that what you are putting into your digital world reflects the professional, caring, compassionate you that you must be because you decided to take care of others for a living.

Win a Kindle Fire and 1 year of Amazon Prime

I need to do some marketing. I need a new website and some new postcards and a new mailing campaign and new business cards... new new new.

Mostly, what I need is a new LOGO. I can't really start on all the other new stuff until I have a decent logo and my logo is very sad. I don't have the tools to properly design a good logo. I don't have anything better than WORD or Paint to design something. I designed my old logo in WORD, but it's sad and I'm definately not proud of it. Good logos are not easily reproducable and anything made is WORD can be reproduced in 2 seconds.

Also... I attended the QUITTER Conference a year ago and got a chance to listen to an amazing man named Ben Arnment. He explained that you should never design your own marketing materials. Even if you are a graphic designer (which I am), marketing design should be done by someone else. I saw his wisdom in this because when you design something, you fall in love with the work you put into it and your own artwork, that it's not easy to be objective about what is best for your business.

So I am offering a contest. Submit a logo and the winner will get a Kindle Fire and a year of Amazon Prime.

1) My colors are Purple and Orange. Any combination of 1 or both is fine
2) Contest goes from 2/27/2012 - 3/31/2012
3) The last week in March, I will put my favorite 3 designs on my website for folks to vote on
4) The winner will be announced 4/2/2012 (I can't post on April Fools, that would be weird)
HELP ME PLEASE!! Share the contest with your friends.

Submissions should be in JPEG form and emailed to essentialtraining@comcast.net with

Name – DOB – Mailing Address – Email Address – Phone Number – Favorite things in the world that are purple!

Be sure to email me at anytime with any questions or concerns. The only restriction is your imagination. Submit as many designs as you want. Encourage any number of friends to participate.