Whether you are new to the field of nursing or you are a veteran and your resident is new to your facility, communicating and conversation is vital. How do you start a conversation with a resident? Does your resident require a message sent to the doctor, nurse or family member? How do you go about doing that? Communication is a skill set for the CNA; you must speak clearly, calmly, in a tone that abrasive and comforting not piercing or threatening.
A) Introduce yourself: If you are working with a new resident, remember they may be a little tense because of the new environment. Some long-term care facilities are more like hospitals instead of a home, so no matter how hard you try, the resident will still feel like they are in a hospital setting. Assisted living residents are different, most are homey and comfortable. Your job is to put your resident at ease. “Hi, Mr. or Mrs. Smith, I am Sharon; I will be your aide for today.” Be clear; speak in a comforting tone and smile, trying not to show too much teeth that might make your resident a little nervous.
B) Attitude: The right attitude speaks volumes. Save the fun bubbly personality for later on in the relationship with your resident. Keep your voice light, cheery and comforting but do not go overboard with the bubbliness. If you have a naturally high loud voice, tone it down to a comforting level. Loud boisterous persons can have the opposite effect of calm and reassurance.
C) Ask Questions: Ask short questions that require only a word or two answers. Like, “How are you today?”, “Can I get you a glass of water?”, “Would you like me to turn the television on for you?”
D) Answer their questions: Explain as much as you can about whom you are, where they are and answer their questions to the best of your ability. If you do not know an answer, do not make one up, tell them you will get that answer for them as soon as you can and do it!
E) Respect: Show respect by listening. If you are having a problem understanding, or your resident is having the difficulty, slow down, speak clearly and ask questions. Repeat back to them what they have said to you. Do not interrupt them, let them finish speaking,
F) Sending messages: Sometimes a resident may have a request to see the doctor or the nurse. Maybe they just want to inform the doctor or nurse about something. Take a note pad and write it down. Address the note to the appropriate nurse, even if it is for the doctor, and put it in her mailbox or slot, if she or he is not on duty, or you can leave it in the patients chart.
G) Sending Messages to family: Sometimes a resident may want to send a message to their family or a friend if the resident is able to make the call, help him or her with it. If you have to do it make sure to state your name and state why you are calling relate the name of the resident and pass the message on word for word?
Starting a conversation the right way with your resident will help put them at ease and is vital to building trust between you and the person you are caring for. Speak to them, as you would have them speak to you. Be clear and understanding, use a soothing tone, smile, and be relaxed. Leaving messages, remember to state your name clearly and the reason you are calling and rely the message word for word as the resident asks. Make sure to verify the message you have sent and has been received and inform the resident.
Showing posts with label CNA Skill. Show all posts
Showing posts with label CNA Skill. Show all posts
Monday, May 6, 2013
CNA Skill: Communicating With The Hearing Impaired
Working with the hearing impaired can be challenging and frustrating for the CNA even on a good day. Communicating with people on a daily basis can be challenges, making one, clear to a person with a hearing impairment can be even more so. It can be frustrating for both the aide and the resident and family members. It is vital to understand and make yourself be understood by your resident:
A) Approach your resident from the front or the side, so that they can see you and gently touch them on the arm or the shoulder, try not to startle them, if they can see you coming from the front or the side, they are more comfortable and at ease.
B) Background noise: Nothing is more frustrating than trying to sort out different sounds and conversations, especially if there is a lot of back ground noise going on. Turn the volume on televisions and radios down, close doors to block out noises from hallways and loud speakers. The less background noise the better able the resident will be able to understand you. If the resident is in a noisy dining area, either move them to a quieter location to speak with them or get down in front of them so they can see your face and your mouth. Avoid talking with your resident while your back is turned to them or from another room. Always look your resident in the face and let them see you, talk clearly and loud enough for them to hear you.
C) Hearing aids: Often times a resident will have hearing aids. Keep them clean and within reach of your resident. Help them adjust the volume level on the devices. If the volume is up to high the resident will be assaulted by loud pitch whistles, causing them discomfort.
D) Sign Language: Sign language, facial expression and lip reading help the resident understand. If you know sign language and your resident does to, use it. Note pad and pencil or pen, is another form of communication that works well with the hearing impaired. Use a black sharpie and make your words and letters clear, bold, and large, so that the resident can read it. The darker the better.
E) Speaking: When speaking to the resident with hearing loss, face them; keep your words short, simple and clear. “Mr. Todd, I am going to make your bed now.” speak slow and clear. Do NOT speak to them as if they were children and do not scream at them, look them in the face and talk to them. You may have to repeat yourself many times, but a good aide will look for ways to make communication much easier. Hand gestures, lips reading, notes, hearing aids, and pictures are all good communication aides.
F) Speak clearly and slowly: Lower you voice from its normal pitch and speak clearly and loudly, do not scream or yell that gives the resident the wrong impression and cause him/her to think you are angry. Some people can hear things in different pitches; work with your resident to see which technique works for both you and them. Pronounce numbers singly. For instance, 67 can be said as “Six Seven” otherwise it might sound like, “Stick a pin in your oven.” Alternatively, something like that. If you are helping a resident with letters and spelling, say it like this “B=boy, r=?…” p and b and d can often get confusing so pronounce your letters clearly.
G) No Hearing Aide? Try using your stethoscope. Put the earpieces in the resident’s ear and speak into the bell at the bottom. If you can hear a heartbeat, they may be able to hear you. Use tools that maybe out of the normal toolbox. Scrabble pieces can be used in place of writing, flash cards, note books, whatever it takes use it.
H) Change up the vocabulary: If a resident is having a hard time, understanding a word or a phrase, change the word or the phrase make it simple. “I’m going to give you an emesis basin” can be rephrased to, “Here is something to spit in.”
I) Single topic conversations: Keep to the conversation at hand. Jumping from one subject to another can get confusing and frustrating for the resident. Keep your conversation brief and to the point and stay on point.
J) Understanding your Resident: if you resident are trying to communicate with you and you cannot understand them, slow them down and have them repeat themselves slowly. Always repeat back to them what they have said to you. Repeating can help clear up confusion. If the resident is using an interpreter, speak directly to your resident. You are communicating with the resident not their interpreter.
K) Finishing up: Let your resident know when you are done with your work in their room and that you are leaving. Make sure they are situated so they are safe and make sure they have their call button within easy reach. Place remote controls, call buttons, water and other needed items, within easy reach of your resident.
A) Approach your resident from the front or the side, so that they can see you and gently touch them on the arm or the shoulder, try not to startle them, if they can see you coming from the front or the side, they are more comfortable and at ease.
B) Background noise: Nothing is more frustrating than trying to sort out different sounds and conversations, especially if there is a lot of back ground noise going on. Turn the volume on televisions and radios down, close doors to block out noises from hallways and loud speakers. The less background noise the better able the resident will be able to understand you. If the resident is in a noisy dining area, either move them to a quieter location to speak with them or get down in front of them so they can see your face and your mouth. Avoid talking with your resident while your back is turned to them or from another room. Always look your resident in the face and let them see you, talk clearly and loud enough for them to hear you.
C) Hearing aids: Often times a resident will have hearing aids. Keep them clean and within reach of your resident. Help them adjust the volume level on the devices. If the volume is up to high the resident will be assaulted by loud pitch whistles, causing them discomfort.
D) Sign Language: Sign language, facial expression and lip reading help the resident understand. If you know sign language and your resident does to, use it. Note pad and pencil or pen, is another form of communication that works well with the hearing impaired. Use a black sharpie and make your words and letters clear, bold, and large, so that the resident can read it. The darker the better.
E) Speaking: When speaking to the resident with hearing loss, face them; keep your words short, simple and clear. “Mr. Todd, I am going to make your bed now.” speak slow and clear. Do NOT speak to them as if they were children and do not scream at them, look them in the face and talk to them. You may have to repeat yourself many times, but a good aide will look for ways to make communication much easier. Hand gestures, lips reading, notes, hearing aids, and pictures are all good communication aides.
F) Speak clearly and slowly: Lower you voice from its normal pitch and speak clearly and loudly, do not scream or yell that gives the resident the wrong impression and cause him/her to think you are angry. Some people can hear things in different pitches; work with your resident to see which technique works for both you and them. Pronounce numbers singly. For instance, 67 can be said as “Six Seven” otherwise it might sound like, “Stick a pin in your oven.” Alternatively, something like that. If you are helping a resident with letters and spelling, say it like this “B=boy, r=?…” p and b and d can often get confusing so pronounce your letters clearly.
G) No Hearing Aide? Try using your stethoscope. Put the earpieces in the resident’s ear and speak into the bell at the bottom. If you can hear a heartbeat, they may be able to hear you. Use tools that maybe out of the normal toolbox. Scrabble pieces can be used in place of writing, flash cards, note books, whatever it takes use it.
H) Change up the vocabulary: If a resident is having a hard time, understanding a word or a phrase, change the word or the phrase make it simple. “I’m going to give you an emesis basin” can be rephrased to, “Here is something to spit in.”
I) Single topic conversations: Keep to the conversation at hand. Jumping from one subject to another can get confusing and frustrating for the resident. Keep your conversation brief and to the point and stay on point.
J) Understanding your Resident: if you resident are trying to communicate with you and you cannot understand them, slow them down and have them repeat themselves slowly. Always repeat back to them what they have said to you. Repeating can help clear up confusion. If the resident is using an interpreter, speak directly to your resident. You are communicating with the resident not their interpreter.
K) Finishing up: Let your resident know when you are done with your work in their room and that you are leaving. Make sure they are situated so they are safe and make sure they have their call button within easy reach. Place remote controls, call buttons, water and other needed items, within easy reach of your resident.
CNA Skill: Assisting Residents Who Have Memory Loss, Confusion or Understanding Problems
Assisting residents with memory loss, confusion and understanding problems make up a decent percent of residents in long-term care facilities. People with head trauma, strokes, various diseases and disease processes and some medications and treatment therapies affect the brains function in memory, clear thought and problem solving skills. The CNA needs to know how to work with and around these issues with dignity, grace and respect for the resident.
A) Knock and Announce: Knock on the resident’s door, call the resident by name, and introduce yourself. Be clear, kind, compassionate and respectful.
B) Keep it Simple: keep your conversation, short, clear and to the point.
C) Instructions: Make sure your instructions are clear and to the point, always use the resident’s name, “Miss Ann, please put your dentures in this cup.”
D) Do not Talk Down to them: it does not matter who you are talking to or how they talk to you, never talk down to your resident. Speak to them as an adult, use simple words and phrases, speak normally, not too fast and not too slow. Pronounce your words completely and use a soothing tone of voice at all times.
E) Listen: Listen to your resident. They can surprise you and they often know more than the aide realized. So listen.
F) Mood: Residents can be sensitive to mood. If you are overwhelmed, frantic or in a hurry your resident will pick on that and can become agitated and incorporative, take a breath and collect yourself before entering the residents room. Keep your mood neutral and light, they respond in kind.
G) Decisions and Agitation: If you offer too many choices to your resident at one time, they can become confused and upset. Limit the choices to two or three, manageable. Ask the resident if they want peanut butter and jelly sandwich or a cheese sandwich. Instead of, what kind of sandwich do they want? For dressing, give the men a choice of shirt to wear from two, let them choose between two pairs of pants. Keep their options limited to avoid agitation and confusion.
H) Frustrated: If you see your resident becoming frustrated, take a break and slow down. Let them collect themselves, calm down, and proceed slowly.
I) Memory: Many residents are not aware that they are living in the present. Do not play into their delusions. Keep them grounded in today. If they call you by their child’s name and they think, it is May 2, 1970, gently tell them who you are and where they are and the correct date.
J) Understanding Problems: Help your resident as much as you can to understand what they are doing. If they are having problems talking, help them with tools. If they are having problems communicating how they are feeling, help them to calm down and take a few breaths. If they can’t figure out or remember how to use a fork, gently and patiently show them. You may have to do this a hundred times or more. Remember they are just as frustrated as you are, but the calmer you remain the calmer they will remain.
A) Knock and Announce: Knock on the resident’s door, call the resident by name, and introduce yourself. Be clear, kind, compassionate and respectful.
B) Keep it Simple: keep your conversation, short, clear and to the point.
C) Instructions: Make sure your instructions are clear and to the point, always use the resident’s name, “Miss Ann, please put your dentures in this cup.”
D) Do not Talk Down to them: it does not matter who you are talking to or how they talk to you, never talk down to your resident. Speak to them as an adult, use simple words and phrases, speak normally, not too fast and not too slow. Pronounce your words completely and use a soothing tone of voice at all times.
E) Listen: Listen to your resident. They can surprise you and they often know more than the aide realized. So listen.
F) Mood: Residents can be sensitive to mood. If you are overwhelmed, frantic or in a hurry your resident will pick on that and can become agitated and incorporative, take a breath and collect yourself before entering the residents room. Keep your mood neutral and light, they respond in kind.
G) Decisions and Agitation: If you offer too many choices to your resident at one time, they can become confused and upset. Limit the choices to two or three, manageable. Ask the resident if they want peanut butter and jelly sandwich or a cheese sandwich. Instead of, what kind of sandwich do they want? For dressing, give the men a choice of shirt to wear from two, let them choose between two pairs of pants. Keep their options limited to avoid agitation and confusion.
H) Frustrated: If you see your resident becoming frustrated, take a break and slow down. Let them collect themselves, calm down, and proceed slowly.
I) Memory: Many residents are not aware that they are living in the present. Do not play into their delusions. Keep them grounded in today. If they call you by their child’s name and they think, it is May 2, 1970, gently tell them who you are and where they are and the correct date.
J) Understanding Problems: Help your resident as much as you can to understand what they are doing. If they are having problems talking, help them with tools. If they are having problems communicating how they are feeling, help them to calm down and take a few breaths. If they can’t figure out or remember how to use a fork, gently and patiently show them. You may have to do this a hundred times or more. Remember they are just as frustrated as you are, but the calmer you remain the calmer they will remain.
CNA Skill: Communicating With Residents Who Have Problems with Speech
Many residents in a long-term care facility have difficulty with speech and communicating their needs and wants. Noises and grunts are sometimes a residents way of communicating with their caregiver/CNA. Depending on the cause of the speech difficulty, the resident may or may not be able to understand what they are saying or what is communicated to them. Within time, you as a CNA will come to know and understand the resident and have them understand you as well, but it takes time. It can be just as frustrating for your resident as it is for you.
A) Knock, Announce, Approach: knock on the door, call out to the resident by name, and introduce yourself. Approach your resident from the front or side, in a non-threatening manner. Be respectful.
B) Conversation: keep conversation to the point and brief and often.
C) Use Simple Direct Questions: Ask simple yes or no questions; “Are you comfortable?”, “Are you hungry?”, “You’re smiling are you happy?” simple short questions asked in a respectful adult tones. If speech is problematic, ask the resident to nod or shake their head for yes or no. If head responses are not possible, ask the client to blink once for yes and twice for no.
D) Allow time for answers: You resident may understand what you are saying but it may take them a moment to respond. Be patient and wait for them to answer in their time.
E) Communication tools: There are all kinds of things and objects and aide can use to help their resident communicate effectively. Note pads and pens, scrabble tiles, flash cards, pointing, picture boards and maybe charades. If it works, use it.
F) Feedback: If you think you know what it is your resident wants, repeat it back to them as simply as you can, to make sure that is what they are communicating. Do not pretend to understand the resident. If you do not understand, what the resident is communicating, try again. If it becomes too frustrating, ask for help. Guarantee there is an aide who can understand your resident and they can help with the communication process.
G) Emphasize the positive aspects of the communication: Let your resident know that you understand them, by repeating back what they have communicated to you, smile and show your resident you understand.
H) Time: Allow adequate time for the conversation between you and your resident. Don’t leave a conversation incomplete. If you have to explain to your resident that you have to leave but will be back to finish the conversation as soon as you can.
I) Encourage: Allow time and encourage you resident to point to objects, pictures, words that will help communicate their need to you.
J) Attitude: Giving your resident the impression that you are in a hurry or frustrated is not going to help. Keep your attitude light, relaxed, and pleasant. Actions speak louder than words, and your attitude will set the stage for ease or difficulty in communication.
K) Let the Resident know you are leaving: let the resident know when you are done, making sure the resident is clean and safe, with their call button; needed personal items and water are within reach.
A) Knock, Announce, Approach: knock on the door, call out to the resident by name, and introduce yourself. Approach your resident from the front or side, in a non-threatening manner. Be respectful.
B) Conversation: keep conversation to the point and brief and often.
C) Use Simple Direct Questions: Ask simple yes or no questions; “Are you comfortable?”, “Are you hungry?”, “You’re smiling are you happy?” simple short questions asked in a respectful adult tones. If speech is problematic, ask the resident to nod or shake their head for yes or no. If head responses are not possible, ask the client to blink once for yes and twice for no.
D) Allow time for answers: You resident may understand what you are saying but it may take them a moment to respond. Be patient and wait for them to answer in their time.
E) Communication tools: There are all kinds of things and objects and aide can use to help their resident communicate effectively. Note pads and pens, scrabble tiles, flash cards, pointing, picture boards and maybe charades. If it works, use it.
F) Feedback: If you think you know what it is your resident wants, repeat it back to them as simply as you can, to make sure that is what they are communicating. Do not pretend to understand the resident. If you do not understand, what the resident is communicating, try again. If it becomes too frustrating, ask for help. Guarantee there is an aide who can understand your resident and they can help with the communication process.
G) Emphasize the positive aspects of the communication: Let your resident know that you understand them, by repeating back what they have communicated to you, smile and show your resident you understand.
H) Time: Allow adequate time for the conversation between you and your resident. Don’t leave a conversation incomplete. If you have to explain to your resident that you have to leave but will be back to finish the conversation as soon as you can.
I) Encourage: Allow time and encourage you resident to point to objects, pictures, words that will help communicate their need to you.
J) Attitude: Giving your resident the impression that you are in a hurry or frustrated is not going to help. Keep your attitude light, relaxed, and pleasant. Actions speak louder than words, and your attitude will set the stage for ease or difficulty in communication.
K) Let the Resident know you are leaving: let the resident know when you are done, making sure the resident is clean and safe, with their call button; needed personal items and water are within reach.
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