SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.1 Demonstrates effective, abuse-free, verbal and non-verbal communication in keeping with the NA's role with clients and their families. Competencies Course Content Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define communication 2. List and define the elements of communication 3. List 5, good verbal communication and nonverbal communication skills 4. List ways to communicate with clients who have visual and hearing impairments 5. List the essential components of answering the phone correctly

1. Communication is the sharing of information. The message a NA has to deliver may be affected by the manner in which she/he stands, moves, and speaks. When a NA communicates, she/he is not only conveying words but also attitudes and feelings about her/himself and the client. 2. Elements of effective communication: Sender-the person who wants to communicate information Message-the information the person needs to send Channel-method of sending information a. Verbal spoken or written words b. Non-verbal facial expressions, posture, hand/body movements, and appearance Receiver person to whom the message is sent Conformation the way the receiver lets the sender know that the message has been received 3. Verbal communication skills: Get the receivers attention before you send a message Use words the receiver understands Choose the correct volume Speak slowly and clearly Be aware of tone of voice Avoid swearing and slang Avoid cultural or double meanings Listen to the receiver without interrupting Always ask questions and encourage the client to respond

Handouts: - Tips for Communicating with Families - Communicating with the Client with Aphasia, Hearing Impairment and Vision Impairment Role Play: Break the class into senders and receivers. Give each sender a written message to deliver. Once they feel they have delivered the message as effectively as possible, have the receivers verbally recite the message received. Scenarios: 1. Angry family member- I do my mothers wash. This is the last time I am going to warn you. Do not send her clothes to the in-house laundry. You have ruined my mothers clothes for the last time. 2. Upset client-They gave me a shower last night. I fell in the shower room and my leg really hurts. I dont think I should stand on it. Can you help me? (Client is smiling the entire time she is relating her story.)

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.1 Demonstrates effective, abuse-free, verbal and non-verbal communication in keeping with the NA's role with clients and their families. Competencies Course Content Learning Activities

Non-verbal skills: Be aware of impact of personal appearance on receiver Be aware of facial expressions used Be aware of touch Be aware of body position and movement Use body language that encourages communication (e.g. smiling, nodding the head, making eye contact, leaning toward the speaker) Avoid body language that discourages further communication (e.g. frowning, scowling, wrapping arms tightly across chest, turning head away from speaker, rolling eyes, and tapping your foot) 4. Communicating with clients who have communication problems may be challenging at times. Visually impaired clients may not see the caregiver; nurse aides should: a. Knock on the clients door and let him/her know you are there b. Stand within the clients visual and hearing range and call him/her by name c. Arrange and manage the clients environment each day/each shift d. Use communication (verbal & nonverbal) to help the client with visual impairment e. Keep the clients glasses clean when on and in a safe place when off

Suggestion: Use the phrase, See something, say something to summarize the importance of abuse identification and reporting.

Handout: Identify the facial expressions then discuss the importance of nonverbal communication when describing behavior and labeling behavior.

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.1 Demonstrates effective, abuse-free, verbal and non-verbal communication in keeping with the NA's role with clients and their families. Competencies Course Content Learning Activities

Hearing impaired: a. Keep hearing aides clean and in a safe place when not in use b. Encourage clients to use their hearing aides and check to see if they can hear you after the hearing aide is in the clients ear c. Gently touch the client on the hand or arm to gain his/her attention before speaking to him/her and providing care d. Always approach the client from the front, facing the client directly, eye-to-eye e. Reduce background noise as much as possible f. Use non-verbal communication as much as possible to help the client compensate for his/her hearing loss Answering the call bell promptly is vital. Clients rely on the call bell to communicate their needs for assistance

5. Answering the telephone may also be the nurse aides responsibility. Knowing how to answer the phone is essential. If you answer the telephone: Identify the nursing unit State your name and title Ask a nurse to take the call if a physician is on the line to give orders Avoid giving out personal information about clients Write down the date, time of the call, name of the caller, and a brief message Sign your name and title to the message Inform the caller that you will deliver the message

1.2.1

Tips for Effective Communication with Families

Communication Helpers 1. Door Openers: invitations to talk, letting the other person decide whether or not to proceed. Do you want to talk about it? You seem upset; is something bothering you? 2. Encouragers: Id like to hear more about your familys concerns. 3. Open-ended Questions: What do you hope your mother will gain from being here? What can we do to make things better for you and your family member? These communication helpers can go a long way toward promoting good communication with family members, but we also need to avoid Communication Blockers.

Communication Blockers 1. Blaming: Its your fault that your mother doesnt have appropriate clothes. 2. Always and Never: You never come to visit. You are always telling me what to do. 3. Name calling: That aide is really stupid if she would say that. 4. Labeling: Her daughter is such a typical WASP, she never shows any warm feelings toward her dad. 5. Moralizing: Families who really care about their relatives come to visit every day. 6. Fixing Things Right Away: Remember that listening needs to be completed before the problem solving begins. 7. Controlling: Good listening requires giving up control, which is no easy task especially when you are feeling like you are already behind in your work. You may need to put aside the task at hand and concentrate more fully on the other person. The more you concentrate on what is really going on with the other person, the more effective you will be as a listener.

From Cornell Universitys Nursing Home-Family Matters Project, 1993

SUPPLEMENTAL MATERIAL: HANDOUTS

1.2.1

Communicating with the Client with Aphasia Face the client and make eye contact before speaking Say the clients name before asking questions Speak slowly and clearly; using short, complete sentences Pause between sentences Determine whether the client understands what you said before continuing Use nonverbal cures or communication aids whenever possible Repeat what the client said to help keep them focused Give the client the benefit of the doubttalk to him or her even if you are not sure he or she understands 9. If client becomes frustrated, let him or her know what you understand; discuss another subject for a while, then try again Communicating with the Client with Hearing Impairment 1. Identify yourself to the client 2. Gently touch the client to get her attention 3. Make sure that the light source is behind the client, not you, so that the client can see your mouth clearly 4. Eliminate outside distractions and noise from the radio television, or other sources 5. Face the client when speaking-use hand gestures and facial expressions to help the client understand you 6. Speak clearly and slowly 7. Keep sentences short 8. Keep your hands away from your face when speaking 9. Stand or sit near the client 10. If the client uses a hearing aid, help insert it Communicating with the Client with Vision Impairment 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Identify yourself when approaching the client Knock before entering the room Call the client by the name the client wants to be called Encourage the use of eyeglasses and help the client as needed-keep the glasses clean Tell the client where items are-keep them in the same place so that the environment is familiar Describe the environment and objects in the room to the client Guide the client as needed Provide adequate light in the room Encourage the client to listen to radio or television to keep up with current events Be sure to inform the client when leaving the room 1. 2. 3. 4. 5. 6. 7. 8.

SUPPLEMENTAL MATERIAL: HANDOUTS

Facial Expression the Demonstrate Affect Identify the Emotion Being Expressed

1.2.1

1.

2.

3.

4.

5.

6.

7.

8.

9.

Facial Expressions

SUPPLEMENTAL MATERIAL: HANDOUTS

Facial Expression the Demonstrate Affect Identify the Emotion Being Expressed

1.2.1

10.

11.

12.

13.

14.

15.

16.

17.

18.

Facial Expressions

SUPPLEMENTAL MATERIAL: HANDOUTS

Facial Expression the Demonstrate Affect Identify the Emotion Being Expressed
This handout is for the instructor

1.2.1

The following are suggested interpretations to the facial expressions activity.

Allow students to share their interpretations. Discuss the importance of non-verbal communication when describing behavior and

labeling behavior. (e.g. a perception between staff members and/or clients and staff) 1. Humorous, very happy, laughter 2. Angry, frustrated, aggressive 3. Suspicious, disapproving, doubtful 4. Surprised, scared, horrified 5. Very sad, painful, grieving, hurt 6. Bored, not interested or dont care 7. Horrified, shocked, worried, afraid 8. Doubtful, distrusting, suspicious 9. Angry, enraged, disgusted 10. Exuberant, ecstatic, delighted 11. Flirty, Secretive, skeptical 12. Peaceful, calm, de-stressing 13. In a hurry, time conscious 14. Feeling ill or down, blue, apathetic 15. Disapproving, negative 16. Overwhelmed, perplexed, swamped 17. Sad, lonely, unhappy 18. Happy, cheerful, confident, positive interest

Facial Expressions

SUPPLEMENTAL MATERIAL: HANDOUTS

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.2 Observes by using the senses of sight, hearing, touch and smell to report client behavior to the licensed professional/practitioner/supervisor. Competencies Course Content Learning Activities

After the completion of the lecture/discussion, the student will: 1. List 5 ways a nurse aide can make observations using each of the senses of sight, sound, smell, and touch 2. List observations which must be reported immediately

1. Use your senses to make observations: Sight - what you see a. The clients skin looks pale b. Open areas on a clients skin c. Sores in a clients mouth d. The clients hand shakes or the client is too weak to hold the glass e. The client limps or cannot stand alone f. The clients urine, stool, or sputum has an unusual color g. The clients emesis (vomit) has an unusual color h. The client is not eating or having trouble eating i. The client squints or bumps into things and people j. The clients usual facial expression has changed k. The client sleeps a lot or does not make facial contact l. The clients breathing is different, labored or slow, or the client gasps for breadth m. A part of the clients body looks different or abnormal to you n. There is blood or leakage coming from some part of the clients body or medical device, such as a drain or intravenous (IV) Sound - what you hear. a. The client is coughing b. The client is making a noise when breathing c. The client is complaining of a change in his/her condition (e.g. pain, numbness, swelling) d. The client is crying e. No response from the client when you speak to them f. The client does not speak as clearly as they normally do

Role play: a series of scenarios in which students act as both clients and NAs. Client roles: The clients present a series of status changes including: Pressure ulcer changing from stage 1 to 2 Client experiencing pain during ROM Client with new sense of being lost and not knowing what day it is During catheter care a student notices blood in the catheter tubing Student roles: Have the students acting as NAs report what they observe. Have the entire group discuss the results.

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.2 Observes by using the senses of sight, hearing, touch and smell to report client behavior to the licensed professional/practitioner/supervisor. Competencies Course Content Learning Activities

Smell - what you smell a. The clients breath has an unusual odor b. The clients emesis (vomit) has an unusual odor c. An unusual odor in the clients urine or stool d. That the clients dressing or wound has an unusual odor Touch - what you feel a. The clients pulse is strong b. The clients pulse is weak c. The clients skin is warm, cool, or moist d. A lump under the clients skin 2. Observations of a change in the client from their normal status must be reported to the supervisor immediately: Changes in a clients physical or mental status Changes in a clients reactions or behavior Clients health statements indicating that he/she senses a change All sensory observations as noted above Clients health complaints or concerns Abnormal observations gained by use of your senses Client care preferences

Prepare various odors in baby food jars to represent possible conditions, such as; - musty, soiled rag for an infected wound - applesauce and honey for a fruity breath as in hyperglycemia - diluted ammonia for a UTI

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.3 Documents observations using appropriate terms that are specific to the work environment. Competency Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define the nurse aides legal responsibility regarding documentation

1. The nurse aide needs to be alert to problems or changes in each clients physical or emotional condition. He/she is legally responsible for recording and documenting complete and accurate details of all care they provide. Legally, if it is not charted, it is not done. The nurse aide must know some commonly used medical abbreviations to communicate with the staff verbally and in writing Never assume an understanding of words: a. Seek clarification if unsure b. Research any unfamiliar terms and abbreviations Components of both written and verbal forms of communication used in sharing information on the health care team include: a. Timeliness b. Legal responsibility c. Completeness d. Accuracy 2. Actual language of medicine: Three components of words: prefix, root, suffix Abbreviations - simple short hand forms of frequently used words and terms

Facilitate an exercise in which students share information using medical terms and abbreviations (e.g., ADL, ROM, cyanosis, dyspnea, apnea, dysphagia). Portray client scenarios - what would they document and when? Completion of ADLs following care plan Client experiencing pain during ROM Client awaking with difficulty breathing Client with a choking episode at breakfast Handouts: List of Medical Abbreviations Forming words

3. Review the list of commonly used abbreviations and medical terms-refer to text book glossary and handout

1.2.3

Example of Facility Approved Medical Abbreviations 1. ABD 2. AC 3. Ad Lib 4. ADM 5. A.M. or am 6. BID, bid 7. B.M., bm 8. B.P. or BP 9. BRP 10. c 11. Ca 12. Cath 13. CBC 14. Cc 15. c/o 16. CVA 17. CPR 18. Disch or D/C 19. drsg 20. DR 21. Dx 22. EKG 23. ED, ER 24. EEG 25. FBS 26. FF 27. hs 28. ht 29. ICU 30. LPN 31. med 32. NA 33. OOB 34. pc 35. q 36. ROM 37. SOB 38. TLC 39. WBC 40. wt 41. abdomen before meals as desired admission or admitted morning twice a day bowel movement blood pressure bathroom privileges with cancer catheter complete blood count cubic centimeter complained of cerebral vascular accident cardiopulmonary resuscitation discharge dressing doctor diagnosis electrocardiogram emergency department, emergency room electroencephalogram fasting blood sugar force fluids hour of sleep height intensive care unit licensed practical nurse medicine nursing assistant, nurse aide out of bed after meals every range of motion shortness of breath tender loving care white blood count weigh

SUPPLEMENTAL MATERIALS: HANDOUT

1.2.3

FORMING WORDS

Prefix Root Suffix re-(again or use (to put into -able (that can be) back) action or service) Example: The blanket and spread may be reusable linens. ab- (away; from; away from) use (to put into action or service) -er (a person or thing that)

Word reusable

Meaning that can be used again

abuser

a person who uses or treats someone or something in a way that is different from the acceptable way not as it should be; not in the usual pattern a condition in which things are not as they should be

Example: The abuser is often someone the victim knows. abnorm (standard; -al (pertaining to) abnormal pattern) Example: The persons bowel elimination pattern has become abnormal. abnorm -ality (the condition of being

Example: The test on the specimen shows whether there is an abnormality. co- (with) operate (work) cooperate to work together with someone

Example: When people on the team cooperate, the work is more easily done. trachea- (tube -tomy (cutting tracheotomy surgical operation of that carries air to into) cutting into the trachea the lungs; windpipe) Example: A nurse assistant must provide special care to someone who has had a tracheotomy. ana- (living) study of a living body based on dissection or cutting open Example: When you study anatomy, you learn about the separate parts of the body. science of the normal function of a living body or its parts Example: We must know about the kidneys, heart, lungs, and blood vessels to understand blood physiology. Forming Medical Words Prefix Root Suffix cardio -ology cardio -ologist cardio -vascular cardio -pulmonary myocardium Word cardiology cardiologist cardiovascular cardiopulmonary myocardium Meaning
science of heart function and disease specialist who studies and treats heart disease having to do with the heart and blood vessels

-tomy (cutting into)

anatomy

physio- (of the body)

-ology (a science or knowledge of)

physiology

having to do with the heart and lung heart muscle

Copied with permission: StayWell. The American Red Cross Nurse Assistant Training, 2nd ed. 2008. StayWell. Yardley, PA. SUPPLEMENTAL MATERIALS: HANDOUT

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.4 Explains the importance of reporting observations and measurements to the licensed professional/practitioner/supervisor. Competencies Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define what is meant by objective reporting 2. List 4, key elements of documentation and site 2 examples of each

1. Reporting - the spoken exchange of information between members of the health care team. Observations may be objective or subjective. Objective information - based on what is seen, heard, and sensed. Subjective information - anything which cannot be observed but is based on something that the client reported (may or may not have actually happened). 2. Key elements of reporting observations: What to report: a. Vital sign measurements. b. ADL assistance provided. c. Client response to care. d. *Change in clients: i. Mood ii. Alertness iii. Awareness iv. Level of independence v. Skin vi. Appetite vii. Sleep Habits How to report: a. Directly to nurse in charge (verbal) b. Written on flow sheets (written) When to report: a. Immediately for any changes in skin condition, mental alertness, abnormal vital signs, difficulty breathing, sudden complaint of pain b. Routinely upon completion of care Why it is important to report: a. Ensures client safety b. Satisfies client needs

Present client scenarios and discuss actions to be taken by the nurse aide: Client with sudden, chest pain Client with a reddened, skin area over the left hip the size of a quarter Client is suddenly confused and does not know where they are or who you are Have the students document what they would have observed based on what you said. Who would they report to and when?

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills. Objective: 1.2.5 Explains the importance of maintaining the clients record. Competencies Course Content

NATCEP Time: Class: Lab: Clinical:

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define the need for maintaining the clients record 2. List the key points of proper documentation 3. List what is included in the clients medical record

1. Recording in the clients medical record is a method of written communication used by the health care members to document all elements of the clients medical condition and progress. 2. Key elements: Importance of Accurate Charting: a. Legal document b. Confidential c. Not charted = not done Key points of proper documentation: a. Remember it is a legal document b. Make objective observations/measurements c. Use black/blue ink Actual charting purpose: a. Communicating to team members b. Documenting delivery of care c. Providing evidence that care was actually provided d. Providing evidence that care has been provided (regulatory agency). e. Documenting for insurance purposes and reimbursement f. NAs are responsible for making charting part of their daily routine and making sure tasks are completed and recorded Basic Rules: a. Be precise and exact b. Do not skip over lines c. Use only approved abbreviations, simple direct terminology d. Never erase or write over a notation e. Chart after all procedures are completed f. Always record the date, (military) time, and signature

Handout: Review Charting Guidelines

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills. Objective: 1.2.5 Explains the importance of maintaining the clients record. Competencies Course Content

NATCEP Time: Class: Lab: Clinical:

Learning Activities

3. The clients record is a permanent, legal document that includes the following: The clients history Progress notes Physician orders Medications Treatments Flow sheets X-ray and lab reports

Exercise: Briefly describe morning (AM care) to include mouth care, breakfast and voiding x1. Handout: Refer to the Generic ADL Flow Sheets to discuss the types of information that should be recorded using appropriate abbreviations. For additional practice, create fictitious clients with specific information about their care during an 8 hour shift. Ask students to document this care on the Generic ADL Flow Sheet.

1.2.5

Charting Guidelines 1. Always use a black pen with non-erasable ink when documenting information 2. Use correct spelling, punctuation, and grammar 3. Write legibly and neatly 4. Include the date and time for each entry 5. Do not erase, mark out, or cover an error with white out-if you make an error, draw a single line through the incorrect entry-write error over the entry and sign your initials-enter the correct information after the marked portion 6. If you use abbreviations, use only the accepted ones for your facility 7. Avoid skipping lines or leaving blank spaces 8. Make sure that each record that you use includes the correct clients name and room number 9. Record only what you have observed or what care you have given 10. Never chart a treatment, procedure, or care provided until it has been completed 11. Always chart information in an accurate, factual, and concise manner-never record your opinions, interpretation, or judgments 12. When possible, use the clients exact words-use quotation marks when quoting a client 13. Be descriptive when noting an observation-use exact measurements whenever possible 14. Sign all entries with your name and title-check your facilitys policy regarding signing a chart entry. (i.e., A. Smith, NA). 15. Follow facility policy concerning computerized documentation (such as Care Tracker Kiosk)

SUPPLEMENTAL MATERIAL: HANDOUT

1.2.5
Generic ADL Flow Sheet Section # _________ Date: _____________ Floor #____________ Observations TPR, I&O, etc. Safety Device

Breakfast %

Supplement

ROOM #

CLIENT

KEY:

1 = Self

2 = Assist

3 = Total
Bath Key

4 = Refused
Activity Key BM Key
S = Small M = Medium L = Large

Safety Device Key

Any additional information will be placed on the back of this sheet Bd = Bed Alarm Ch = Chair Alarm PA = Personal Alarm Mat = Mats on Floor SSB = Safe Seat Belt SR = Side rails BB = Bed Bath

SH = Shower WP = Whirlpool

W/C = Wheelchair G-C = Geri-chair Amb. = Ambulatory CBR = Complete Bedrest

TB = Tub Bath PB = Partial Bath

SUPPLEMENTAL MATERIAL: HANDOUT

Inst. Initials

Breakfast AM/cc's

Shampoo

Oral Care

Lunch %

Lunch PM/cc's

Voiding

Activity

Shave

Nails

Bath

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.6 Demonstrates effective, communication skills with supervisor/manager/charge nurse, staff and other disciplines. Competencies Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define how the nurse aide is a vital link in the communication chain 2. List the skills needed to effectively communicate within the health care team 3. Define what is meant by chain of command and why it is an important tool for the nurse aide

1. The nurse aide serves as the communication link between the health care team and clients. Effective communication within the nursing team and with other health care members is essential. The nurse aide must: a. Understand tasks delegated; ask for clarification when unclear b. Realize that he/she functions as the eyes and ears of the nurse, physical therapist, dietician, social worker, etc. c. Gather information. d. Share observations of clients status (i.e., ADL ability) e. Alert health care members to changes in client that influence care needed 2. Reinforce communication techniques emphasizing: Receivers are good listeners. Senders make sure message is clear. Utilization of feedback to assure or clarify message. Mindfulness of body language and tone of voice. The ability to read, write and speak English at the level necessary for performing NA duties. Listening and responding to verbal and non-verbal communication in an appropriate manner. The use of accepted, health care terminology to record and report observations, action, and information accurately and in a timely manner.

Handout: - Five Elements of Effective Communication - Guidelines for Effective, Verbal Communication with Co-Workers, Manager, and Supervisors - Factors that Affect NonVerbal Communication Demonstration: Ask volunteers to demonstrate a feeling (i.e. sadness, pain, joy) by using non-verbal communication. Other students try to name the feeling and the clues that were demonstrated. Scenarios for discussion: 1. The client is on a restorative, ambulation program and the Physical Therapist asks the nurse aide about the clients progress. The client walked this morning 100 feet with minimal contact guard and no breathlessness. 2. The client does not like the meal provided and will not eat. What should the nurse aide do?

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.6 Demonstrates effective, communication skills with supervisor/manager/charge nurse, staff and other disciplines. Competencies Course Content

Learning Activities

3. Chain of Command: Describes the line of authority and communication in health care If a nurse aide has a problem within the nursing department, all communication regarding that problem will be directed to his/her immediate supervisor (charge nurse) In the event that a nurse aide experiences a problem with another department, that nurse aide will communicate with her/his charge nurse first By utilizing the chain of command, the nurse aide can help facilitate communication and solve problems.

Handout - Case Study: Charge nurse chooses not to assist nurse aide with a clients care.

1.2.6

Five Elements of Effective Communication

Communication Element Sender Message Channel

Description of the Element The person who wants to communicate information The information the person sends The way the message is sent verbally (talking), nonverbally (facial expressions, body movements) or in writing The person to whom the message is sent The way the receiver lets the sender know that he has received the message

Receiver Confirmation

--------------------------------------------------------Effective Verbal Communication has 2 parts: 1. What you say 2. How you say it ---------------------------------------------------------Guidelines for Effective, Verbal Communication with co-workers, managers, and supervisors 1. 2. 3. 4. 5. 6. Get the Receivers attention before you start talking Use words that the Receiver understands Choose the right volume Speak slowly and clearly Be aware of your tine of voice Listen to the Receiver

---------------------------------------------------------Factors that Affect Non-Verbal Communication 1. 2. 3. 4. Personal appearance Facial expressions Touch Body position and movement

Copied with permission: The American Red Cross. Nurse Assistant Training, 2nd ed. 2008. StayWell. Yardley, PA.
SUPPLEMENTAL MATERIAL: HANDOUT

1.2.6

CASE STUDY: When a charge nurse chooses not to assist a nurse aide with a clients care LPN Cathy Complainer is the charge nurse for South Hall. She passes medications to 20 clients. Two nursing assistants, Kathy Constant and Rella Reliable, are assigned to give routine care to the same 20 clients. Kathie Constant went on break. Clara, a client, is screaming I have to go to the bathroom! Clara requires assistance of two caregivers to go to the bathroom. Cathy Complainer is busy passing out her medications. Rella Reliable asks for help, but the LPN is reluctant to leave her medication cart and says, Clara will just have to wait, and besides, its not my job!

QUESTIONS: 1. 2. 3. What should the nursing assistant do? What other issues, are part of this scenario? Discuss ways to improve or develop effective teamwork.

Source Unknown: Submitted by a PA Nurse Aide Training Program, 2011

SUPPLEMENTAL MATERIAL: HANDOUT

Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

Time:

Class:

Lab:

Clinical:

Objective: 1.2.7 Communicates thoughts, feelings, and ideas to justify decisions or support position on workplace issues. Competency Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define the terms assertive, aggressive, and passive, and how they relate to nurse aide communication.

1. NAs can be assertive, valuable, team members. Define and discuss assertive, aggressive, and passive behavior and how it is communicated. Assertive behavior: a. Speaking up b. Asking for what you want and need to know c. Saying no to things you do not want or should not do d. Behaving confidently e. Being direct yet considerate of others Aggressive behavior (often confused for assertiveness): a. Being pushy b. Being stubborn c. Not sharing d. Always pushing to have your way e. Being manipulative f. Making threats Passive behavior (opposite of assertive): a. Going along with others b. Not speaking up c. Accepting situations even when they are uncomfortable d. Doing what you need to do in order to get what you want without making anyone angry

Handout: Discuss and demonstrate assertive, aggressive, and passive communication styles. Handouts: - Conduct the Assertiveness Survey - Review and discuss actions for Using Assertiveness Effectively

Role play using assertive, aggressive, and passive communication styles.

Group Discussion

1.2.7

Guide students in sharing perspectives of Assertive, Aggressive and Passive behaviors. Ask student to share examples of anecdotes from their experiences. For example; Examples of Assertive behavior are: __ Speaking up __ Asking for what you want (Use sentences that begin with I (I want, I need) Saying what you want is being assertive. (There is no guarantee you will get it) __ Saying no to things you do not want or should not do (Repeat no if needed. Dont give reasons or excuses. Walk away) __ Behaving confidently (body language) __ Being direct while being considerate of others (being assertive is different is different from being aggressive)

Examples of Aggressive behavior are: __ Being pushy __ Never giving in __ Being loud __ Not sharing __ Always having to have your way __ Being manipulative __ Making threats

Examples of Passive behavior are: __ Going along with others __ Not speaking up __ Accepting situations even when they are uncomfortable __ Doing what you need to do to get what you want without making anyone angry or hurt
Copied with permission from; The American Red Cross. Nurse Assistant Training, 2nd ed. 2008. StayWell. Yardley, PA. SUPPLEMENTAL MATERIAL: HANDOUT

Assertiveness Survey

1.2.7

1. Explain to students that using assertiveness is another way to modify ones behavior to achieve desired results. Tell then they are going to find out how assertive they are. 2. Post the following point system on the white/black board or flip chart 1 point for almost always 2 points for sometimes 3 points for never 3. Tell the students to take out a pencil or pen and a piece of paper to keep track of their own scores during this activity. Write numbers 1 through 9 and leave a space after each number. 4. Explain that you are going to read sentences that describe things they may do in their lives. 5. After each sentence students should write down how often they do that particular thing - almost always, sometimes or never and the number of points for that response. (or pick one option) Assertiveness Survey Read each sentence below aloud to students. 1. I talk about my feelings when Im upset 2. I say no to things I shouldnt do without feeling guilty 3. I tell people when Im angry 4. I ask for what I want or need. 5. I ask questions if I dont fully understand what someone is telling me. 6. I say how I really feel even when I know my friends disagree. I tell people when they make me feel good. 7. When I disagree with someone, I try not to make that person feel bad. 8. When people hurt me, I let them know how I feel. 9. I look for solutions to problems instead of just complaining After the Survey

Ask the students to add up the number of 1s they have. This total is their assertiveness level. Ask a few students to share their scores. Display the Assertiveness Scale and discuss survey results. Explain that most people score below 5. Discuss factors that affect assertiveness such as: a. Sometimes it is harder for women or for members of some cultural groups to be assertive. b. Some cultures teach children not to ask for what they want. c. Some cultures teach women to do what they are told whether they want to or not.

Copied with permission from; The American Red Cross. Nurse Assistant Training, 2nd ed. 2008. StayWell. Yardley, PA. SUPPLEMENTAL MATERIAL: HANDOUT

1.2.7 Using Assertiveness Effectively Read the situations and go through the list of responses.

Situation
A person says no to your request. You decide to keep trying to get the person to comply with your request.

Assertive Action
Decide whether it is important to keep trying to get what you want and, if so, keep trying. Tell the person you understand his/her position (if you do).

Ineffective Action
Give in right away.

Tell the person his or her idea is wrong or silly Repeat what you said and demand to know why your request was denied. If that doesnt work, whine. Glare at the person and shout. Make angry gestures and pound on the table. Say, No. Thats that. The case is closed. Yell, Didnt you hear me? I said no!

Repeat what you want and explain why it is important.

Speak in a firm voice, look into the persons eyes and stand tall. Keep your hands by your side or hold them in your lap. You must refuse someones request. Say no firmly and explain why. Listen carefully to what the person says; then say no politely. Ask the person to stop pressuring you. Excuse yourself and walk away from the situation. You say you are rejecting her request, not her.

The person asks again.

The person asks again.

Ask, Are you deaf? Tell the person to leave you alone. You say its because she annoys you.

The person asks again. The person asks why you dont like him or her.

Copied with permission from; The American Red Cross. Nurse Assistant Training, 2nd ed. 2008. StayWell. Yardley, PA.
SUPPLEMENTAL MATERIAL: HANDOUT

Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

Time:

Class:

Lab:

Clinical:

Objective: 1.2.8 Demonstrates speaking, listening, writing, and social skills that supports participation as an effective, team member. Competencies Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. List 2 reasons why communication is vital on the health care team 2. List 6 qualities of an effective team communication.

1. Communication will happen verbally and non-verbally, directly and indirectly. Health care team members communicate with one another to provide coordinated and effective client care. 2. Qualities of a good communicator: Positive in all contexts Open and courteous Reports problems through the chain of command Is clear and concise in both verbal and written communication Provides and seeks feedback Avoids and dispels gossip Is mindful of body language and tone of voice Resolves conflicts immediately

Activity: Turn with your back to the students and speak a direction in a monotone voice. For example: Take out a piece of paper and write the first three words that come to your mind when you hear these words good team player. Pause for a few seconds then turn around and discuss the barriers to effective communication. Repeat the direction using proper inflections and facing the students. Discuss their responses to the assignment. Observe and recognize their tonal inflections, smiles, nods, or note taking as demonstration of speaking, listening, writing and social skills.

SUPPLEMENTAL MATERIAL: HANDOUT

Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

Time:

Class:

Lab:

Clinical:

Objective: 1.2.9 Demonstrates actions for asking appropriate questions to clarify meaning, understand outcomes or solve problems. Competencies Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define why clear communication is necessary 2. Define the concepts of openended and close-ended questions

1. Clear communication with clients and coworkers is an essential element in the delivery of care. As the receiver of communication, it is important that a nurse aide clearly understand the message. Never assume-when in doubt, ask questions. Questions are used to clarify communication and reach mutual understanding. 2. There are two types of questions: Close-ended question will result in a yes/no answer. It does not provide a great deal of information. It will often begin with words such as are, can, do, did, have, when, where, and why. Open-ended question require an answer beyond yes/no. It will provide more information. It often begins with words such as how, what, show me, describe, and suppose.

Small, group discussion. Dividing the class into groups. Each group should have a volunteer to serve as one of the following: (see handout) - A client with a problem - A supervisor with a directive - A coworker with a problem Each volunteer will have a script describing his/her issue. In the script, have initial, limited information in bold print. Direct the remaining students to question the volunteer to gain clarity and decipher the full script. Have one group use only closeended questions-compare results

SUPPLEMENTAL MATERIAL: HANDOUT

1.2.9

Scripts for Group Discussion

Scenario #1 A client with a problem Mrs. Allens call light has just gone on. Mrs. Allen has expressive aphasia. As you enter the room you notice that her language board is across the room on her dresser. She is distressed and keeps pointing to the bathroom. Scenario # 2 A supervisor with a directive The supervisor has been asked to address a concern brought to her attention by the dietary department. The dietary aide states that trays are delivered to the dining room on a timely basis. When trays are delivered, the clients are seated at the tables, but there are no nursing aides available to assist the clients. This happens pretty frequently and the clients are complaining that their food is often cold. Scenario # 3 A coworker with a problem Rita, a fellow coworker appears stressed and at wits end. No one will ever help me! Ill never get done today. It is 9:00 and two of her assigned clients need a complete shower. Both clients are total assist of two to transfer from bed to the shower chair, then back to bed to be dressed and then up in their chair.

SUPPLEMENTAL MATERIAL: HANDOUT

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills. Objective: 1.2.10 Explains the concept of diversity and why it is important. Competencies Course Content

NATCEP Time: Class: Lab: Clinical:

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define diversity 2. List what can be achieved when a nurse aide acknowledges and accepts each client as an individual 3. List 4 ways a nurse aide will experience the need to identify, and therefore respect, diversity in the health care setting

1. Diversity has to deal with the different groups of people with varied backgrounds and experiences living in the community. Diversity has enriched the country, yet problems can arise when people are not sensitive to, or respectful of, the cultural uniqueness of each individual. 2. Through listening, acknowledging, and accepting each person as an individual with a diverse background, the nurse aide will: Be able to portray positive responses to diversity including accepting and knowledge Be aware of and eliminate bias and prejudice Focus on compassionate, respectful, and culturally sensitive care Treat clients and coworkers as they wish to be treated 3. Areas where diversity and health care often intersect include: Beliefs and practices associated with food Religious beliefs and practices Attitudes towards health, sickness and death Touch, personal space, and eye contact, which are used and interpreted differently among different cultures

Discussion: Direct each student to write a definition of diversity and then proceed to discussion this term. Discussion: Students are to think of someone they respect. Discuss the reason(s) they respect that person. How is respect demonstrated? What could you do if you heard someone making fun of the person you respected?

SUPPLEMENTAL MATERIAL: HANDOUT

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.11 Describes cultural diversity and how the nurse aide manages cultural differences among people. Competencies Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define what is meant by cultural diversity 2. List ways in which individual cultures affect a clients life 3. List 10 guidelines for working with culturally diverse clients

1. Cultural diversity - how individuals differ in appearance, beliefs, and behaviors based on country of origin, ethnic background, and upbringing. Culture a set of values, beliefs, normal activities, possessions, rules, codes, and assumptions about life that generally define groups of people giving them commonality. Culture is not genetically determined, it is learned. Culture continues and is ongoing; it is passed from generation to generation. 2. Cultures affect every aspect of an individuals life including: Personal values Attitudes and beliefs Religious beliefs Decision making Response to illness and health care systems Interpersonal relationships Food preferences and dietary practices Gender related roles Traditions Language Identity Acceptable behaviors Skin color Beliefs about older persons and their role in society

Class discussion: How many cultures are represented in the class? Have students describe their cultures and traditions Ask again, How many cultures are there in the class?

SUPPLEMENTAL MATERIAL: HANDOUT

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.11 Describes cultural diversity and how the nurse aide manages cultural differences among people. Competencies Course Content

Learning Activities

3. Guidelines for working with culturally diverse clients: Learn about other cultures Understand your own feelings; this will help you accept and understand others Realize how your attitude may affect clients-a person cannot feel comfortable when he/she does not feel accepted Help clients feel comfortable and accepted so they will be able to maintain independence and health Be aware that culture and religion influence a persons beliefs and practices in regard to health as well as the causes and cures of disease Observe individual reactions to pain, which are often influenced by culture Seek understanding in communication with clients who speak a different language Be aware of differences in body space requirements, privacy issues, family issues, family interactions, and levels of formality Realize that hand gestures may have different meanings to clients of different cultures Be aware that you may seem strange to the client Remember that being different does not lessen a persons value Understand how you would feel in similar circumstances and be sensitive to the individuals of a different culturehave empathy

SUPPLEMENTAL MATERIAL: HANDOUT

1.2.11

A Definition of Culture: Different cultures are made up not only of different styles of food, clothing, music, and art, but also of different languages and different rules for dealing with social situations. A concise definition of culture is: a set of attitudes, beliefs, values, and behaviors that a group of people share. Learning to appreciate cultural differences can do more than prevent hurt feelings; it can improve relations with other members of the caregiving team and help in understanding the sometimes baffling behavior of clients in your care. Cultural Diversity in the Nursing Home: Many of the clients living in long term care facilities today spent their younger years in a segregated society. For example, the older clients may have been born in the old country meaning Russia, Italy, Ireland, etc. When the client came to the United States, he/she may have settled in an area where everyone had the same ethnic origins. Sometimes, especially for women who did not work outside the home, coming to a nursing home may be their first experience with people who are different from themselves. It can be frightening to be cared for by people who are different from you and who share no common bonds, no similar backgrounds. For many clients, this is the first time they are dependent upon people they know very little about. The preconceptions about other groups that they may have learned from their parents, grandparents or other family are brought with then to the nursing home. Nursing home staff are also culturally and ethnically diverse, which impacts on the communication we have with co-workers and supervisors. The best approach to understanding the differences is to ask questions and listen carefully to the answers. We should not assume that things have the same meaning for people from a different culture. For example, touching means different things in different cultures. Even facial expressions are not understood in the same way. Therefore, we need to use effective communication skills to make sure that we understand the feelings and the meanings behind what people say. In a long term care facility, handling situations that arise as a result of cultural differences can be a challenging job, but it is an area in which nursing assistants can make a difference for clients from varied backgrounds. We all know how good it feels to be accepted for who we are, and the nursing assistant is often in a position to help new clients or co-workers who find their surroundings unfamiliar. By talking and listening to people who view the world differently, looking beyond stereotypes, and thinking about the ways we are shaped by our own culture, we can help.

SUPPLEMENTAL MATERIALS: HANDOUTS

1.2.11

Six Steps to Cultural Understanding 1. Denial of Differences The attitude were all the same under the skin discounts the very, real differences among people from other cultures. This attitude refuses to see the differences at all. Defensiveness In this step, differences are acknowledged, but ones point of view is considered right, and differences from that view are considered wrong. Minimizing Differences In this step, differences are recognized, but are granted no importance. This step could be called the So What step. Acceptance This step recognizes and appreciates the importance of cultural differences. Adapting to Reality In this step, empathy and communication skills are used to bridge cultural differences. Ongoing Learning This final step involves a habitual respect for others differences and a growing understanding of the skills needed to live and work together.

2.

3.

4.

5.

6.

Tips for Honoring the Differences in Others 1. 2. Learn and use some key words of the languages around you. Watch how others of the same culture communicate. Observe how members of your own relate to one another. Compare the two ways without judging either one better than the other. Be sensitive to others customs, holidays, and religious practices. Express your interest by asking respectful, polite questions. Be prepared to share some of your own customs with them as well. Examine the attitudes and beliefs you have about other groups of people. Where did your attitudes and beliefs come from? Make a friend from another cultural group. Defend people who are different from you when you hear others using stereotypes to describe them.

3.

4.

5. 6.

SUPPLEMENTAL MATERIALS: HANDOUTS

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills. Objective: 1.2.12 Demonstrates respect for differences among clients and people. Competencies Course Content

NATCEP Time: Class: Lab: Clinical:

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define the impact of understanding the differences among clients and people. Why is it important? 2. List 4, important aspects that help a nurse aide respect the differences among clients. 3. List what the nurse aide will accomplish by respecting individual difference.

1. Everyone we come in contact with is an individual with his/her own unique differences. When giving care and working within the health care team, nurse aides must take into account that an individualized approach to care is a landmark of quality. When care givers better understand the differences among the needs of different people, the quality of care improves. 2. There are four, important aspects in the development of providing care to different individuals and working in a diverse climate. They are: (acronym DOOR) Dont judge anyone you meet or care for Obtain the services of an interpreter as soon as possible, if you need one Observe everyone carefully to look for changes in condition and to learn from them about what makes them different-respect their differences Respect everyone 3. The nurse aide will accomplish the following when he/she treats each client as an individual: Respect the differences among clients, coworkers and visitors in all interactions/contacts Perform tasks and communicate in a manner that embodies understanding and sensitivity towards everyone Review each clients care plan for individual accommodations regarding customs and habits. Bring any concerns to the professional nurse before providing care Seek a way of understanding when communicating with a client who speaks a different language

Small group discussion: How many different individuals are represented in the room? - How do they differ? - How are they alike?

People Bingo - Exercise

1.2.12

People Bingo

Has lied about their age

Has taken care of a sick friend or relative

Has a tattoo

Is a religious person

Has been on a diet

Has always lived in a city

Has lived with a family member who passed away

Parents or grandparents came from another country

Speaks a language other than English at home

Travels more than 10 miles to work or training

Has dyed their hair more than once

Speaks another language

Your Name

Has children over the age of eighteen

Sings in a choir

Was raised on a farm

Has more than Plays a musical three siblings instrument

Has lived with his or her grandparents

Reads the newspaper in the morning

Is first-born in their family

Has children under the age of six

Has lived in more than one state

Knows how to polka

Loves to cook

SUPPLEMENTAL MATERIALS: HANDOUTS

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.13 Identifies elements of one's own, cultural formation and their potential impact in nursing practice. Competency Course Content

Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define the way a nurse aide can improve communication with a client of a different culture.

1. Culture and experience have shaped out thinking. Clients Small group discussion: and coworkers may come from a different culture and may have different experiences which shape the way they think. Arrange group of 3-4 Our individual and cultural wants and needs are unique to us. students with one member of the group volunteering to Nurse aides are obliged to respond positively and without prejudice to each client. A nurse aide must share information about their understand the clients individual culture and how it may culture and beliefs. After the be perceived by clients and coworkers. volunteer shares their responses to the first, 4 Communication in this regard is critical. Communication questions, and all members of starts from within: the group discuss #5. a. Knowing yourself is important when working with a wide range of people from different cultures and 1. Where did you grow up? communities. b. Past experiences can affect how we relate to people 2. What foods did you like to we see as different from ourselves. The nurse aide eat? must be sensitive to this and not allow previously formed opinions to adversely affect the care they 3. How did you celebrate the provide. holidays? Nurse aides may communicate openly about their respective cultures in an effort to increase their clients 4. Do you have grandparents? comfort level. What role do they play within the family? 5. How does the volunteers background/culture compare with the other members of the group? What was similar? What was different?

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills. Objective: 1.2.14 Uses effective, communication skills to promote clients well-being. Competency Course Content

NATCEP Time: Class: Lab: Clinical:

Learning Activities

After the completion of the lecture/discussion, the student will: 1. List and define the 10 cardinal rules to encourage effective communication

Nursing aides communicate with clients during all aspects of care. During each interaction, the NA will learn many things about each client that will broaden his/her understanding of each individual client and in so doing will improve the delivery of client care. 1. To encourage effective communication we can build upon the 5 elements of good communication (sender, receiver, message) discussed previously by adding 10, additional rules: Be aware of body language, facial expressions and how we appear to clients. This is important to every client but especially to the clients from different cultures who may speak a different language. A nurse aide, who appears relaxed, friendly, non-threatening and not rushed, can more quickly put the client at ease. When the client is at ease, communication can flow more easily. Get the clients attention. Get down to his/her level, which may mean that you bend, stoop or sit down to make eye contact while speaking or listening. Be aware of the clients cultural attitudes with regards to touching and direct eye contact. Call clients by their desired name. In many cultures the preference may be Mr. or Mrs. or Miss. Abide by their preference. Look for non-verbal cues of the client while they are speaking, for example, do they seem upset, are they frowning, smiling, etc.? Take in the whole message, verbal and non-verbal. Be an active listener, that is, listen carefully and allow the client time to express their self. Paraphrase, that is, repeat back to the client what you understood them to say. This is to check if your understanding is correct. Be patient, do not rush the client. Show the client that you care about them, their needs and opinions.

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills. Objective: 1.2.14 Uses effective, communication skills to promote clients well-being. Competency Course Content

NATCEP Time: Class: Lab: Clinical:

Learning Activities

Speak in a clear, concise manner. Do not talk to an adult as if they are a child. Use words that have the same meaning for you and the client. Avoid medical words and words that the client is not familiar with. Dont jump to conclusions or make assumptions. Listen to exactly what the client is saying and how he/she feels. Ask questions if you do not understand and give the client feedback about what you do or dont understand. Dont be judgmental. Allow clients their opinion and treat them respectfully. Be patient. People with memory problems may ask the same question many times. Do not call attention to the repetition. Accept the memory loss as part of their disability. Include the client in conversation when others are present. This includes when a co-worker is assisting you with care.

SECTION 1: INTRODUCTION TO HEALTHCARE Unit 2: Communication Skills Primary Objective: 1.2 Demonstrates appropriate and effective, communication skills.

NATCEP Time: Class: Lab: Clinical:

Objective: 1.2.15 Communicates in a respectful, adult manner in accordance with the clients stage of development and cultural background. Competencies Course Content Learning Activities

After the completion of the lecture/discussion, the student will: 1. Define why it is important to be aware of the clients stage of development and cultural background 2. List 4, developmental tasks of the elderly

1. The nurse aide must be aware of his/her own attitudes toward cultural differences and seek to understand and respect those differences among clients. Persons in late adulthood (65 years and older) experience many physical, psychological, and social changes. This group is referred to as the elderly. It is important that the nurse aide becomes familiar with these changes and treats clients with understanding and respect. 2. Developmental tasks of the elderly are: Adjusting to decreased physical strength and loss of health. Adjusting to retirement and reduced income. Developing new friends and relationships. Preparing for death.