The CNA Study Guide – Promotion of Personal Health and Safety
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Section 2 – Promotion of Personal Health and Safety
It is an established fact that nursing assistants are responsible for the health and well-being of patients within the residence of work. However, beyond that, nursing assistants must also work to maintain their own health. A nursing assistance that is under the weather will not have the same level of focus required to meet all of the job duties.
Taking Care of One’s Health and Body Mechanics
In order for a nursing assistant to take care of him or herself, they need to look towards what is referred to as body mechanics. With much of what a nursing assistant does, they are in physical contact with residents. Whether helping residents in and out of bed, transferring them to seat or to the bathroom, all the way to working with them and helping them work, nursing assistant work is both taxing and it is a drain physically on the body.
Now, there will be different kinds of options available for moving residents from one location to the next (depending on the facility itself). It is important for any new nursing assistant hire to familiarize him or herself with this kind of equipment and how it can reduce the physical toll taken on their own body. It is recommended for a nursing assistant to take full advantage of the equipment whenever it is available. This is even the case if using the equipment takes a bit more time, as it will help improve the body mechanics of the nursing assistant.
Lifting is part of the job (typically), so proper lifting techniques is important. A nursing assistant needs to lift with their legs. In other words, to squat down without twisting the back. Then, when standing, to push up with the legs and not turn up with the back. Leg muscles are far stronger than back muscles. Lower body muscles are made for lifting while core muscles are used to stabilize, so putting extra weight on the back will result in not only added discomfort but increase injury potential. It is very important for a nursing assistant to focus on themselves and make sure they are in a proper lifting position before helping a patient from one seat to another. This not only prevents possible injuries to the nursing assistant but reduces the chance of slipping and dropping the patient as well.
With all the moving and little downtime, members of the healthcare community can easily injure themselves when not careful. This leads to days away from work, lost income, medical bills, not to mention potential problems with lack of staffing at the facility. With all of the lifting and running around a nursing assistant performs, they are at a high risk for potential injury. That is why it is crucial for a nursing assistant to always follow proper techniques (such as for lifting) in order to reduce the chance of sprains and strains on muscles and joints around the body.
At the time, it may be best for a nursing assistant to utilize assistive devices (depending on what kind of work their job requires) in order to reduce strain on the body. There is an eight-step process for lifting in order to prevent injury. These steps are as follows:
Plan out the lift from start to finish and test out the load weight. If necessary, ask for someone to help. Then, get a firm footing, bend with the knees and tighten the core muscles. Now, lift up through the legs while keeping the back straight and maintain the load close to the body.
Performing Self Care
The job of a nursing assistant isn’t just physically based. It is also emotionally and mentally draining. With the strain of physical and personal interactions with patients, it can drain the body. Going to different rooms, answering constant questions and remaining emotionally checked into the job will leave most people completely exhausted. It is crucial for a nursing assistant to organize their time and to set certain tasks as priorities. Of course, the constant talking with patients, answering and asking questions will make an impact on the mental state of the nursing assistant as well. Seeing patients in pain and suffering will leave a nursing assistant emotionally impacted as well. It’s very difficult to perform the job without becoming attached while draining the body personally, emotionally and physically. All of this combined can lead to some very serious health problems.
One of the top ways of avoiding mental issues while on the job is to develop a way to cope with these stressful situations and to do it positively. There are all sorts of negative coping mechanism, ranging from eating poorly to alcohol and drug abuse. All of this will impact performance and even damage personal relationships.
On the other hand, some positive ways to cope with stress is to exercise daily. This is a great way to burn off frustration. Spending time with friends and family also help. Others like to practice yoga and open up their bodies and mind, while others simply relax in a nice bath and book at the end of the day. Whatever a person does, it’s important for a nursing assistant to discover these stress-reducing methods.
When beginning, it is easy for a nursing assistant to take on too many hours. The extra money it brings in is tempting, as it brings added financial stability, but due to the overall mental and physical stress, it increases the chance of a nursing assistant becoming fatigued and sick. Instead, it is always best to come into the shift well rested. It reduces burnout potential while keeping them on the top of his or her game.
Another important foundation in remaining healthy on the job is to eat a balanced, healthy diet and to sleep at least six hours a night (although eight is ideal). If a nurse’s health dwindles, so too does their ability to care for patients. So developing healthy eating habits is a must. Different facilities do provide varying forms of assistance for joining gyms or for meal planning, all of which should be taken advantage of.
Protecting and Promoting Resident Rights
Regardless of where a nursing assistant works, every resident has specific rights that must be respected. Many patients are put in a vulnerable position upon being checked into the facility. Due to this, it is essential for all members of the healthcare time to never abuse any power or violate the rights of the residents. It should be seen as an honor to care for these patients.
What are Resident Rights?
For starters, all residents have the right to privacy. This includes their personal health information. This data should only be shared with those given specific permission. In 1966, the Health Insurance Portability and Accountability Act was passed in order to provide additional health information protection. This HIPAA act is designed to provide specific guidelines into how a patient’s data can be shared.
A nursing assistant is an essential part of maintaining patient rights. This includes not sharing personal details in any inappropriate way. They are not able to discuss patients outside of work or with others who do not work with the patient. A nursing assistant may not access medical records if they are not working with a specific patient, regardless of who the patient is. Accessing the patient’s records without being a caregiver is a violation of their HIPAA rights.
Should a nursing assistant (or anyone else within the healthcare community) violate HIPAA regulations, they may receive punitive actions against them and they may be fired.
Beyond the protection of patient information, a nursing assistant needs to remain respectful at all times. This includes knocking on a patient’s door before entering, closing the door of a patient and avoiding any unnecessary personal questions that may make the patient feel uncomfortable.
All patients have the right to self-determination. In other words, a patient has the right to make his or her own healthcare decisions. Along with the staff, patients are considered members of the internal healthcare team, so if what the resident thinks is right for them, this overrides that of a nursing assistant (unless it may prove detrimental to their health). When working with the patient, the team creates a specific plan for care and informs the patient of this plan, although it is up to the resident to accept or reject any plan details.
In the event that a patient is not able to make decisions on their own, the person who holds power of attorney will make the decisions for the patient.
Residents have the right to freedom of opinion and expression. They still hold onto all of their speech rights. They can voice their ideas and thoughts on any aspect of their medical care. Regardless of what they say, a nursing assistant must remain respectful and try to assist whenever there is an issue they can help with. Should a problem arise, the nursing assistant can inform the next higher up individual within the chain of command. This is especially the case if the patient believes they are experiencing certain medical conditions.
A patient has the right to fair treatment. They should not be treated better or worse than other patients. If a patient is provided improved treatment and services over another it is a direct violation of the patient’s rights. Should this happen, the individual who did this can be held responsible. No patient should feel abused. Whether in the form of mental, financial, physical, sexual or emotional, abuse comes in many forms and nursing assistants (as well as all other members of the medical team) need to avoid any and all of these forms of abuse.
Identifying Violations and Reporting
There may be times where a nursing assistant suspects patient neglect has taken place. Should this ever happen, the nursing assistant is required to report it. First, the nurse manager or charge nurse (depending on the facility) must be made aware of the situation. This individual can then take appropriate action. There is also a National Center on Elder Abuse hotline (1 – 800 – 677 – 1116).
Abuse against a patient can come in different forms. Physical abuse includes punching and kicking or any other physical action taken against the patient. If a nursing assistant sees any kind of bruises or cuts, it is a possible sign of physical abuse.
It can be a bit difficult to know exactly when emotional abuse is carried out, as it does not have physical signs. Mental or emotional abuse takes place when a patient is verbally assaulted. This can be anything from a patient being belittled or directly criticized. Eventually, the patient may feel afraid or even worthless. If a nursing assistant ever hears any of these verbal abuses or they sense the patient is uncomfortable around a particular individual, it needs to be monitored and looked into. Should the nursing assistant discover abuse, it is then necessary to report it.
Any kind of sexual content carried out without consent from the patient, is sexual abuse. This ranging from the touching of genitals to coercion into performing sexual acts and rape. If there is unexplained bruising around the genitals or bleeding around this area it may be a sign of sexual abuse.
Financial abuse is another form of abuse that doesn’t have physical signs on the patient’s body, but it instead occurs when a patient’s financial history and the information is used against them. This can include someone accessing their money or using the patient’s finances without their permission. Often times, caregivers are given added privileges, including access to the patient’s personal financial records in order to help maintain bill payments. Should this information be abused or used in a non-approved way, it constitutes financial abuse.
While as a nursing assistant, the professional will likely work with a diverse group of people. This includes individuals of all different ages, sexual orientations, economic backgrounds, cultures, races and so on. When working in such a diverse community, it is important for nursing assistants to not show any signs of favoritism and to be respectful to all walks of life. There will be times where the nursing assistant will work alongside others who have varying belief systems. This varying belief system may come up not only in language but also in the food they eat or the clothing they wear. At times, if a nursing assistant is not familiar with these other walks of life they may be a bit taken back, or at the very least, curious, regarding the cultural differences. It is important to remain educated and open to these different beliefs while avoiding judgment. The individual does not need to take on the new beliefs; they just need to not discriminate against these altering beliefs or diversity.
Working in a diverse location with both diverse employees and patients is often one of the enriching parts of the job, as nursing assistants can learn new ways of life and a greater understanding of the community they live in.
Workplace Disputes and Resolutions
There will likely come a time, at some point in a nursing assistant’s career, where a workplace dispute occurs. When this moment occurs, it is important for the individual to know how to handle the situation.
This is where following the chain of command is important. The nurse in charge of the shift will want to look into the situation in order to straighten it out and to prevent it from happening again. The nurse manager may act as the mediator in order to usher in a resolution. It is important to remain professional during the conflict and to avoid any kind of personal confrontation or attack.
While on the job, a nursing assistant will have personal effects and property. This may be stored in a locker or another private space (depending on the facility). Residents will also have personal items in their rooms. Residents trust employees around their items. This can include everything from clothing to jewelry and photographs. It is very important for a nursing assistant to respect the personal property of the resident, the same as they would want someone else to respect their own items.
If there is a safe or another storage area available in the room, nursing assistants should recommend the residents store valuables in these areas for safe keeping and to avoid any possible loss issues.