Communication, Reported Situations, Emergencies

Verbal communication is the use of spoken words but not written words.


Nonverbal communication is communicating without words:


NAs are required to document and report their observations.


observations that should be immediately reported to a nurse

FallsChest PainSevere headacheTrouble breathingAbnormal pulse, respiration, or blood pressureChange in mental statusSudden weakness or loss of mobilityFeverLoss of consciousnessChange in level of consciousnessBleedingSwelling of a body partChange in resident's conditionBruises, abrasions, or other signs of possible abuse

Proper communication with residents means being present with the resident and:

Always greet the resident by his or her preferred name.Identify yourselfFocus on the topic to be discussedFace the resident while speaking and avoid talking into space.Talk with the resident, not other staff members while giving care.Listen and respond when the resident speaks.Praise the resident and smile often.Encourage the resident to interact with you and others.Be courteousTell the resident when leaving the room

Objective observations

Senses, measurable, observable, Vital Signs, Bruises, Blood in urine, Urine output from a catheter

Subjective observations

unobservable symptoms, "I have a headache" , "I feel sick to my stomach", "My foot hurts

What is Verbal Communication?

Spoken or written words

Non-Verbal Communication

communicating without words, gestures, facial expressions, body language

verbal communication

speaking, writing

medical terms

prefix, root, suffix

When speaking to residents and family members, NA should use:

simple, non-medical terms

CNAs sometimes answer phones in a facility.

Identify the facility name, Be friendly and professional, If you take a message, write it down

Call light

A call system that residents can use to call for help, respond immediately, leave within reach of resident

barriers to communication

1. Resident does not hear, or hear correctly, or does not understand.2. Resident is difficult to understand.3. NA, resident, or others use words that are not understood.4. NA uses slang or profanity.5. NA uses clich├ęs.6. NA responds with "Why?"7. NA gives advice8. NA asks questions that only require yes/no answers.9. Resident speaks a different language10. NA or resident uses nonverbal communication.11. Defense mechanisms

Defense mechanisms can be barriers to communicating

1. Denial2. Projection3. Displacement4. Rationalization5. Repression6. Regression

What is the definition of culture?

A system of learned behaviors, practiced by a group of people, that is considered to be the tradition of that group and is passed on from one generation to the next. Aspects: Knowledge, Behaviors, Beliefs, Values, Attitudes, Religions, Customs

What four questions should you ask yourself before you try to communicate with a resident who has a different culture than you do?

1. What information do I need to communicate to this person?2. Does this person speak English as a first or second language?3. Do I speak this person's language, or do I need an interpreter?4. Does this person have any cultural practices about touch or gestures that I should know about?

guidelines for communicating with someone who is hearing impaired/deaf:

If the person has a hearing aid, make sure he or she is wearing it and it is turned on.Keep hearing aids clean and cared for.Reduce or remove noise.Get residents' attention before speaking.Speak clearly, slowly, and in good lighting.Do not shout.Keep the pitch of your voice low.Do not chew gum or eat while speaking.If the resident hears better out of one ear, try to speak and stand on that side.Use short sentences and simple words.Repeat what you have said using different words when needed.Use picture cards or a notepad as neededBe patient and empathetic.Do not pretend to understand if you do not.Be understanding and supportive

guidelines for communicating with someone who is visually impaired/blind:

1. If the resident has eyeglasses, make sure they are clean and that he or she wears them.2. Knock on the door and identify yourself as soon as you enter the room. Do not touch the resident until you have identified yourself.3. Make sure there is proper lighting in the room and face the resident while speaking.4. Orient the resident to where things are when entering a new room.5. Always tell the resident what you are doing while caring for them.6. Use the face of an imaginary clock as a guide to explain the position of objects.7. Do not move personal items or furniture.8. Tell the resident where the call light is.9. Leave doors completely open or completely closed.10. If the resident needs guidance walking around, walk slightly ahead.11. Encourage the use of the other senses, such as hearing, touch and smell.12. Use large clocks, clocks that chime, and radios to help keep track of time.13. If the resident has a guide dog, do not play with, distract, or feed it.

Kevin is escorting a visually impaired resident to a visit with family in the lounge. When Kevin gets to the lounge, he tells the resident he will be back in an hour and leaves. What else should Kevin do to make sure the resident is safe?

Make sure the call light is within reach

mentally healthy person is able to do:

1. Get along with others2. Adapt to change3. Care for self and others4. Give and accept love5. Deal with situations that cause anxiety, disappointment, and frustration6. Take responsibility for decisions, feelings, and actions7. Control and fulfill desires and impulses appropriately

People with mental health disorders could get better if they really tried.


Do not talk to people with mental health disorders as if you are speaking to a child.


You may have to shout to get a person with a mental health disorder to listen to you.


Show respect and concern for a person with a mental health disorder


Do not stand or sit near a person with a mental health disorder.


Avoid eye contact with a person with a mental health disorder.


Be honest and direct and avoid arguments.


In general, combative behavior is not about:

the caregiver

You may block blows but you should never

hit back

CNAs should always _______ combative behavior to the charge nurse.


Anger has only one cause.


If a resident gets angry with you, it is okay to not to care for them anymore.


When someone is angry, stay ________. Do not argue or respond to __________ __________.

calm, verbal attacks

Try to find out what caused the resident's ________. Listen _____________.

anger, attentively

examples of inappropriate behavior on the part of the resident:

Trying to establish person rather than professional relationshipAsking personal questionsRequesting visits on personal timeAsking for or doing favorsGiving tips and giftsBorrowing possessions

What should a CNA do if faced with a resident that is acting inappropriately?

Say "That makes me uncomfortable", or something similar, remain professional, don't overreact, try to distract the resident or take the resident to a private area, notify the nurse

Inappropriate behavior should always be ____________ to the charge nurse


CNAs should always be _____________ and ________ to residents.

comforting, kind

four things a CNA should check before leaving a resident's room:

1. Call light within reach2. Room tidy and items put away3. Furniture in same place, bed lowest position4. Clear walkway in room and to bathroom

Back strain and injury is a SERIOUS problem for CNAs.


Using proper body mechanics is an important way to prevent back injury.


When standing, sitting down or lying down, the body should be in alignment.


Keeping an object as far from the body as possible while carrying it is safest.


Base of support is the foundation that supports an object.


The center of gravity in the body is not the point where the most weight is concentrated.


Proper alignment of the spine is crucial.


A fall is not serious for seniors because their bones are so strong.


Falls make up most of the injuries in LTC.


A fracture is a broken bone.


In order to guard against falls, objects (such as rugs, furniture, etc.) should be removed from hallways & stairs.


factors that can increase the risk of falls

1. Clutter2. Throw rugs3. Exposed electrical cords4. Slippery or wet floors5. Uneven floors or stairs6. Poor lighting7. Call lights that are out of reach or not promptly answered

you can help prevent falls

Clear walkways of clutter, trash, throw rugs and cords.Use rugs with non-slip backingHave residents wear non-skid shoes with tied lacesResidents should avoid wearing clothing that is too long or dragsKeep often-used items close to resident.Answer call lights right awayImmediately clean up spillsReport loose handrailsMark uneven flooring/stairs with tapeImprove lightingLock wheels and move footrests out of the wayLock bed wheels before helping a resident into and out of bedAfter completing care, return bed to lowest positionGet help when moving residents.Offer help with toileting often.Leave furniture in the same place as you found it.Know which residents are at risk for falls.If a resident starts to fall, be in good position to help support her.When a resident falls, report it to the nurse.

Burns can only be caused by wet heat.


People most at risk are those with loss of sensation (kids, seniors, diabetics)


It takes about one minute for a serious burn to occur.


Chemical burns can only be caused by exposure to heat


you can help prevent burns

1. Always check water temperature with a water thermometer or on your wrist before using.2. Report frayed electrical cords or unsafe looking appliances.3. Let residents know you are about to pour or set down a hot liquid.4. Pour hot drinks away from residents.5. Keep hot drinks and liquids covered with a lid and away from edges of tables6. Make sure residents are sitting down before serving hot drinks.7. If plate warmers are used, monitor them carefully.

To prevent burns, you should:

a. Always check water temperatureb. Report frayed electrical cords.c. Pour hot drinks away from residents.

You can tell a person is choking because:

He or she will put their hands around their throat and cough

Cleaning products should never be left in a resident's room.


Most facilities do not have harmful substances in the facility.


Most cuts occur in the bathroom.


An abrasion is a cut that occurred by using a knife improperly.


When moving a resident in a wheelchair the CNA should push the chair backwards.


What is OSHA?

Occupational Safety and Health Administration

What is a 'safety data sheet'?

A sheet that details the chemical ingredients, chemical dangers, and safe handling, storage, and disposal procedures for the product.

Why should you know where the SDSs are located?

To be able to access emergency response actions for any product used that could be hazardous to residents.

What does stop, drop, and roll mean?

A safety technique to extinguish a fire on clothing or hair.

In case of a fire, the most important first step is to make sure residents are safe.


In a fire, once a resident is safe, saving expensive equipment is the next move.


If a fire occurs, you should herd as many residents as you can and proceed to the closest elevator and exit the building as quickly as possible.


Attend to residents one-on-one who need more help or use assistive devices.


The fastest and safest way out of a building is to use the elevator.


Staying low and helping residents get out as quickly as possible is important.


LTC facilities expect you to create an evacuation plan that works for you.