Guided Tour Key Points at the end of each chapter summarize important information and provide a brief review of the content for your reference. Action Steps to Holistic Care at the end of each chapter are activities that will challenge you to review what you have learned and apply it to your own practice and life. Preparing for the Certifi cation Competency Examination questions at the end of each chapter provide an opportunity for you to practice answering questions similar to those on the certifi cation competency examination. Becoming a Holistic Nursing Assistant features highlight principles of holistic care and how they apply to each area of nursing. These scenarios will help you understand the connection between theory and application. Culture Cues features illustrate the impact of culture on care delivery. This will help you appreciate and value the importance of diversity. Healthcare Scenario features challenge you to apply nursing concepts to real-life scenarios. This will offer insight into challenges that might appear in your workplace or community. Think About This features throughout each chapter provide additional information about healthcare topics of interest to keep your knowledge fresh and up to date. Remember features share nursing-related quotes to keep you motivated. Copyright Goodheart-Willcox Co., Inc. Chapter 4 Working in Healthcare 77 3. When communicating, a nursing assistant should show she understands the chain of command sharing resident concerns with which member fi rst? A. her coworkers B. the DON C. the charge D. the nurse manager 4. Which of following is one way nursing assistants can self-examine and refl ect back on the care they deliver? A. contemplating B. analyzing C. reading D. journaling 5. When nursing assistants are being mindful, they are doing which of the following? A. making a resident’s bed B. being aware of call lights ringing C. being present and focused on residents’ needs D. keeping residents’ rooms tidy and clean 6. Which of the following actions would you recommend a new nursing assistant take to ensure she is an effective member of the healthcare team? A. She should let everyone know she is experienced. B. She should tell everyone how much she likes them. C. She should go out with her team after her shift. D. She should be dependable, respectful, and present. 7. Which of the following statements or questions made by a nursing assistant is the most professional and best demonstrates holistic care? A. “Are you getting out of bed today? I need to change the linens.” B. “I have been so busy with other residents that I was not able to give you your bath today.” C. “I need to help you with a bath today. What would be the best time for us to do that?” D. “You need to get up and walk today, and I am busy. Maybe your family can help when they get here.” 8. Which healthcare staff member coordinates administrative and support responsibilities such as processing doctors’ orders? A. RN B. HUC C. LPN D. PTA 9. For a healthcare team to function optimally, its team members need to do which of the following? A. know one another well B. spend time talking about everyone’s experience C. have worked on the unit for a long time D. make decisions collaboratively 10. Which of the following behaviors demonstrates that a holistic nursing assistant is an effective team member? A. sharing only personal opinions and giving advice B. disagreeing without being rude or argumentative C. declining when asked to participate D. reviewing everything said using one’s own experience 11. Which healthcare staff member provides activities and assistance to maintain and improve resident fl and mobility? A. speech therapistexibility B. language therapist C. physical therapist D. occupational therapist 12. There are 32 residents in today’s census at a community long-term care center. The ratio of nursing assistants to residents is 1:8 on the day shift. How many nursing assistants will be needed for this shift? A. six B. three C. fi ve D. four 13. A nursing assistant always tries to keep peace and avoid confl ict during healthcare team meetings. Which team role is she playing? A. initiator B. optimist C. clarifi er D. harmonizer 14. Which of the following considerations are most important to the staffi ng of a unit? A. census and level of care B. level of care and doctor’s preferences C. census and available resources D. staff education and training 15. Which of the following is not example of professional communication?an A. speaking in a courteous and polite manner B. speaking clearly and being concise in your directions C. using fi rst names when addressing residents and their families D. always taking the time to respond to residents and their families Did you have diffi culty with any of the questions? If you did, review the chapter to fi nd the correct answer(s). Becoming a Holistic Nursing Assistant Cultural Humility and Cross-Cultural Communication The following list includes qualities of holistic nursing assistants who practice cultural humility and use cross-cultural communication skills. Read through this list and consider whether you possess each quality. • I have a good understanding of my own cultural and ethnic identity. • I use self-refl ection and avoid making assumptions or believing stereotypes. • I respect others and do not impose my own values and beliefs on them. • I work hard at understanding differing perspectives. • I know that a person’s skill in the English language has nothing to do with his or her level of intelligence or literacy. • I pursue needed resources by asking questions and seeking training when I am uncertain about a cultural group or religion. • I always use cross-cultural communication skills when working with people or groups from different cultures or religions. Apply It 1. Which of the qualities in this list do you already possess? 2. Consider which qualities you do not possess and brainstorm ways you could develop your knowledge and skills to possess them in the future. Culture Cues Personal Space Different cultures have different perspectives on personal space. For example, in public places in Japan, personal space is limited, and people push up against each other when standing and walking. In Italy, the personal space between strangers is an arm’s length, but personal space is much closer with friends and family, and people often hug and kiss in public. In Egypt, sex plays a signifi cant role in the amount of personal space that exists between people. If two people of the same sex are talking, personal space will be very close however, if two people of the opposite sex are talking, they will usually stand an arm’s length apart or more. In the United States, people value personal space and tend to be most comfortable 2–3 feet from another person during conversation. Pay attention to your residents’ cultures and adjust your personal actions and care accordingly. Apply It 1. Explain any experiences you have had with your own personal space and different cultures. 2. How do you think the perceptions of personal space in different cultures will affect the care you give as a holistic nursing assistant? Healthcare Scenario Digital ROM Exercise For the past few months, healthcare staff at a local nursing home have encouraged immobile residents to play games and puzzles on tablets. This exercise has improved resident engagement, mobility, and dexterity. Tablets’ touch screens, puzzles, and games have helped reeducate residents who have suffered a stroke or have dementia. This way, older adults who are not mobile enough to play active video games can still engage and learn using tablets. The swipe, tap, and slide functionality of the tablet allows these residents to play a game of checkers, even if they cannot pick up a checker piece. Apply It 1. If you were a nursing assistant at this facility, how might you teach residents to use a tablet, even if they are not familiar with this technology? 2. What strategies could you use to integrate the use of tablets with physical exercises? Remember People forget how fast you did a job—but they remember how well you did it. Howard W. Newton, American advertising executive and author Think About This In the very early days of healthcare delivery, barber- surgeons could perform minor surgical procedures, pull teeth, and amputate limbs. They could also give enemas, as well as cut hair and shave or trim facial hair. The red-and-white pole, used as a symbol in front of a barbershop, actually signifi es the blood and the napkins used to clean up after bloodletting (a medical practice believed to eliminate disease). 3. When commun should show sh command by sh which sstaffby taff mem A. her coworke B. the DON C. the charge nnurse D. the nurse ma 4. Which of tthe he foll assista nts can self the care they deliv A. contemplating B. analyzing 5. When nursi ng assi are doing which of A. making a resid B. being aware of C. being prese nt an D. keeping residen 6. Which of the follow recommend a ne w nu she is an effective me A. She should let ev experienced. B. She should tell ev likes them. C. She should go out D. She should be dep and present. 7. Which of the following made by a nursing ass professional and best d A. “Are you getting ou change the linens.” B. “I have bee n so bu sy I was not able to giv C. “I n eed to help you would be the best tim D. “You need to get up am busy . Maybe you they get here.” 8. Which heal thcare staff me adminis trative and suppo as processing doctors’ ord A. RN B. HUC 9. For a heal thcare team to fu team m b 76 The Nursing Assistant Copyright Goodheart-Willcox Co., Inc. Chapter 4 Summary and Review Key Points Reviewing the key points for this chapter will help you practice more safely and competently as a holistic nursing assistant and will help you prepare for the certifi cation competency examination. • Healthcare teams may consist of a combination of RNs LPNs/LVNs HUCs nursing assistants and in some cases, respiratory therapists, transport aides, and social workers. • Engagement can be accomplished through mindfulness and self-refl ection. Practicing mindfulness means accepting your thoughts and feelings, as well as the thoughts and feelings of others, without bias or judgment. Self-refl ection requires you to examine your behaviors and actions and determine if there is a need for improvement. • In nursing, critical thinking is an important skill for solving a problem, observing a resident, or learning something new. • Various communication methods, including nonverbal strategies, are used to ensure holistic care. Being able to effectively and professionally commu- nicate and share issues and concerns optimizes the ability to achieve a holistic healing environment. Action Steps to Holistic Care Review the information in this chapter. Complete the following activities. 1. Select one of the following aspects of staffi ng: ratio, census, or staffi ng plan. Prepare a short paper or digital presentation that describes the aspect of staffi ng selected in more detail than what is found in the chapter. 2. With a partner, write a short song or poem that expresses the importance of critical thinking. 3. With a partner, prepare a poster that illustrates communication and teamwork among nursing assistants and other healthcare staff. 4. Research current scientifi c information about either mindfulness or self-refl ection. Write a brief report that describes three current facts. Preparing for the Certifi cation Competency Examination To prepare for the nursing assistant certifi cation competency examination, you will need to know content found in this chapter. This content may be tested in the knowledge (written or oral) and skills (hands-on demonstration) portions of the competency examination. The following areas will be emphasized: • healthcare staff and their roles • the roles and functions of healthcare teams • ways of communicating and working with members of healthcare teams • positive, nonthreatening communication with others • professional communication These sample test questions are similar to ones you will fi nd on the certifi cation competency examination. See how well you can answer them. Be sure to select the best answer. 1. When nursing assistants engage with residents, they are being which of the following? A. compliant B. present C. happy D. noticed 2. A nursing assistant prides himself on being an outstanding critical thinker. Which of the following characteristics most confi rms that this is true? A. He works well with others, and everyone likes working with him. B. He is fun to be around, and everyone seeks him out. C. He stops and thinks carefully about a situation before acting. D. He is a very competent and experienced nursing assistant.