Nursing Fundamentals HN43

Nursing Fundamentals HN43

Indicator 1.02

Understand nurse aide range of function.

Introduction

As a member of the Nursing Department, the nurse aide plays an important role in resident care.

The nurse aide spends more time in direct contact with the resident than any other member of the

healthcare team. Knowledge of nurse aide range of function, legal limitations, and other expectations

gives the nurse aide direction as they provide quality care for residents.

Instructional Activities and Resource Materials

1.02 Teacher’s Script

1.02 PowerPoint (104 slides) ‐ Slides can be divided to meet local lesson plan and pacing guide

needs.

Nurse aide training laboratory as required by NC DHSR ‐ Center for Aide Regulation and

Education.

Equipment and supplies necessary for skills acquisition as required by NC DHSR‐Center for Aide

Regulation and Education.

1.02 Terminology ‐ Student Worksheet

1.02 Terminology ‐ KEY

Oral Presentation Rubric

Culminating Activity Example

DHSR Module “Being Part of a Team”

Activities:

o Script Slide 34 ‐ Facilitate students as they go to the NC Board of Nursing Website to

locate and study the tasks that can be delegated to the Nurse Aide I by the licensed

nurse. Discuss and role play as described on slide 34 script.

o Script Slide 38 ‐ Discussion described on slide 38 script.

o Script Slide 54 ‐ Suggested HOSA Community Awareness Project.

o Script Slide 85 ‐ Discussion described on slide 85 script.

o Script Slide 97 ‐ Additional information in the script that is not on the PowerPoint slide.

o Script Slide 102 ‐ Teach the DHSR module “Being Part of a Team.”

o Script Slide 103 ‐ Culminating Activity outlined in script for slide 102.


1.02 Understand nurse aide's range of function as a member of the healthcare team. 1

Understand nurse aide’s range of function as a member of the healthcare team.

Unit ANurse Aide Workplace Fundamentals

Essential Standard 1.00Understand the range of function, legal and ethical responsibilities of the nurse aide within the healthcare system.

Indicator 1.02Understand nurse aide’s range of function as a member of the healthcare team.

11.02 Nursing Fundamentals HN43

F Y I ‐ Intentional Repeat

There is intentional repeat of some HSII course content in Nursing Fundamentals.

Repeating course content distributes learning over time and increases long term memory.

Academic and skill competence must be maintained at a very high level for direct resident care.

Nursing Fundamentals HN43 21.02


1.02 Introduction

As a member of the Nursing Department, the nurse aide plays an important role in resident care.

The nurse aide spends more time in direct contact with the resident than any other member of the healthcare team.


1.02 Introduction

A knowledge of the range of function, legal limitations, expected qualities, personal habits and obligations is important to provide quality care.



NURSE AIDE RANGE OF FUNCTION


• Assist the licensed nurse by performing delegated tasks directly to residents who are ill and unable to care for themselves.



•Nurse aide tasks are supervised by the licensed nurse.



•Serve as the eyes and ears for the healthcare team



Make and report/record observations accurately regarding

1. Resident condition, care, and resident’s response to care

2. Resident’s environment





Measure and report/record:

1. Vital signs

2. Height and weight

3. Intake and output



Help residents with personal needs:

• Hygiene• Safety

• Nutrition

• Exercise

• Elimination

• Mobility



Help residents with personal needs: (continued)• Communication

• Socialization activities

• Comfort measures

• Restorative procedures



•Assist in resident admission and discharge to the facility





Maintains a clean and safe resident environment



Assist in the collection of various specimens



Answer call signals



Call signals/lights should NOT be perceived as noise and interruption





Call signals/lights are an important way for residents to request assistance!



Answering call lights in a timely manner:1. helps prevent falls.

2. improves rapport between resident/family and staff.

3. increases resident/family confidence in the staff’s ability to care for the needs of the resident.



Assist in the transportation of residents within a facility

Transporter Describes His Job



Cleaning and care of

equipment





Comply with infection control and safety practices, policies, and procedures…

Standard Precautions

Fire Drills/Preparedness

Disaster Drills/Preparedness



Resident Care Plan and Resident Care Conferences:

• May attend Resident Care Conferences

• Assist to develop/revise care plans

• Share care suggestions

• Report observations

Ethical Responsibilitiesof the Nurse Aide


Ethical Responsibilities of the Nurse Aide


ETHICS• Discipline concerned with right or wrong conduct

• Guides to moral behavior

• Making choices or judgments





•Put resident’s needs ahead of your own

• Be sincere, honest and trustworthy in performance of duties– caring and concerned– “golden rule”



• Show respect for each resident as an individual

• Understand the limits of role

• Perform only acts for which adequately prepared

• Perform acts only within legal scope of nurse aide



• Carry out assignments to best of ability

• Be loyal:

• Maintain a positive attitude toward institution that employs you

• Support co‐workers



• Be responsible citizen at all times

• Respect others

• Respect values that differ from yours





• Resident information should be kept confidential

• Discuss only in appropriate places

• Resident information should be kept confidential

– Discuss only in appropriate places

– Discuss only with proper people

– Refer questions from residents about their condition to supervisor

• Discuss only with proper people

• Refer questions from residents about their condition to supervisor



• Respect privacy of others:

–while dressing

–while performing personal hygiene

–during examination or treatment

–during visits with clergy

–during visits with spouse or significant other



• Do not accept monetary tips

–Residents are paying for service

– You are paid to provide service

–Do not discriminate regardless of race, creed, color, age, financial resources

– Provide care based on need



• Do not accept monetary tips (continued)

– Display tactful and courteous refusal of tips

– Display continued desire to be helpful



Legal Parameters of Nurse Aide Work




• BON does not recognize the term “practice” for nurse aides. BON states the phrase “practice” is reserved for the professional nurse.

• NCDHSR will use the phrase “range of function” to enumerate what the nurse aide can and cannot do.

• NCDPI will use the phrase “range of function” to be consistent with NCDHSR



• Nurse aides do not do sterile procedures.

• Nurse aides do not give information about the diagnosis or treatment plans to the resident or his/her family.

• Nurse aides do not give medications.

• Nurse aides do not insert or remove tubes from the resident’s body.



• Nurse aides do not take oral or telephone orders from a physician

• Nurse aides do not diagnose or prescribe treatments or medications for residents.

• Nurse aides do not supervise the work of other nurse aides.





Nurse aides do not agree to do something beyond the nurse aide’s range of function as defined by the North Carolina Board of Nursing.

BRAIN STORM

38

ThinkWhat are the consequences of working out of the range of function for a nurse aide?

ActRaise your hand and share your thoughts! Wait to be called on.




Legal issues related to nurse aide work and all of healthcare are legislatedby state and federal governments.



Healthcare legal issues are based on one of two types of law:

Civil – Fines are imposed

Criminal – You can go to prison





Healthcare legal issues typically

involve CIVIL LAW



Malpractice:• Giving care for which you are

not legally allowed to do

• Providing improper or “BAD” care



Malpractice examples:

Nurse aide giving medication

Nurse aide performing treatment



Negligence:• Unintentional wrong

• Failure to provide goods and services (patient care) necessary and normally expected to avoid physical harm, mental anguish, or mental illness.





Negligence examples:

Brakes on wheelchair not locked and resident falls

Defective equipment not reported and resident is harmed



Assault and Battery:These terms are closely related and often used together.



Assault and Battery:• Assault – threatening or attempting

to touch a person without his consent, causing that person to fear bodily harm



Assault examples:

Threatening to restrain a resident

Angry gesture – shaking a fist in someone’s face or acting as if you are going to slap someone





Assault and Battery:

• Battery – touching of another without consent



Battery examples:

Performing procedure resident has refused

Restraining a resident to prevent them from leaving a room



A B U S E



ABUSE:Willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.





Types of Abuse:• Physical • Verbal• Psychological• Sexual• Others

http://www.preventelderabuse.org/elderabuse/

1.02 Nursing Fundamentals HN43 54



Signs of Abuse:Unexplained bruises, fractures, burns, or injuries.



Signs of Abuse:Signs of neglect such as poor hygiene





Signs of Abuse:Irrational fears or change in personality



Signs of Abuse:Aggressive, withdrawn, or paranoid behavior



Signs of Abuse:Resident statements that indicate abuse or neglect







PHYSICAL

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Abuse MUST be reported!!!!


Elder AbuseDisabled adults of any age are protected in North Carolina under State law (N.C. General Statute 108A-102), which mandates that "any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information." The county departments of social services provide adult protective services under the supervision of the State Division of Aging and Adult Services.

Abuse MUST be reported!!!!


If observed in the resident care facility, stop abuse and report IMMEDIATELY to supervisor if at work.

If observed or have reasonable suspicion of abuse in private life, call the county Department of Social Services where the abuse occurred.

Not reporting is aiding and abetting!



Residents at risk of being abused:• Noisy residents• Residents who wander• Philandering residents• Socially or logistically isolated residents• Residents with a history of aggressive

behavior are at risk to abuse other residents





Perpetrator’s Action…• May be cause for immediate dismissal• If abuse is proven, perpetrator’s name is

posted on the NC Healthcare Personnel Registry AND The National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank

• May be cause for civil or criminal charges



Invasion of Privacy:

Unnecessary exposure of an Individual

Revealing personal informationwithout consent

The Bottom Line


“Do not expose their bodyor their business!”



Invasion of Privacy: examples

• Exposing the entire body when only a body part should be exposed.

• Leaving a door or curtain open during a procedure.





Invasion of Privacy: examples

• Leaving resident information in plain view

• Discussing residents in public areas



False imprisonment:

• Restraining an individual• Restricting residents freedom• Confining an individual

against his/her will



False imprisonment: examples

• Use of physical restraints without authorization or justification

• Preventing resident from leaving facility against their will



Defamation:False statements that cause a resident to be ridiculed or cause damage to their reputation• Spoken – Slander• Written – Liable (Letter)





Fraud:• Intentional deception or misrepresentation

by a person with knowledge that deception could result in some unauthorized benefit to himself or some other person

• Includes any act that constitutes fraud under applicable Federal or State law




WillLegal document giving direction on how resident wants property distributed after death.Refer requests to prepare will to supervisorNurse aide may witness signing of will• Check facility of policy• Discuss with supervisor

Nurse Aide Qualities and Characteristics




Characteristics of Nurse Aide


• Cheerful

• Enthusiastic

• Responsible

• Considerate

• Courteous

• Cooperative



• Willing to learn

• Tactful

• Competent

• Committed to job

• Punctual

• Self‐aware



• Dependable

• Empathetic

• Honest

• Patient

• Respectful

• Trustworthy

Nurse Aide Personal Hygiene and Health




Personal Hygiene Practices


• Taking a daily bath or shower

• Using deodorants/antiperspirants

• Brushing teeth and using mouthwash

• Keeping hair clean and neatly styled

• Cleaning and maintaining short, smooth nails

Personal Hygiene Practices


• Washing hands after using bathroom

• Wearing clean underwear, socks or stockings and uniform daily

• Do not use products having odors that might be offensive to residents

Factors that Promotes Good Health


• Rest and sleep

• Diet

• Exercise

• Good posture and body mechanics

• Eye examinations

• Dental care

• No use of drugs, alcohol or cigarettes

Professional Dress


• Uniform clean, pressed

• Shoes polished and comfortable

• Shoe laces clean

• Stockings without holes/runs

• Jewelry limited to watch and wedding ring



BRAIN STORM

85

ThinkWhy is it important to look and feel healthy while working as a nurse aide?

ActRaise your hand and share your thoughts! Wait to be called on.


Nurse Aide Work Assignment




• Made by a licensed nurse

• Based on needs of residents and availability of staff

• Allows staff to work as team

• Includes being cooperative and helping others when asked



• Includes never ignoring a resident that needs help, is uncomfortable or in danger





• Includes notifying the supervisor of unfinished assignments

• Includes answering call signals even though not assigned to the resident

Nurse Aide Work Plan Considerations


• Workload

• Resident condition

• Time

• Support services assigned

Establishing Priorities for Resident Care


• Activities of daily living

• Meeting hygiene needs

• Positioning and providing for exercise

• Maintaining proper nutrition

• Providing for elimination of wastes



Special procedures:

• Taking vital signs

•Measuring urine





• Support services

• Providing drinking water

• Delivering and picking up meal trays

• Providing clean linen and making beds

• Cleaning and caring for equipment



• Documentation/ reporting

• Presenting oral reports to supervisor

• Writing on record if directed to do so

Healthcare Team Member Practices


Function within Chain of Command


LTC Facility Administrator

Director of Nursing

RN Shift Supervisors

Staff Nurses

Nurse Aides



Identification of Team Members


Nurse Aide MUST wear name tag or photo ID!North Carolina G.S. 90‐640 reads as written:

§ 90‐640. Identification badges required.

Working with Others ‐ Guidelines


• Know the responsibilities, functions and role expectations listed in job description

• Display qualities and characteristics befitting a nurse aide

• Be prompt in reporting to work



• Notify facility of absence ASAP

• Display good health and hygiene practices

• Follow facility dress code policy

• Practice ethical & legal actions

• Direct questions about things you don’t understand to supervisor



• Follow instructions and directions of supervisor

• Display pride in appearance

• Promptly report unusual observations to the supervisor

• Make supervisor aware of family and resident complaints





• Perform duties in spirit of cooperation

• Do not waste supplies and equipment

• Follow facility rules and regulations

• Be accurate in measuring, recording and reporting

• Notify supervisor when leaving and returning to unit



• Assist other healthcare workers willingly

• Never use supplies or equipment belonging to the facility or resident

• Never discuss personal problems with the residents

Culminating Activity


Understand nurse aide’s range of function as a member of the healthcare team.

104

END

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1.02 Nurse Aide Range of Function 2

• Vital signs • Height and weight • Intake and output

Slide 10 Help residents with personal needs: • Hygiene • Safety • Nutrition • Exercise • Elimination • Mobility

Slide 11 Help residents with personal needs: (continued) • Communication • Socialization activities • Comfort measures • Restorative procedures

Slide 12 Nurse Aide Range of Function: • Assist in resident admission and discharge to the facility

Slide 13 Nurse Aide Range of Function: • Maintains a clean and safe resident environment

Slide 14 Nurse Aide Range of Function: • Assist in the collection of various specimens

Slide 15 Nurse Aide Range of Function: • Answer call signals

Slide 16 Nurse Aide Range of Function: • Call signals/lights should NOT be perceived as noise and interruption

Slide 17 Call signals/lights are an important way for residents to request assistance!

Slide 18 Nurse Aide Range of Function: Answering call lights in a timely manner:

1. helps prevent falls. 2. improves rapport between resident/family and staff. 3. increases resident/family confidence in the staff’s ability to care

for the needs of the resident.

Slide 19 Assist in the transportation of residents within a facility Transporter Describes His Job



Slide 20 Nurse Aide Range of Function: Cleaning and care of equipment

Slide 21 Nurse Aide Range of Function: Comply with infection control and safety practices, policies, and procedures… • Standard Precautions • Fire Drills/Preparedness • Disaster Drills/Preparedness

Slide 22 Nurse Aide Range of Function: Resident Care Plan and Resident Care Conferences: • May attend Resident Care Conferences • Assist to develop/revise care plans • Share care suggestions • Report observations

Slide 23 Ethical Responsibilities of the Nurse Aide

Slide 24 Ethics Defined • Discipline concerned with right or wrong conduct • Guides to moral behavior • Making choices or judgments

Slide 25 Ethical Responsibilities of the Nurse Aide • Put resident’s needs ahead of your own • Be sincere, honest and trustworthy in performance of duties

– caring and concerned – “golden rule”

Slide 26 Ethical Responsibilities of the Nurse Aide • Show respect for each resident as an individual • Understand the limits of role • Perform only acts for which adequately prepared • Perform acts only within legal scope of nurse aide

Slide 27 Ethical Responsibilities of the Nurse Aide • Carry out assignments to best of ability • Be loyal: • Maintain a positive attitude toward institution that employs you • Support co‐workers

Slide 28 Ethical Responsibilities of the Nurse Aide

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Slide 41 Healthcare legal issues typically involve CIVIL LAW

Slide 42 Malpractice: • Giving care for which you are not legally allowed to do • Providing improper or “BAD” care

Slide 43 Malpractice examples: Nurse aide giving medication Nurse aide performing treatment

Slide 44 Negligence: • Unintentional wrong • Failure to provide goods and services (patient care) necessary and

normally expected to avoid physical harm, mental anguish, or mental illness.

Slide 45 Negligence examples: • Brakes on wheelchair not locked and resident falls • Defective equipment not reported and resident is harmed

Slide 46 Assault and Battery: These terms are closely related and often used together.

Slide 47 Assault and Battery: • Assault – threatening or attempting to touch a person without his

consent, causing that person to fear bodily harm

Slide 48 Assault examples: Threatening to restrain a resident Angry gesture – shaking a fist in someone’s face or acting as if you are going to slap someone

Slide 49 Assault and Battery: • Battery – touching of another without consent

Slide 50 Battery examples: Performing procedure resident has refused Restraining a resident to prevent them from leaving a room

Nursing F

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Disabled adults of any age are protected in North Carolina under State law (N.C. General Statute 108A‐102), which mandates that "any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information." The county departments of social services provide adult protective services under the supervision of the State Division of Aging and Adult Services.

Slide 63 If observed in the resident care facility, stop abuse and report IMMEDIATELY to supervisor if at work. If observed or have reasonable suspicion of abuse in private life, call the county Department of Social Services where the abuse occurred. Not reporting is aiding and abetting!

Slide 64 Residents at risk of being abused: • Noisy residents • Residents who wander • Philandering residents • Socially or logistically isolated residents • Residents with a history of aggressive behavior are at risk to abuse

other residents

Slide 65 Perpetrator’s Action… • May be cause for immediate dismissal • If abuse is proven, perpetrator’s name is posted on the NC

Healthcare Personnel Registry AND The National Practitioner Data Bank‐Healthcare Integrity and Protection Data Bank

• May be cause for civil or criminal charges

Slide 66 Invasion of Privacy: • Unnecessary exposure of an Individual • Revealing personal information without consent

Slide 67 “Do not expose their body or their business!”

Slide 68 Invasion of Privacy: examples • Exposing the entire body when only a body part should be

exposed. • Leaving a door or curtain open during a procedure.

Slide 69 Invasion of Privacy: examples • Leaving resident information in plain view • Discussing residents in public areas

Slide 70 False imprisonment:

Nursing F

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Slide 78 • Willing to learn • Tactful • Competent • Committed to job • Punctual • Self‐aware

Slide 79 • Dependable • Empathetic • Honest • Patient • Respectful • Trustworthy

Slide 80 Nurse Aide Personal Hygiene and Health

Slide 81 Personal Hygiene Practices • Taking a daily bath or shower • Using deodorants/antiperspirants • Brushing teeth and using mouthwash • Keeping hair clean and neatly styled • Cleaning and maintaining short, smooth nails

Slide 82 Personal Hygiene Practices • Washing hands after using bathroom • Wearing clean underwear, socks or stockings and uniform daily • Do not use products having odors that might be offensive to

residents

Slide 83 Factors that Promotes Good Health • Rest and sleep • Diet • Exercise • Good posture and body mechanics • Eye examinations • Dental care • No use of drugs, alcohol or cigarettes

Slide 84 Professional Dress • Uniform clean, pressed • Shoes polished and comfortable • Shoe laces clean

Nursing F

1.02 Nurs

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related occupation involving the direct provision of healthcare to patients.”

“When providing healthcare to a patient, a healthcare practitioner shall wear a badge or other form of identification displaying in readily visible type the individual's name and the license, certification, or registration held by the practitioner. If the identity of the individual's license, certification, or registration is commonly expressed by an abbreviation rather than by full title, that abbreviation may be used on the badge or other identification.”

Slide 98 Working with Others ‐ Guidelines • Know the responsibilities, functions and role expectations listed in

job description • Display qualities and characteristics befitting a nurse aide • Be prompt in reporting to work

Slide 99 Working with Others ‐ Guidelines • Notify facility of absence ASAP • Display good health and hygiene practices • Follow facility dress code policy • Practice ethical & legal actions • Direct questions about things you don’t understand to supervisor

Slide 100

Working with Others ‐ Guidelines • Follow instructions and directions of supervisor • Display pride in appearance • Promptly report unusual observations to the supervisor • Make supervisor aware of family and resident complaints

Slide 101

Working with Others ‐ Guidelines • Perform duties in spirit of cooperation • Do not waste supplies and equipment • Follow facility rules and regulations • Be accurate in measuring, recording and reporting • Notify supervisor when leaving and returning to unit

Nursing F

1.02 Nurs

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1.01 1

1.02 Terminology - Student Worksheet

Directions: Record key terms and definitions on this chart as they are encountered throughout this objective.

1.02 Understand nurse aide range of function.

Term Definition

Ethics The knowledge of right and wrong. Guides to moral behavior.

Law Rules made by government to help protect public. Laws tell people what they

can and cannot do.

Civil Law Law that deals with relationships between people. May have to pay money to

someone if found guilty of civil law. Fines are imposed. Healthcare legal

issues typically involve civil law.

Criminal Law Offenses against the public and society. May go to jail for breaking criminal

law.

Malpractice Giving care for which you are not allowed legally to perform

Negligence Failure to provide goods and services necessary to avoid physical harm,

mental anguish, or mental illness

Assault and Battery Assault is act of threatening to touch, or attempting to touch a person,

without proper consent. Battery is touching a person without consent.

Types of Abuse Abuse is willful infliction of injury, unreasonable confinement, intimidation or

punishment with resulting physical harm, pain, or mental anguish. Abuse can

be emotional or psychological, physical, fiscal, sexual, or misappropriation of

property. Self‐neglect is a form of abuse.

Vulnerable Adults Adults who are at risk for abuse or mistreatment because they are not able to

protect selves from harm due to mental, emotional, development disability;

or brain damage; or changes from aging.

NC GS 108A‐102 (a) Any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information to the director.

(b) The report may be made orally or in writing. The report shall include the name and address of the disabled adult; the name and address of the disabled adult's caretaker; the age of the disabled adult; the nature and extent of the disabled adult's injury or condition resulting from abuse or neglect; and other pertinent information.


1.01 2

(c) Anyone who makes a report pursuant to this statute, who testifies in any

judicial proceeding arising from the report, or who participates in a required

evaluation shall be immune from any civil or criminal liability on account of

such report or testimony or participation, unless such person acted in bad

faith or with a malicious.

Invasion of Privacy Failure to prevent the intrusion of one person onto another. Violation of right

to control personal information or the right to be left alone.

False Imprisonment Unlawful restraining or restricting a person’s environment

Defamation False statement made to a third person that causes a person shame or

ridicule, or ruins their reputation; written is called libel; verbal is called

slander

Fraud An intentional deception or misrepresentation made by a person with

knowledge that deception could result in some unauthorized benefit to self or

some other person

NC GS 90‐640 North Carolina General Statute that states that Identification badges must be

worn.

Nurse Aide Range of

Function

Tasks that nurse aides are trained to do and legally able to do. The NCBON

lists the tasks that NA Is can legally do.

Priorities for Resident

Care

Activities of daily living, hygiene needs, positioning and providing exercise,

nutrition, elimination of waste.

RN Practice The NCBON refers to what a RN can legally do as “practice.”

Delegation The act of authorizing a person to act as a representative of another. The RN

delegates to the nurse aide personal care tasks. The aide is acting on behalf

of the nurse.


1.01 1

1.02 Terminology - KEY

Directions: Record key terms and definitions on this chart as they are encountered throughout this objective.

1.02 Understand nurse aide range of function.

Term Definition

Ethics The knowledge of right and wrong. Guides to moral behavior.

Law Rules made by government to help protect public. Laws tell people what they

can and cannot do.

Civil Law Law that deals with relationships between people. May have to pay money to

someone if found guilty of civil law. Fines are imposed. Healthcare legal

issues typically involve civil law.

Criminal Law Offenses against the public and society. May go to jail for breaking criminal

law.

Malpractice Giving care for which you are not allowed legally to perform

Negligence Failure to provide goods and services necessary to avoid physical harm,

mental anguish, or mental illness

Assault and Battery Assault is act of threatening to touch, or attempting to touch a person,

without proper consent. Battery is touching a person without consent.

Types of Abuse Abuse is willful infliction of injury, unreasonable confinement, intimidation or

punishment with resulting physical harm, pain, or mental anguish. Abuse can

be emotional or psychological, physical, fiscal, sexual, or misappropriation of

property. Self‐neglect is a form of abuse.

Vulnerable Adults Adults who are at risk for abuse or mistreatment because they are not able to

protect selves from harm due to mental, emotional, development disability;

or brain damage; or changes from aging.

NC GS 108A‐102 (a) Any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information to the director.

(b) The report may be made orally or in writing. The report shall include the name and address of the disabled adult; the name and address of the disabled adult's caretaker; the age of the disabled adult; the nature and extent of the disabled adult's injury or condition resulting from abuse or neglect; and other pertinent information.


1.01 2

(c) Anyone who makes a report pursuant to this statute, who testifies in any

judicial proceeding arising from the report, or who participates in a required

evaluation shall be immune from any civil or criminal liability on account of

such report or testimony or participation, unless such person acted in bad

faith or with a malicious.

Invasion of Privacy Failure to prevent the intrusion of one person onto another. Violation of right

to control personal information or the right to be left alone.

False Imprisonment Unlawful restraining or restricting a person’s environment

Defamation False statement made to a third person that causes a person shame or

ridicule, or ruins their reputation; written is called libel; verbal is called

slander

Fraud An intentional deception or misrepresentation made by a person with

knowledge that deception could result in some unauthorized benefit to self or

some other person

NC GS 90‐640 North Carolina General Statute that states that Identification badges must be

worn.

Nurse Aide Range of

Function

Tasks that nurse aides are trained to do and legally able to do. The NCBON

lists the tasks that NA Is can legally do.

Priorities for Resident

Care

Activities of daily living, hygiene needs, positioning and providing exercise,

nutrition, elimination of waste.

RN Practice The NCBON refers to what a RN can legally do as “practice.”

Delegation The act of authorizing a person to act as a representative of another. The RN

delegates to the nurse aide personal care tasks. The aide is acting on behalf

of the nurse.

BADGE LAW

GENERAL ASSEMBLY OF NORTH CAROLINA AN ACT TO PROTECT PATIENTS’ RIGHTS BY REQUIRING NAME

BADGES OR OTHER IDENTIFICATION FOR HEALTH CARE PRACTITIONERS

Medicine and Allied Occupations - Health Care Practitioner Identification. G.S. 90-640 reads as written: § 90-640. Identification badges required. (a) For purposes of this section, "health care practitioner" means an individual who is licensed, certified, or registered to engage in the practice of medicine, nursing, dentistry, pharmacy, or any related occupation involving the direct provision of health care to patients. (b) When providing health care to a patient, a health care practitioner shall wear a badge or other form of identification displaying in readily visible type the individual's name and the license, certification, or registration held by the practitioner. If the identity of the individual's license, certification, or registration is commonly expressed by an abbreviation rather than by full title, that abbreviation may be used on the badge or other identification. (c) The badge or other form of identification is not required to be worn if the patient is being seen in the health care practitioner's office and, the name and license of the practitioner can be readily determined by the patient from a posted license, a sign in the office, a brochure provided to patients, or otherwise. (d) Each licensing board or other regulatory authority for health care practitioners may adopt rules for exemptions from wearing a badge or other form of identification, or for allowing use of the practitioner's first name only, when necessary for the health care practitioner's safety or for therapeutic concerns. (e) Violation of this section is a ground for disciplinary action against the health care practitioner by the practitioner's licensing board or other regulatory authority. (1999-320, s. 1

Being Part of a Team Curriculum Module

By Teressa W. Banks, RN, Ph.D.

Coastal Region Education Consultant Center for Aide Regulation and Education Health Care Personnel Registry Section

North Carolina Division of Health Service Regulation North Carolina Department of Health & Human Services

2000

Being Part of a Team

Curriculum Module

Introduction


Directions for Use

Being Part of a Team is a curriculum module that has been prepared for two groups of people. First, the instructors, for whom we wish to provide a curriculum that can be used to complement their teaching skills and help them to educate nurse aides to remain knowledgeable, efficient, and caring. Second, the nurse aides, for whom we wish to provide the knowledge and skills necessary to remain competent and current in their provision of care.

Curriculum Pages

Each objective has been featured on a single page divided into two areas – Content Area and Instructor Notes.

• The “Content” area included in each part of the curriculum module outlines the lecture information to be covered in order to meet the objective. Handouts, written activities, discussions, and overheads complimenting each part of the curriculum module are also included.

• The “Notes” area for each part of the curriculum module includes a blank area specially designed for instructor notes. Instructors may choose to write notes beforehand, during class, or afterwards. The notes may serve as reminders for the instructor or may include additional content or examples.

Overhead Transparencies

Each of the three parts of the curriculum module contains a set of overhead transparencies. Each transparency corresponds with a specific objective or objectives and includes information gleaned from curriculum pages. Each transparency is numbered and corresponds with the curriculum content. Even though use of overhead transparencies by the instructor is optional, their use may be an effective teaching tool for nurse aides who are visual learners.

2

Handouts

A set of handouts for each part of the curriculum module is included. Each handout is numbered and corresponds with specific content. Handouts include information gleaned from each of the three parts of the curriculum module. The master copy of each handout should be duplicated and distributed to each nurse aide at the appropriate time during the lecture sequence. Participants should be encouraged to complete appropriate portions of handouts, based on information provided during lecture.

Written Activities

Written learning activities are designed to enhance understanding of the content included in the curriculum module. Completion of each written activity requires the application of concepts learned by the health care provider.

Each written activity corresponds to a specific objective or objectives and is coded with a number corresponding with curriculum content. A master copy of each written activity and an instructor key (when applicable) are included. The master copy of each written activity should be duplicated and distributed to each health care provider at the appropriate time during the lecture sequence.

Group Discussions

Group discussions are done after each health care provider has completed written activity worksheets and are based on the answers to the worksheets. Group discussions are facilitated by the instructor and allow the health care providers to voluntarily answer the questions on the written activity worksheets.

3

Being Part of a Team Curriculum Module Syllabus

Description:

Being Part of a Team is a curriculum module designed for the nurse aide employed in a variety of health care settings. Effective teams do not just happen. Creating an effective team requires specific knowledge, skills, and effort. A nurse aide may be a member of a variety of groups and/or teams. The knowledge gained from this module may therefore be used by the nurse aide, both in the health care setting and outside the boundaries of a health care institution.

Objectives:

1. Identify three types of groups. 2. Describe what it is like to be a part of a working group, also known as a team. 3. Describe the stages of team development. 4. List the features of effective teams with committed team members. 5. List the features of ineffective teams with non-committed team members. 6. Identify patterns of communication among team members. 7. Compare positive and negative roles demonstrated by members of a team.

Teaching Methods:

• Lecture; • Overhead Transparencies (Optional); • Worksheets; • Role Play; and • Class Discussion

Method of Evaluation:

In order to meet requirements for the curriculum module, the nurse aide must:

• Attend the entire class; • Participate in class discussions; and • Complete each of the four worksheets; • Pass the “closed book” written test with a minimum grade of 80.

4

Being Part of a Team Curriculum Module Vocabulary

Brainstorm when two or more people suggest wild, weird, brilliant, or very simple ideas during a certain period of time.

Clarification to make clear or easier to understand.

Cohesiveness the act of sticking together or forming a tight bond.

Collaboration the working together of health team members in the delivery of care to a resident or group of residents.

Collegial every member of a group or team is considered equal in value as a person and recognized based on their contribution to the group or team, rather than on status within the organization.

Conflict when two or more people, groups, agencies, or organizations have opposite views about a situation.

Fiscal when something relates to the finances of an agency or organization.

Group two or more people that work together for a purpose.

Inter- a prefix that means between, among, or together.

Interdependent depending on one another.

Interdisciplinary a team that consists of different people that represents a variety of professions.

Hierarchical a group of people classified according to rank or position within an agency or organization.

Mix of people the planned blending of people on a team based on level of skills, experience, and education.

5

Motivation to work

Objective

Purpose

Team

Unified

the degree to which members of an agency or organization is willing to work.

the identified outcomes that direct activities toward achieving the purpose of the agency or organization.

the service or services provided and for which an agency or organization exists.

working groups with a stable membership, a common purpose, and adequate resources.

united and viewed as one body.

6

Handouts

Duplicate the following as handouts: • Syllabus • Vocabulary

7


8

Being Part of a Team

Overhead - Title 9

Being Part of a Team Objectives

• Identify 3 types of groups. • Describe what it is like to

be part of a working group, also known as a team.

• Describe the stages of team development.

• List the features of effective teams with committed members. • List the features of ineffective

teams with non-committed

10

members. • Identify patterns of

communication among team members.

• Compare positive and negative roles demonstrated by members of a team.

Overhead – Objectives

Being Part of a Team Method of Evaluation

Pass the test Attend class

Do worksheets Participate

Overhead – Evaluation 11


Part One

12

Objective 1: Identify three types of groups. Content

Handout - Distribute Handout Number 1.

Overhead - Show Overhead Number 1.

Definition of a Group

Two or more people that work together for a purpose

Three Types of Groups:

Overhead – Show Overhead Number 2.

1. Formal

• Purpose is to carry out a task or goal instead of meeting the needs of the group members.

• Control of group and choice of leadership is determined from above and based on qualifications.

• Management and managers are symbols of power. • Fiscal goals and funds are of no concern to

members. • Group must follow behavior and rules that are

handed down from above. • Membership in the group is partly voluntary and may

be based on selection by others in authority. • Contact among group members is limited. • Example of this type of group – the work

organization.


2. Semi-formal

• Formal structure. • Membership is voluntary, but may be need to be

Notes

13


Semi-formal (cont.)

approved by others in authority. • Fame and status may be obtained by being a

member. • Structured and pre-planned activities take up a

large part of the meeting time. • Objectives and goals are rigid. • Often, leader has direct control over choice of

his/her replacement. • Expected standards of behavior and rules are

determined by the group. • Examples of this type of group – churches, PTAs,

country clubs, social clubs.


3. Informal

• Informal structure. • Group does not have to follow written rules, but is

based on unwritten rules, standards of acceptable behavior of members, and strong code of ethics.

• Group is purely practical and has very basic objectives.

• Group assigns duties to members best qualified for certain duties.

• Leaders are easily replaced when mistakes are made.

• Harmony and group friendship are needed to maintain the group.

• Group members talk and relate to each other’s at will.

Notes

14


3. Informal (cont.)

• Examples of this type of group – friendship groups, hobby groups, groups that have a useful purpose (carpool).

Instructor Example – Instructor will share an example of a group that he/she belongs to and will include information requested on Written Activity 1 - Group Involvement Worksheet.

Written Activity – Distribute Written Activity 1 – Group Involvement Worksheet. Instruct nurse aides to complete the Group Involvement Worksheet using Handout Number 1 as a resource.

Group Discussion – Ask nurse aides to share individual responses to the Group Involvement Worksheet with the group.

Notes

15

Objective 2: Describe what it is like to be a part of a working group, also known as a team.

Content

Handout – Distribute Handout Number 2.


Definition of a Team

Working groups with a stable membership, a common purpose, and adequate resources.

Team members

• Work together and function as interrelated parts of the whole team.

• Communicate with each other. • Coordinate work activities and share responsibility.

Two types of teams

1. Collegial – Members relate to each other as equals and recognition is based on their contribution to the team. Example – an interdisciplinary team is made up of people from different professions and may include a pharmacist, social worker, physician, nurse, and dietician.

2. Hierarchical – Members relate to each other based on status and position. Members are not treated equally and recognition is based on status. Example – a nursing team is made up of people at different levels within the same profession and includes RNs, LPNs, NAs.

Overhead - Show Overhead Number 6

Notes

16


Content

Steps to Build a Successful Team

• Select team members – people chosen based on ability to perform tasks, ability to work with others, level of education, and stable work history. Selection is determined based on desired mix of people; for example, Unit B has a mix of 2 RNs, 4 LPNs, and 5 NAs.

• Set goals that clearly define the purpose. • Define roles – people are told exactly what is expected

of them as members of the team. • Develop team identity and cohesiveness – people are

told about the team (its purpose and its function) and introduced to other team members. Teamwork, commitment, and identity with the team are encouraged. Many contacts or links with each other on team increases cohesiveness, a shared spirit, and a feeling of enthusiasm. A team area is established where the team will function and meet.

• Open communication – open written and verbal communication leads to understanding and positive relationships. Provides simple purposes and objectives, defines roles, and keeps members informed.

• Manage conflicts – conflict should not be shunned or encouraged, but managed. Too much conflict damages the team and reduces team effectiveness.


Team Assignments

Communicating team assignments ensures that each team

Notes

17


Content

Team Assignments (cont.)

member knows what to do. Members will know what is expected of them and how to plan work schedules.

• Verbal – allows for clarification and questions. • Written assignment – may be used for later reference

and evaluation, used as a reminder.

Notes

18

Objective 3: Describe the stages of team development. Content

Overhead - Show Overhead Number 8

Orientation

• Members seek to be accepted and look for ways of how they are alike and they are different from each other.

• Anxiety is high. • Group is viewed as a group of individuals rather than a

group as a whole. • Members feel unsure, unfamiliar, insecure, and do not

trust others. • Team’s mission and purpose are defined.

Forming

• Members begin to accept each other. • Communication skills learned. • Period of high energy and motivation. • Taking part in the team encouraged.

Storming

• Team spirit is developing. • Trust is developing. • Conflict may arise. • Members may be impatient and frustrated. • Goals and objectives set up. • Most stressful and unpleasant for everyone. • Member decides if he/she wants to stay in the group. • Power struggles may occur.

Notes

19

Objective 3: Describe the stages of team development. Content

Norming

• Increased comfort among members. • Effective team interaction. • Responsibilities identified. • Conflicts resolved. • Plans are made. • Interactions are practical. • Progress is made toward goals.

Performing

• Clear purpose. • Members are unified and hang together. • Group solves problems and works together. • Members act as a team. • Increased responsibility is encouraged. • Members carry out their part of the tasks or job. • Members talk out disagreements. • Group functions as a whole. • Climate is open, pleasant, and relaxed. • Trust is high and individual members are valued.

Written Activity – Distribute Written Activity 2 – Team Building Worksheet. Instruct nurse aides to complete the Team Building Worksheet using Handout Number 1 as a resource.

Group Discussion – Ask nurse aides to share individual responses to the Team Building Worksheet with the group.

Notes

20

Handouts

Handout #1 Three Types of Groups


� Two or more people � Work together for a purpose

Three Types of Groups

1. Formal Group 2. Semi-formal Group 3. Informal Group

Formal Group

• Purpose – carry out a task or goal • Control of group and choice of leadership determined from above • Symbols of power – management and managers • Group must follow behavior and rules handed down • Membership in the group – partly voluntary and may be based on selection • Contact among group members is limited • Example of this type of group – the work organization

Semi-formal

• Formal structure. • Membership - voluntary, but may need to be approved by others • Members may achieve fame and status • Structured and pre-planned activities • Objectives and goals are rigid • Often, leader has direct control over choice of replacement • Expected standards of behavior and rules – determined by the group • Examples – churches, PTAs, country clubs, social clubs.

1

Informal

• Informal structure • Rules and behaviors – group does not have to follow written rules, but

follows unwritten rules, standards of acceptable behavior of members, and strong code of ethics

• Group purpose – is purely practical and has very basic objectives • Duties – group assigns duties to members based on qualifications • Leaders – easily replaced when mistakes are made • Maintenance – harmony and group friendship are needed • Group members – talk and relate to each others at will • Examples – friendship groups, hobby groups, groups that have a useful

purpose (carpool).

2

Handout #2 Team Building


Working group that has

� A stable membership; � A common purpose; and � Adequate resources

Two Types of Groups

1. Collegial Team 2. Hierarchical Team

Collegial Team

� Members relate to each other as equals � Members are recognized based on their contribution to the team � Example – an interdisciplinary team is made up of people from different professions and may

include: • a pharmacist • social worker • physician • nurse • dietician

Hierarchical

� Members relate to each other based on status and position. � Members are not treated equally and recognition is based on status. � Example – a nursing team is made up of people at different levels within the same profession

and and may include: • RNs • LPNs • NAs

3

Steps to Build a Successful Team

� Select team members. People chosen based on • Ability to perform tasks; • Ability to work with others; • Level of education; • Stable work history; and • Desired mix of people (numbers of RNs, LPNs, and NAs).

� Set goals that clearly define the purpose. � Define roles – people are told exactly what is expected of them as members of the team. � Develop team identity and cohesiveness • People told about the team (its purpose and its function) • People introduced to other team members. • Teamwork, commitment, and identity with the team encouraged. • Increased contact with each other on team increases cohesiveness, shared spirit, and a

feeling of enthusiasm. • Team area is established where the team will function and meet.

Open Written and Verbal Communication

� Communicating team assignments • Ensures that each team member knows what to do. • Members will know what is expected of them and how to plan work schedules.

� Verbal assignment – allows for clarification and questions. � Written assignment – may be used for later reference and evaluation, used as a reminder.

4

Stages of Team Development

� Orientation

• Members seek to be accepted and look for ways of how they are alike and how they are different from each other.

• Anxiety is high. • Group is viewed as a group of individuals, rather than a group as a whole. • Members feel unsure, unfamiliar, insecure, and do not trust others. • Team’s mission and purpose are defined.

� Forming

• Members begin to accept each other. • Communication skills learned. • Period of high energy and motivation. • Taking part in the team encouraged.

� Storming

• Team spirit and trust developing. • Conflict may arise. • Members may be impatient and frustrated. • Goals and objectives set up. • Most stressful and unpleasant for everyone. • Member decides if he/she wants to stay in the group. • Power struggles may occur.

� Norming

• Increased comfort among members. • Effective team interaction. • Responsibilities identified. • Conflicts resolved. • Plans are made. • Interactions are practical. • Progress is made toward goals.

5

� Performing

• Clear purpose. • Members are unified and hang together. • Group solves problems and works together. • Members act as a team. • Increased responsibility is encouraged. • Members carry out their part of the tasks or job. • Members talk out disagreements. • Group functions as a whole. • Climate is open, pleasant, and relaxed. • Trust is high and individual members are valued.

6


�Two or more people �Work together for a purpose

Three Types of Groups

1. Formal Group 2. Semi-formal Group 3. Informal Group

Overhead Number 1, Objective 1, Part 1 1

Formal Group

�Purpose �Control �Power �Rules & Behavior �Membership �Contact �Example


Semi-formal Group

�Formal Structure �Membership � Fame & Status �Activities �Objectives & Goals �Control �Rules & Behavior �Examples

Overhead Number 3, Objective 1, Part 1

3

Informal Group

� Informal Structure �Rules & Behavior �Practical � Member Duties �Leaders � Group Maintenance �Members �Examples



� Working groups � Stable membership � Common purpose � Adequate resources

Two Types of Teams

1. Collegial team 2. Hierarchical team


Steps to Building a Team

1. 2. 3.

Select team members Set goals Define roles

4. Develop team identity 5. Open communication 6. Manage conflict


Team Assignments

Each member knows � What to do � What is expected � How to plan work schedules

Verbal Assignment � Allows for clarification � Allows for questions

Written Assignment � Used for later reference � Used for later evaluation �Used as a reminder


Stages of Team Development

Orientation ⇓

Forming ⇓

Storming ⇓

Norming ⇓

Performing ⇓

A Team is Born


Written Activities

____________________________________________________________

____________________________________________________________

____________________________________________________________

Written Activity #1 Group Involvement Worksheet

Instructions: Pick a group (other than your work group) that you are a member of and answer the following questions. Be ready to share your responses with the group. You will have 10 minutes to complete the worksheet.

Name of Group: ______________________________________________

Type of Group: _____ Formal _____ Semiformal _____ Informal

How long have you been in the group? ________________________________

How often does the group meet? ____________________________________

Where does the group meet? ______________________________________

Do you enjoy being with the members of the group? _____ yes; _____ no

Describe the leader of the group. ___________________________________

How was the leader chosen? ______ volunteered ______ elected ______ it just happened

Would you like to be the leader of this group? ______ yes; ______ no

How do you contribute to the good of the group?

1

Written Activity # 2 Team Building Worksheet

Instructions: Read the Descriptions for Team Number One and Team Number Two. Answer the questions about each team. You have 10 minutes to complete the worksheets.

Team Number One

I am a member of a team. I am a cafeteria manager. I am responsible for supervising the cafeteria employees, developing policies, ordering food and supplies, and working with state regulators. I have a two-year management degree from the local community college and have worked at the nursing home ten years.

Other members of my team include dietetic technicians, cafeteria servers, and cooks. Dietetic technicians place food and drinks on resident trays and transport trays to and from the nursing units. Cafeteria servers are responsible for serving food and drinks to people eating in the nursing home cafeteria. Cooks are responsible for cooking and preparing all food that is eaten in the nursing home. Dietetic technicians and cooks are required to have high school diplomas. Cafeteria servers are not required to have a high school diploma.

The nursing home employs one cafeteria manager. Five dietetic technicians are needed to work each day at the nursing home (three work on first shift and two work on second shift). Four cafeteria servers are needed to work each day at the nursing home (two work on first shift and two work on second shift). Four cooks are needed to work each day at the nursing home (two work on first shift and two work on second shift).

1. I am a member of what kind of team? (Check one.) _____ Hierarchical _____ Collegial

2. Who is the leader of my team? (Check one.) _____Cafeteria Manager _____ Dietetic Technicians _____ Cafeteria Servers _____ Cooks

2

____________________________________________________________

____________________________________________________________

____________________________________________________________

3. What is the mix of people on 1st shift? _____ Cafeteria Manager _____ Dietetic Technicians _____ Cafeteria Servers _____ Cooks

4. What is the common purpose for this team?

3

Team Number Two

I am a member of a team. The chair of my team is a physician. I am a Registered Dietician. I make sure residents are receiving the proper diets and the proper supplements. I read the residents’ charts and note weights, intake, and lab reports. I have a Masters Degree and I have worked at the nursing home three years.

Other members of my team include a physician, the Director of Nursing, a speech therapist, a pharmacist, and a social worker. The physician is in charge of the medical care of each of the residents and is the leader of the team. The Director of Nursing is responsible for the entire nursing staff. The speech therapist assists residents with oral communications problems. The pharmacist receives orders for medications, prepares medications for the residents, and checks lab reports. The social worker counsels residents and helps locate community and financial resources.

The physician has a medical degree. The Director of Nursing, social worker, and pharmacist each have advanced educational degrees.

The team meets once a month. Members of the team trust each other and work well together. The members function well as a team and as a whole. Team members appear relaxed during meetings and communication is always open and pleasant. Each of the team members are valued, always prepared, and carries out their duties. The team members rarely quarrel. Disagreements are always discussed and problems worked out.

1. I am a member of what kind of team? (Check one.) _____Hierarchical _____ Collegial

2. Who is the leader of my team? (Check one.) _____Physician _____ Registered Dietician _____ Pharmacist _____ Social Worker

4

____________________________________________________________

____________________________________________________________

____________________________________________________________

3. What is the common purpose for this team?

4. What is the stage of development of this team? (Check one.) _____ Orientation _____ Forming _____ Storming _____ Norming _____ Performing

5

Written Activity #2 Team Building Worksheet Answer Key Team Number 1 and Team Number 2

Instructions: Read the Team Descriptions for Team Number One and Team Number Two. Answer the questions about each team. You have 10 minutes to complete the worksheet.

Team Number One

I am a member of a team. I am a cafeteria manager. I am responsible for supervising the cafeteria employees, developing policies, ordering food and supplies, and working with state regulators. I have a two-year management degree from the local community college and have worked at the nursing home ten years.

Other members of my team include dietetic technicians, cafeteria servers, and cooks. Dietetic technicians place food and drinks on resident trays and transport trays to and from the nursing units. Cafeteria servers are responsible for serving food and drinks to people eating in the nursing home cafeteria. Cooks are responsible for cooking and preparing all food that is eaten in the nursing home. Dietetic technicians and cooks are required to have high school diplomas. Cafeteria servers are not required to have a high school diploma.

The nursing home employs one cafeteria manager. Five dietetic technicians are needed to work each day at the nursing home (three work on first shift and two work on second shift). Four cafeteria servers are needed to work each day at the nursing home (two work on first shift and two work on second shift). Four cooks are needed to work each day at the nursing home (two work on first shift and two work on second shift).

1. I am a member of what kind of team? Hierarchical

2. Who is the leader of my team? Cafeteria Manager

3. What is the mix of people on 1st shift? _ _1_ Cafeteria Manager ___3_ Dietetic Technicians ___2_ Cafeteria Servers ___2_ Cooks

4. What is the common purpose for this team? To provide a nutritional meal for

the residents.

6

Written Activity #2

Team Building Worksheet Answer Key for Team Number Two

I am a member of a team. The chair of my team is a physician. I am a Registered Dietician. I make sure residents are receiving the proper diets and the proper supplements. I read the residents’ charts and note weights, intake, and lab reports. I have a Masters Degree and I have worked at the nursing home three years.

Other members of my team include a physician, the Director of Nursing, a speech therapist, a pharmacist, and a social worker. The physician is in charge of the medical care of each of the residents and is the leader of the team. The Director of Nursing is responsible for the entire nursing staff. The speech therapist assists residents with oral communications problems. The pharmacist receives orders for medications, prepares medications for the residents, and checks lab reports. The social worker counsels residents and helps locate community and financial resources.

The physician has a medical degree. The Director of Nursing, social worker and pharmacist each have advanced educational degrees.

The team meets once a month. Members of the team trust each other and work well together. The members function well as a team and as a whole. Team members appear relaxed during meetings and communication is always open and pleasant. Each of the team members are valued, always prepared, and carries out their duties. The team members rarely quarrel. Disagreements are always discussed and problems worked out.

1. I am a member of what kind of team? collegial

2. Who is the leader of my team? physician

3. What is the common purpose for this team? provide optimal care for the

residents

4. What is the stage of development of this team? performing

7


Part Two

1

Objective 4: List the features of effective teams with committed team members. Content



Qualities of Effective Teams

• Climate – informal, comfortable, and relaxed. Members are interested and involved.

• Communication – open and two-way. Ideas and feelings encouraged.

• Interactions – inclusive, trusting, people like each other and like working with each other.

• Getting the job done – goals, tasks, objectives are appropriate, under-stood, and modified so that members can be committed.

• Leadership and member participation shift from time to time, depending on what is going on at the time and level of expertise of the individuals.

• Decision-making done by consensus.


• Cohesion – high levels of inclusion, trust, liking, and support.

• Reasons for disagreements or conflicts are looked at and group tries to resolve them. Group learns to live with disagreements that cannot be resolved.

• Power is based on abilities, knowledge, and is shared. Main point is how to get the job done.

• Problem-solving is high. Constructive criticism is frequent, honest, and oriented to removing the problem.

• Group self-evaluation is often. All members evaluate progress and how to improve functioning.

Notes

2

Objective 4: List the features of effective teams with committed team members. Content

• Creativity is encouraged. Members have the chance to become all they can be and excel.


Indications of Group Commitment

• Members feel a strong sense of belonging. • Members enjoy being with each other. • Members ask each other for advice. • Members seek and provide support in times of

difficulty. Members value each other and contributions. • Members are motivated and want to do a good job. • Members express good feelings openly. • Members feel the goals of the group are important and

achievable.

Notes

3

Objective 5: List the features of ineffective teams with non-committed team members. Content

Overhead – Show Overhead Number 4 & 5.

Qualities of Ineffective Teams:

• Tense climate, signs of boredom. • Closed and one-way communication. Ideas and feelings

are discouraged. Members are reluctant to speak up. May be “hidden agendas.”

• Interactions are based on authority. Chair may dominate the group. Members participate unequally. People with more power dominate.

• Unclear, misunderstood, or imposed goals may be accepted by members.

• Decision-making done by the highest authority, with minimal group involvement.

• Distrust among members, and members forced to conform.

• Disagreements or conflicts are ignored, denied, suppressed.

• Power is based on position in group. Employees do what they are told to do or suffer the consequences.

• Problem-solving is low. Criticism is destructive, members are attacked, prevents job from getting done.

• Group self-evaluation is seldom done. If evaluation is done, it is done by the highest authority.

• Creativity is discouraged. Members are afraid they will be laughed at or will appear foolish if they suggest something that is creative.

Notes

4

Objective 5: List the features of ineffective teams with non-committed team members. Content


Indications of Group Non-commitment:

• Members do not feel a strong sense of belonging. • Members do not enjoy being with each other and dread

meetings. • Members are in a hurry to leave after the meeting is

over. • Members do not confide in each other. • Members generally do not like each other and do not

value contributions made. • Members are not motivated to work for the good of the

team. • Members speak negatively about the team.

Written Activity – Distribute Written Activity 1 – Go Team Worksheet. Instruct nurse aides to complete the Team Building Worksheet using Handout Number 1 as a resource.

Group Discussion – Ask nurse aides to share individual responses to the Go Team Worksheet with the group.

Notes

5

Handouts

Handout #1

Go Team


∑ Climate • Informal, comfortable, and relaxed • Members are interested and involved

∑ Communication • Open and two-way • Ideas and feelings encouraged

∑ Interactions • Inclusive, trusting • People like each other and like working with each other

∑ Getting the job done • Appropriate and understood goals, tasks, objectives. • Goals, tasks, objectives are often modified as needed

∑ Leadership and member participation • Shift from time to time • Depends on what is going on at the time and level of expertise of the

individuals. ∑ Decision-making – done by consensus ∑ Cohesion – high levels of inclusion, trust, liking, and support ∑ Reasons for disagreements or conflicts

• Are looked at and group tries to resolve them. • Group learns to live with disagreements that cannot be resolved.

∑ Power • Based on abilities and knowledge • Shared • Main point is how to get the job done

∑ Problem-solving is high ∑ Constructive criticism

• Frequent and honest • Oriented to removing the problem

∑ Group self-evaluation • Is often • All members evaluate progress and how to improve functioning

∑ Creativity is encouraged and all have a chance to excel

1

Indications of Group Commitment

Members

✔ Feel a strong sense of belonging.

✔ Enjoy being with each other.

✔ Ask each other for advice.

✔ Seek and provide support in times of difficulty.

✔ Value each other and contributions.

✔ Are motivated and want to do a good job.

✔ Express good feelings openly.

✔ Feel the goals of the group are important and achievable.

2

Qualities of Ineffective Teams

∑ Climate • Tense • Signs of boredom

∑ Communication • Closed and one-way • Ideas and feelings discouraged • Members are reluctant to speak up • May be “hidden agendas”

∑ Interactions • Based on authority • Chair may dominate the group • Members participate unequally • People with more power dominate

∑ Getting the job done • Unclear, misunderstood, or imposed goals • May or may not be accepted by members

∑ Decision-making • Done by the highest authority • Minimal group involvement

∑ Cohesion • Used to control members • Distrust among members and are forced to conform

∑ Disagreements or conflicts are ignored, denied, suppressed ∑ Power is based on position in group and are told what they are told to do

or suffer consequences ∑ Problem-solving is low ∑ Criticism

• Is destructive • Members are attacked • Job does not get done

∑ Group self-evaluation • Seldom done and if it is done, it is done by the highest authority

∑ Creativity • Is discouraged • Members are afraid they will be laughed at or will appear foolish if

they make suggestions

3

Indications of Group Non-commitment

Members

✔ Do not feel a strong sense of belonging.

✔ Do not enjoy being with each other and dread meetings.

✔ Are in a hurry to leave after meetings are over.

✔ Do not confide in each other.

✔ Generally do not like each other and do not value contributions made.

✔ Are not motivated to work for the good of the team.

✔ Speak negatively about the team.

4


Climate is positive

Communication open/two-way

Interactions are positive

Getting the job done

Leadership/member participation

Decision-making done by all



Cohesion is high

Disagreements/conflicts dealt with

Power is shared

Problem-solving is high

Constructive criticism is positive

Group self-evaluation is often

Creativity is encouraged


Group Commitment

✰✰✰✰ Strong sense of belonging

✰✰✰✰ Enjoy being with each other

✰✰✰✰ Ask each other for advice

✰✰✰✰ Seek & provide support

✰✰✰✰ Value each other

✰✰✰✰ Motivated & want to do good

✰✰✰✰ Express good feelings openly

✰✰✰✰ Group goals important

✰ Group goals achievable



Climate is tense

Communication is closed/one-way

Interactions - based on authority

Job rarely gets done

Decision-making done by authority



Cohesion is absent

Disagreements/conflicts ignored

Power based on position

Problem-solving is very low

Group self-evaluation seldom done

Creativity is discouraged


✰

Group Non-commitment

✰✰✰✰ No strong sense of belonging

✰✰✰✰ Hate being with each other

✰✰✰✰ Dread meetings

✰✰✰✰ Not motivated

✰✰✰ Do not like

each other

✰✰✰✰ Do not confide

in each other

✰✰✰✰ Do not value each other

✰✰✰✰ Do not want to do a good job

✰✰✰✰ Express negative feelings


Written Activities

Written Activity #1

Go Team Worksheet

Instructions: Read the following conversations overheard in various health care facilities. Decide whether a member of an effective team or an ineffective team is talking. Place a check in the correct box – effective or ineffective. Place a check mark in the third box if you have heard, thought, or said a similar comment in the past. You have 15 minutes to complete the worksheet.

Conversation Effective Ineffective Heard, Thought, or Said Comment?

1. “No, I won’t get Mr. James up to the bathroom, because he is not my resident.” 2. “I can’t wait until the staff Christmas party!” 3. “Why don’t you get Mrs. Smith on the bedpan, and I’ll turn Mr. Peters.” 4. “If I have to sit in another end-of-shift report with that witch, Mrs. Billingsworth, I’ll scream!” 5. “Don’t you think Jackie is a good charge nurse?” 6. “I really enjoy working with you, Katie.” 7. “Hey Marty, let’s go turn all our residents together.” 8. “Cindy, I sure do see why we can’t keep any Nurse Aides here. I’ve been here the longest and I’ve only been here eight months!” 9. “That Mary, she looks like a horse whenever she shakes her head, no.” 10. “Guess what I heard about Johnnie? It will really shock you!” 11. “I am really glad to be a part of the care planning team.” 12. “You are such a good person to work with.”

1


13. “The infection control nurse said that we only had a 2% infection rate. We did better on our goal than we predicted.” 14. “Sophie, you know Mrs. Atkins better than anyone. Why do you think she seems so unhappy?” 15. “Gee, Betsy, I sure am glad you and Sam resolved the disagreement about the luncheon date.” 16. “Hey Cecil, can I ask your advice about something?” 17. “I don’t care what you think, Missy. We are not going to do it that way. We are going to do it my way.” 18. “That’s a stupid goal. How in the world will we ever achieve that?” 19. “You will do it now, because I said so!” 20. “Man, I never seem to get done with all my assigned work.” 21. “Frankly, I don’t care what you think.”

Think About It Activity

Instructions: After discussing the Go Team Worksheet with your instructor, take three minutes to think about all the teams that you have been a part of, during your lifetime. These teams may be work teams, church teams, social teams, etc. Were the teams effective? Why or why not?

2

Written Activity #1

Go Team Worksheet Answer Key

Instructions: Read the following conversations overheard in various health care facilities. Decide whether a member of an effective team or an ineffective team is talking. Place a check in the correct box – effective or ineffective. Place a check mark in the third box if you have heard, thought, or said a similar comment in the past. You have 15 minutes to complete the worksheet.


1. “No, I won’t get Mr. James up to the bathroom because he is not my resident.” X 2. “I can’t wait until the staff Christmas party!”

X 3. “Why don’t you get Mrs. Smith on the bedpan, and I’ll turn Mr. Peters.” X 4. “If I have to sit in another end-of-shift report with that witch, Mrs. Billingsworth, I’ll scream!”

X

5. “Don’t you think Jackie is a good charge nurse.”

X

6. “I really enjoy working with you, Katie.” X 7. “Hey Marty, let’s go turn all our residents together.” X 8. “Cindy, I sure do see why we can’t keep any Nurse Aides here. I’ve been here the longest and I’ve only been here eight months!”

X

9. “That Mary, she looks like a horse whenever she shakes her head, no.” X 10. “Guess what I heard about Johnnie? It will really shock you!” X 11. “I am really glad to be a part of the care planning team.” X 12. “You are such a good person to work with.” X 13. “The infection control nurse said that we only had a 2% infection rate. We did better on our goal than we predicted.”

X

3


14. “Sophie, you know Mrs. Atkins better than anyone. Why do you think she seems so unhappy?”

X

15. “Gee, Betsy, I sure am glad you and Sam resolved the disagreement about the luncheon date.”

X

16. “Hey Cecil, can I ask your advice about something?” X 17. “I don’t care what you think, Missy. We are not going to do it that way. We are going to do it my way.”

X

18. “That’s a stupid goal. How in the world will we ever achieve that?” X 19. “You will do it now, because I said so!” X 20. “Man, I never seem to get done with all my assigned work.” X 21. “Frankly, I don’t care what you think.” X

Think About It Activity

Instructions: After discussing the Go Team Worksheet with your instructor, take three minutes to think about all the teams that you have been a part of, during your lifetime. These teams may be work teams, church teams, social teams, etc. Were the teams effective? Why or why not?

This is just a thinking exercise for the nurse aides. They do not need to answer the questions in class.

4


Part Three

Objective 6: Identify patterns of communication among team members. Content



One-way

• Verbal communication moves one way – from leader to group members.

• Highly planned and controlled by leader. • Group allows control by leader. • Nonverbal responses may affect leader (frowns, yawns,

nods, smiles) • Leader may permit questions or comments from group,

but maintains control. • Efficient way to communicate facts to lots of people in

short amount of time. • Not good for decision making, problem solving, or

evaluation. • Example, lecture or stage performance.


Stilted

• Verbal communication flows both ways. • Pattern is slightly formal. • Usually each member takes a turn to speak, in formal

manner. • Communication is directed toward leader. • Very structured. • Gives everyone a chance to speak. • Discourages discussion.

Notes

2

Objective 6: Identify patterns of communication among team members. Content

Limited

• Some group members communicate with leader and each other, while others do not.

• Can result from strong smaller group of people within the big group or members not wishing to join in.


Open

• Free and easy exchange between leader and members. • Each member has a chance to speak, to be heard, and

get a response. • Communication is planned and expected, yet flexible. • Each member knows what to expect from each other. • Not a great way to make decisions.


Chaotic

• Leader has no control of group. • Disorganized, unpredictable, and out of control. • Side conversations between two members occur. • Members interrupt each other, ignore each other, talk

at the same time, shout at each other. • May be relaxed or tense. • Not a good way to meet if goals must be met.

Notes

3

Objective 7: Compare positive and negative roles demonstrated by members of a team. Content



Team Roles

Are positive or negative patterns of individual behavior that affect the team. One person can assume one role or many roles.

Three Components of a Team Meeting

• Leader – oversees the team. • Recorder – writes down what team has done. • Members – participants of the team.


Positive Roles

• Contributor – suggests something, proposes new ideas. • Information giver – offers important information from

own knowledge or experience. • Information seeker – asks for information from others. • Opinion giver – offers opinions or feelings about things. • Opinion seeker – asks for opinions or feelings from

others. • Disagreer – points out mistakes or takes a different

point of view. • Coordinator – points out relationships between two or

more ideas. • Elaborator – expands on ideas or provides examples. • Energizer – stimulates and moves the group toward

goals, encourages activity.

Notes

4


• Summarizer – pulls together ideas of the group, outlines what group has done.

• Gatekeeper – makes sure everyone has a chance to speak, may limit people who talk too much.

• Follower – accepts group decisions, goes along with the group, does not take an active role.

Handout – Distribute Handout Number 3.


Negative Roles

• Aggressor – makes mean, attacking remarks, criticizes others.

• Recognition seeker – does things to call attention to himself/herself.

• Monopolizer – talks so often or so long that others don’t get a chance to speak.

• Dominator – tries to take over the leader’s role, wants to have his/her own way.

• Playboy – makes irrelevant and silly comments, whispers, jokes around, does not take group seriously.

• Zipper-mouth – does not share at all, may sulk, sits with arms folded, does not accept group.

• Busy body – not committed to group, arrives late, leaves early, takes care of personal business during meetings, simply shows up for appearance sake.

• Squasher – stops idea before it is discussed, always has a reason for why something will not work, blocks progress of group.

• Interrupter – never allows others to finish thoughts or ideas.

Notes

5


Role Play Activity – Distribute Role Play Activity #1 and assign parts to six nurse aides. Instruct them to act out skit.

Role Play Activity Worksheet – After skit, instructor and nurse aides complete Role Play Activity Worksheet #1 together in class, using Handout Numbers 1, 2, and 3.

Role Play Activity – Distribute Role Play Activity #2 and assign parts to six to ten nurse aides. Instruct them to act out skit.

Role Play Activity Worksheet – After skit, instructor and nurse aides complete Role Play Activity Worksheet #2 together in class, using Handout Numbers 1, 2, and 3.

Notes

6

Handouts

Handout #1

Patterns of Communication

One-way

∑ Verbal communication moves one way ∑ Highly planned and controlled by leader ∑ Nonverbal responses may affect leader ∑ Leader may permit questions or comments ∑ Efficient way to communicate to lots of people ∑ Not good for decision making or evaluation ∑ Example lecture

Stilted

∑ Verbal communication flows both ways ∑ Slightly formal and structured pattern ∑ Members take turns to speak in formal manner ∑ Communication directed toward leader ∑ Everyone has a chance to speak ∑ Discussions discouraged

Limited

∑ May or may not communicate with each other ∑ Can result from strong smaller group

Open

∑ Free and easy exchange ∑ Members can speak/be heard/get a response ∑ Communication is planned/expected, flexible. ∑ Members know what to expect ∑ Not a great way to make decisions

1

Chaotic

∑ Leader has no control of group ∑ Disorganized/unpredictable/out of control ∑ Side conversations ∑ Members are interrupted and ignored ∑ Members talk at the same time and shout ∑ May be relaxed or tense ∑ Not a good way to meet if goals must be met

2

Handout #2

Roles of Team Members

Team Roles



Leader – oversees the team

Recorder – writes down what team has done

Members – participants of the team

Positive Roles

Contributor – suggests something, proposes new ideas

Information giver – gives important information from own knowledge/

experience

Information seeker – asks for information from others

Opinion giver – offers opinions or feelings about things

Opinion seeker – asks for opinions or feelings from others

Disagreer – points out mistakes or takes a different point of view

Coordinator – points out relationships between two or more ideas

Elaborator – expands on ideas or provides examples

Energizer – stimulates/moves the group toward goals, encourages activity

Summarizer – pulls together group’s ideas, outlines what group has done

Gatekeeper – makes sure everyone has a chance to speak, may limit people

Follower – accepts group decisions, goes along with the group, not active

3

Handout #3


Team Roles



Leader – oversees the team

Recorder – writes down what team has done

Members – participants of the team

Negative Roles

Aggressor – makes mean, attacking remarks, criticizes others

Recognition seeker – does things to call attention to himself/herself

Monopolizer – talks so often or so long that others don’t get a chance to speak

Dominator – tries to take over the leader’s role, wants to have own way

Playboy – irrelevant/silly comments, whispers, jokes around, not serious

Zipper-mouth – does not share or accept group, may sulk, sits with arms folded

Busy body – not committed, arrives late, leaves early, takes care of personal business during meetings, simply shows up for appearance sake

Squasher – stops idea before discussed, always has a reason for why something will not work, blocks progress

Interrupter – never allows others to finish thoughts or ideas

4

Patterns of Communication One-way

• Verbal communication moves one way

• Highly planned/controlled by leader

• Nonverbal responses may affect leader

• Leader may permit questions or comments

• Efficient way to communicate to lots of

people

• Not good for decision making or evaluation

• Example, lecture


Patterns of Communication Stilted

• Verbal communication flows both ways

• Slightly formal and structured pattern

• Members take turns to speak in formal

manner

• Communication directed toward leader

• Everyone has a chance to speak

• Discussions discouraged

Limited

• May or may not communicate with each

other

• Can result from strong smaller group


Patterns of Communication Open

• Free and easy exchange

• Members can speak/be heard/get a

response

• Communication is planned/expected,

flexible.

• Members know what to expect

• Not a great way to make decisions


Patterns of Communication Chaotic

• Leader has no control of group

• Disorganized/unpredictable/out of

control

• Side conversations

• Members are interrupted

and ignored

• Members talk at the same time

and shout

• May be relaxed or tense

• Not a good way to meet if goals must be

met


Roles of Team Members Team Roles



1. Leader – oversees the team

2. Recorder – writes down things done

3. Members – participants of the team



Positive Roles

+ Contributor

+ Coordinator

+ Information giver

+ Elaborator

+ Information seeker

+ Energizer

+ Opinion giver

+ Summarizer

+ Opinion seeker

+ Gatekeeper

+ Disagreer

+ Follower



Negative Roles

- Aggressor

- Zipper-mouth

- Recognition Seeker

- Busy body

- Monopolizer

- Squasher

- Dominator

- Interrupter

- Playboy


Role Play Activities

Role Play Activity #1

Instructions: This is a skit that includes 6 characters. If you are assigned a part, take five minutes to read over the skit. If you are not assigned a part, take a small stretch break and do not read the skit.

Sally: Hello everyone. I am really glad you could make it for today’s meeting. As you know, we are here to plan for Mrs. Smith’s surprise 100th birthday party. Jane, will you take notes please?

Jane: Sure. I’ll be glad…

Mary: [Interrupts Jane.] Well, we sure better hurry up and plan this thing because Mrs. Smith sure isn’t getting any younger, you know!

Jean: Well, since her birthday falls on a Saturday this year, why don’t we have it on the exact day of her birthday?

Joanne: [Rolls her eyes and speaks in a sarcastic tone.] Gee, Jean what a great idea. We’ll have her birthday party on her birthday! While we are at it, why don’t we plan the Halloween Party on Halloween day and our Columbus Day Party on Columbus Day. Oh brother, give me a break.

[Betty enters room. Betty sits down at the table.]

Betty: Hi there. Sorry I’m late, but I got stuck at the beauty salon.

Joanne: Based on how your hair looks, you should’ve stayed there a little while longer.

Betty: Oh Joanne, you’re such a kidder.

Joanne: [Mumbles to the person next to her.] I wasn’t kidding.

Jane: OK. Let’s get back to Mrs. Smith’s birthday party. We need to decide on food, decorations, and a guest list.

Jean: Well, you know Mrs. Smith’s favorite cake is chocolate and her favorite ice-cream is . . .

1

Mary: [Interrupts Jean.] Vanilla. And we can have fruit punch to drink. Chips, dip, nuts, fruit slices.

[Ring. Ring. Ring. Betty’s cellular telephone rings. Betty answers the phone and starts talking to the person.]

Betty: Oh really? Yeah, sure. OK. You need me now. Well, OK, if this is the only time. [Betty hangs up the telephone and starts to leave.]

Betty: Sorry. Gotta go. My nail technician just called and she has an appointment for me now. Toodles.

[Betty leaves the room.]

Joanne: [Rolls her eyes and replies in a sarcastic tone.] Toodles.

Sally: Jean, I think having chocolate cake is a good idea, but I’m not sure about vanilla ice-cream. With Mrs. Smith bad heart, cold foods may not . . .

Mary: [Interrupts Sally.] Well, I think we should have the party on the 27th of May at 3:00 in the afternoon. That way day and evening shifts can attend the party.

Joanne: [Real sarcastic.] Hey, I got a better idea. Why not have it at 11:00 at night? That way evening and night shifts can attend the party. All the residents will be asleep and the staff can eat all the goodies.

Sally: [Ignores Joanne.] Now, let’s see where we are. We will have the party on the 27th at. . .

Mary: [Interrupts Sally.] 3:00 PM.

Sally: Right. We’re going to have chocolate cake, chips, dip, nuts, and punch. Who do you think we should invite, besides staff?

Jane: I think we should invite…

Mary: [Interrupts Jane.] Her sons, her daughter, her three sisters, and the preacher from her church. Oh, what’s his name?

Jean: Reverend Scott. What about the Mayor and also Senator Jackson? 2

Joanne: Oh come on!!!! Don’t you think the Mayor and the Senator have more important things to do than attend someone’s birthday party?

Sally: [Ignores Joanne.] Yes, we’ll invite Mrs. Smith’s whole family, the Mayor, Senator Jackson, and the staff. I’ll also order a center piece for the table.

Jean: Sally, don’t forget. Mrs. Smith is allergic to roses.

Sally: Right. OK.

Jane: To summarize, we are going to have the party on the 27th…

Mary: [Interrupts Jane.] Of May. Jane: At 3:00…

Mary: [Interrupts Jane.] In the afternoon.

Jane: We are having chocolate cake, potato…

Mary: [Interrupts Jane.] Chips, dip, nuts, and punch.

Jane: We are inviting Mrs. . .

Mary: [Interrupts Jane.] Smith’s family, the staff, the Mayor, and the Senator.

Sally: Sounds real good. Let’s meet again next Tuesday at 10:00 am.

Joanne: [Real sarcastic.] Oh no! I’m getting my nails done then. Maybe I can switch my appointment with Beautiful Betty.

Sally: [Ignores Joanne.] Meeting adjourned.

3

Role Play Activity Worksheet #1

Instructions: After observing or participating in the skit, complete the Role Play Activity Worksheet in class with your instructor. You may use your Patterns of Communication Handout and Roles of Team Members Handout.

Character Dialogue Positive or Negative

Role

Sally Hello everyone. I am really glad you could make it for today’s meeting. As you know, we are here to plan for Mrs. Smith’s surprise 100th birthday party. Jane, will you take notes please?

Jane Sure. I’ll be glad. Mary [Interrupts Jane.] Well we sure better hurry up and

plan this thing because Mrs. Smith sure isn’t getting any younger, you know!

Jean Well, since her birthday falls on a Saturday this year, why don’t we have it on the exact day of her birthday?

Joanne [Rolls her eyes and speaks in a sarcastic tone.] Gee, Jean what a great idea. We’ll have her birthday party on her birthday! While we are at it, why don’t we plan the Halloween Party on Halloween day and our Columbus Day Party on Columbus Day. Oh brother, give me a break.

Betty [Betty enters room. Betty sits down at the table.] Betty Hi there. Sorry I’m late, but I got stuck at the

beauty salon. Joanne Based on how your hair looks, you should’ve stayed there

a little while longer. Betty Oh Joanne, you’re such a kidder. Joanne [Mumbles to the person next to her.] I wasn’t kidding. Jane OK. Let’s get back to Mrs. Smith’s birthday party.

We need to decide on food, decorations, and a guest list. Jean Well, you know Mrs. Smith’s favorite cake is

chocolate and her favorite ice-cream is . . . Mary [Interrupts Jean.] Vanilla. And we can have fruit

punch to drink. Chips, dip, nuts, fruit slices.

4


Role

Betty Sorry. Gotta go. My nail technician just called and she has an appointment for me now. Toodles. [Betty leaves the room.]

Joanne [Rolls her eyes and replies in a sarcastic tone.] Toodles.

Joanne [Real sarcastic.] Hey, I got a better idea. Why not have it at 11:00 at night? That way evening and night shifts can attend the party. All the residents will be asleep and the staff can eat all the goodies.

Sally [Ignores Joanne.] Now, let’s see where we are at. We will have the party on the 27th at. . .

Mary [Interrupts Sally.] 3:00 PM. Sally Right. We’re going to have chocolate cake, chips, dip,

nuts, and punch. Who do you think we should invite, besides staff?

Jane I think we should invite… Mary [Interrupts Jane.] Her sons, her daughter, her

three sisters, and the preacher from her church. Oh what’s his name?

Jean Reverend Scott. What about the Mayor and also Senator Jackson?

Joanne Oh come on!!!! Don’t you think the Mayor and the Senator have more important things to do than attend Someone’s birthday party?

Sally [Ignores Joanne.] Yes, we’ll invite Mrs. Smith’s whole family, the Mayor, Senator Jackson, and the staff. I’ll also order a center piece for the table.

Jean Sally, don’t forget. Mrs. Smith is allergic to roses. Sally Right ,OK. Jane To summarize, we are going to have the party on the

27th. . . Mary [Interrupts Jane.] Of May. Jane At 3:00… Jane We are having chocolate cake, potato… Mary [Interrupts Jane.] Chips, dip, nuts, and punch. Jane We are inviting Mrs… Mary [Interrupts Jane.] Smith’s family, the staff, the

Mayor, and the Senator.

5

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

____________________

________________________________________________________________________________

____________________________________


Role

Joanne [Real sarcastic.] Oh no! I’m getting my nails done then. Maybe I can switch my appointment with Beautiful Betty.

Sally [Ignores Joanne.] Meeting adjourned.

Is Sally a good leader? ______ yes; ______ no Why or why not? ______________________________

If you were the leader of a group, which characters would you like to have in your

group?___________________________________________________________________________

Identify the pattern of communication among team members.__________________________________

6

Role Play Activity Worksheet #1 Answer Key

Instructions: After observing or participating in the skit, complete the Role Play Activity Worksheet in class with your instructor. You may use your Patterns of Communication Handout and Roles of Team Members Handout.


Role

Sally Hello everyone. I am really glad you could make it for today’s meeting. As you know, we are here to plan for Mrs. Smith’s surprise 100th birthday party. Jane, will you take notes please?

Positive Energizer

Jane Sure. I’ll be glad… Positive Opinion Giver

Mary [Interrupts Jane.] Well we sure better hurry up and plan this thing because Mrs. Smith sure isn’t getting any younger, you know!

Negative Interrupter

Jean Well, since her birthday falls on a Saturday this year, why don’t we have it on the exact day of her birthday?

Positive Information Giver

Joanne [Rolls her eyes and speaks in a sarcastic tone.] Gee, Jean what a great idea. We’ll have her birthday party on her birthday! While we are at it, why don’t we plan the Halloween Party on Halloween day and our Columbus Day Party on Columbus Day. Oh brother, give me a break.

Negative Aggressor

Betty [Betty enters room. Betty sits down at the table.] Negative Busy Body Betty Hi there. Sorry I’m late, but I got stuck at the

beauty salon. Negative Busy Body Joanne Based on how your hair looks, you should’ve stayed there

a little while longer. Negative Aggressor Betty Oh Joanne, you’re such a kidder. Positive Opinion

Giver Joanne [Mumbles to the person next to her.] I wasn’t kidding. Negative Aggressor Jane OK. Let’s get back to Mrs. Smith’s birthday party.

We need to decide on food, decorations, and a guest list.

Positive Energizer

Jean Well, you know Mrs. Smith’s favorite cake is chocolate and her favorite ice-cream is . . .


Mary [Interrupts Jean.] Vanilla. And we can have fruit punch to drink. Chips, dip, nuts, fruit slices. Negative Interrupter

7


Role

Betty Sorry. Gotta go. My nail technician just called and she has an appointment for me now. Toodles. [Betty leaves the room.]

Negative Busy Body

Joanne [Rolls her eyes and replies in a sarcastic tone.] Toodles.

Negative Playboy

Joanne [Real sarcastic.] Hey, I got a better idea. Why not have it at 11:00 at night? That way evening and night shifts can attend the party. All the residents will be asleep and the staff can eat all the goodies.

Negative Playboy

Sally [Ignores Joanne.] Now, let’s see where we are at. We will have the party on the 27th at. . . Positive Summarizer

Mary [Interrupts Sally.] 3:00 PM. Negative Interrupter Sally Right. We’re going to have chocolate cake, chips,

dip, nuts, and punch. Who do you think we should invite, besides staff?

Positive Summarizer

Jane I think we should invite… Positive Opinion Giver

Mary [Interrupts Jane.] Her sons, her daughter, her three sisters, and the preacher from her church. Oh what’s his name?

Negative Interrupter

Jean Reverend Scott. What about the Mayor and also Senator Jackson?


Joanne Oh come on!!!! Don’t you think the Mayor and the Senator have more important things to do than attend someone’s birthday party?

Negative Squasher

Sally [Ignores Joanne.] Yes, we’ll invite Mrs. Smith’s whole family, the Mayor, Senator Jackson, and the staff. I’ll also order a center piece for the table.

Positive Energizer

Jean Sally, don’t forget. Mrs. Smith is allergic to roses. Positive Information Giver

Sally Right ,OK. Positive Energizer Jane To summarize, we are going to have the party on

the 27th . . . Positive Summarizer Mary [Interrupts Jane.] Of May. Negative Interrupter Jane At 3:00… Positive Summarizer Jane We are having chocolate cake, potato… Positive Summarizer Mary [Interrupts Jane.] Chips, dip, nuts, and punch. Negative Interrupter

8

Character Dialogue Positive or Negative Role Jane We are inviting Mrs… Positive Summarizer Mary [Interrupts Jane.] Smith’s family, the staff, the

Mayor, and the Senator. Negative Interrupter

Sally Sounds real good. Let’s meet again next Tuesday at 10:00 am. Positive Contributor

Joanne [Real sarcastic.] Oh no! I’m getting my nails done then. Maybe I can switch my appointment with Beautiful Betty.

Negative Recognition Seeker

Sally [Ignores Joanne.] Meeting adjourned. Positive Contributor

Is Sally a good leader? No

Why or why not? She did not acknowledge the negative behavior of some of the members. She did not have

control of the group. The meeting was unpredictable and out of control. Side conversations were occurring.

Members were constantly being interrupted.

If you were the leader of a group, which characters would you like to have in your group? Sally, Jane, Jean

Identify the pattern of communication among team members. Chaotic. The leader did not acknowledge the

negative behavior of some of the members and did not have control of the group. The meeting was

unpredictable and out of control. Side conversations were occurring. Members were constantly being

interrupted.

9

Role Play Activity #2

Instructions: This is a skit that includes 10 characters. Read the following scene and descriptions of the 10 characters. After choosing a character or being assigned a character, take part in the role-play activity, based on how your individual characters would respond. Remember to respond in a positive, committed manner when speaking to other characters.

The Setting:

A 150-bed long-term care facility located in a small, rural town in eastern North Carolina.

The Purpose of the Meeting:

To choose a slate of candidates for the 2000 Nurse Aide of the Year.

Characters:

Steve Forrester is the administrator of the long-term care facility. He has worked at the facility for ten years. He is a good administrator and is well respected by the employees at the facility.

Mary Scott is the Director of Nursing at the long-term care facility. She has worked at the facility for ten months. She used to work as a staff development coordinator at a local facility for five years. She enjoys working at the facility and is often seen on the units helping out when needed. Mrs. Scott is the chair of the committee.

John Smith is a staff supervisor at the long-term care facility. He has worked at the facility for three years. He works hard, gets along well with others, and often works extra shifts when needed.

Betsy Stewart is a nurse aide at the long-term care facility. She has worked at the facility for three years. She was voted Nurse Aide of the Year in 1998. She is well liked by the others at the facility and treats her residents very well.

Mrs. Barnes is a 92-year old female resident who has lived at the long-term care facility. Mrs. Barnes is alert, mobile, and President of the Resident’s Association.

10

Mr. Meredith is the 32-year old son of a 72-year old resident living at the long-term care facility. He visits his father about three to four times a week. He often brings the staff candy and is very grateful for the excellent care that his father has received.

Other Characters:

Dr. Timothy Robbins, Medical Director of the long-term care facility

Jessica Allen, Staff Dietician

Brittany Daniels, Staff Licensed Practical Nurse

Kaitlyn Gabriel, Staff Nurse Aide

11

Role-Play Activity Worksheet #2

After performing in the final role-play activity, complete the following questions and participate in the final discussion.

1. How did you feel in your role?

2. Did you like your character? Why or why not?

3. How did the team perform as a whole?

4. Was Mrs. Scott an effective leader? Why or why not?

5. Did everyone participate in the role play activity?

6. What positive roles did you observe during the role-play activity?

7. Would you like to work at the long-term care facility described in the activity? Why or why not?

12

Test

Being Part of A Team

Name _____________________________

Being Part of a Team Test

Answer the following questions. You may not use your notes or handouts. You have 30 minutes to complete the test.

Part 1. Match the following types of groups with the correct examples.

_____ 1. Informal Group a. a church group

_____ 2. Formal Group b. a work team at a nursing home

_____ 3. Semi-formal Group c. a friendship group

Part 2. Read each of the statements below. Circle each sentence that is a quality of an effective team with committed members.

1. The members feel a strong sense of belonging to the team.

2. The members are motivated and want to do a good job.

3. The members do not enjoy being with each other.

4. The climate of the team is very tense.

5. The goals of the team are unclear and misunderstood.

6. There is a lot of trust among team members.

7. The members speak badly about the team.

8. Members do not confide in each other.

9. The members are afraid that their ideas will be laughed at if they offer a suggestion.

10. Members are afraid to speak up at meetings.

14

Part 3. Read each of the following questions and circle the correct answer.

1. A working group with a stable membership, a common purpose, and adequate resources is called a:

a. Verbal assignment b. One-way communication c. Team d. Climate

2. Which of the following statements is a feature of a formal group?

a. The group does not follow written rules. b. The leader is easily replaced when he/she makes a mistake. c. The group decides on expected standards of behavior. d. The group must follow rules that are handed down from above.

3. A team that consists of registered nurses, licensed practical nurses, and nurse aides is called a:

a. Hierarchical team b. Collegial team c. Storming team d. Norming team

4. The first stage of team development when the team’s mission is defined and members seek to be accepted:

a. Performing b. Storming c. Norming d. Orientation

15

5. Chaotic communication:

a. Occurs when the leader has no control of the group or the team members b. Is well planned and controlled by the leader c. Is very structured and formal d. Verbal communication moves from the leader to the group only

6. Which of the following team roles is positive?

a. Playboy b. Aggressor c. Squasher d. Summarizer

7. A team member that often arrives late, leaves early, and takes care of personal business during a meeting is called a:

a. Playboy b. Busy body c. Energizer d. Contributor

16

Being Part of a Team Test Answer Key

Answer the following questions. You may not use your notes or handouts. You have 30 minutes to complete the test.

Part 1. Match the following types of groups with the correct examples.

c 1. Informal Group a. a church group

b 2. Formal Group b. a work team at a nursing home

a 3. Semi-formal Group c. a friendship group

Part 2. Read each of the statements below. Circle each sentence that is a quality of an effective team with committed members.

✔ 1. The members feel a strong sense of belonging to the team.

✔ 2. The members are motivated and want to do a good job.

3. The members do not enjoy being with each other.

4. The climate of the team is very tense.

5. The goals of the team are unclear and misunderstood.

✔ 6. There is a lot of trust among team members.

7. The members speak badly about the team.

8. Members do not confide in each other.

9. The members are afraid that their ideas will be laughed at if they offer a suggestion.

10. Members are afraid to speak up at meetings.

17

Part 3. Read each of the following questions and circle the correct answer.

1. A working group with a stable membership, a common purpose, and adequate resources is called a:

a. Verbal assignment b. One-way communication

✔ c. Team

d. Climate

2. Which of the following statements is a feature of a formal group?

a. The group does not follow written rules. b. The leader is easily replaced when he/she makes a mistake. c. The group decides on expected standards of behavior.

✔ d. The group must follow rules that are handed down from above.

3. A team that consists of registered nurses, licensed practical nurses, and nurse aides is called a:

✔ a. Hierarchical team b. Collegial team c. Storming team d. Norming team

4. The first stage of team development when the team’s mission is defined and members seek to be accepted:

a. Performing b. Storming c. Norming

✔ d. Orientation

18

5. Chaotic communication:

✔ a. Occurs when the leader has no control of the group or the team members b. Is well planned and controlled by the leader c. Is very structured and formal d. Verbal communication moves from the leader to the group only

6. Which of the following team roles is positive?

a. Playboy b. Aggressor c. Squasher

✔ d. Summarizer

7. A team member that often arrives late, leaves early, and takes care of personal business during a meeting is called a:

a. Playboy

✔ b. Busy body c. Energizer d. Contributor

19

Bibliography

Fuszard, B. (1995) Innovative teaching strategies in nursing. 2nd Ed. Gaithersburg, Maryland: Aspen Publishers, Inc.

Huber, D. (1996) Leadership and nursing care management. Philadelphia: W.B. Saunders Company.

Kozier, B., Erb, G., and Blais, K. (1997) Professional nursing practice, 3rd Ed. Menlo Park, California: Addison Wesley Longman, Inc.

Potter, P. and Perry, A. (1997) Fundamentals of nursing – concepts, process, and practice, 4th Ed. St. Louis: Mosby Publishing Company.

Tappen, R. (1995) Nursing leadership and management: concepts and practice. Philadelphia: F.A. Davis Company.

Taylor, C., Lillis, C. and LeMone, P. (1997) Fundamentals of nursing – the art and science of nursing care, 3rd Ed. Philadelphia: Lippincott-Raven Publishers.

20

Curriculum Module Evaluation

21

Evaluation Form for Instructor Being Part of a Team Curriculum Module

Instructions: Please take a few minutes to complete the following evaluation. Read each statement and circle the response that represents your opinion about the curriculum module. Your responses and comments will help us improve the contents of the curriculum module, Being Part of a Team. Thank you for your time.

Statements Rating Scale

Strongly Agree

Agree Disagree Strongly Disagree

Does not Apply

1.The objectives were appropriate for the content.

1 2 3 4 0

2.The content was appropriate for the nurse aide’s level of learning.

1 2 3 4 0

3.The Activity Worksheets were appropriate and complemented the teaching/learning process.

1 2 3 4 0

4.The role-play activities were appropriate and complemented the teaching/learning process.

1 2 3 4 0

5.Clinical practice was appropriate and complemented the teaching/learning process.

1 2 3 4 0

6.The handouts were appropriate and complemented the teaching/learning process.

1 2 3 4 0

7.The overhead transparencies were used, were appropriate and complemented the teaching/learning process.

1 2 3 4 0

8.The nurse aides will be able to use what they have learned in the work setting.

1 2 3 4 0

9.The nurse aides will be able to use what they have learned away from the work setting.

1 2 3 4 0

Please write additional comments in the space below:

What are the learning needs of the nurse aides employed at your facility?

22

Evaluation Form for Nurse Aide Being Part of a Team Curriculum Module

Instructions: Please take a few minutes to complete the following evaluation. Read each statement and circle the response that represents your opinion about the curriculum module. Your responses and comments will help us improve the contents of the curriculum module, Being Part of a Team. Thank you for your time.

Statements Rating Scale

Strongly Agree

Agree Disagree Strongly Disagree

Does not Apply

1.The objectives were written clearly and easy to understand.

1 2 3 4 0

2.The content was appropriate for my level of learning.

1 2 3 4 0

3.The Activity Worksheets were helpful and helped me learn the content.

1 2 3 4 0

4.The role-play activities were helpful and helped me learn the content.

1 2 3 4 0

5.Clinical practice was helpful and helped me learn the content.

1 2 3 4 0

6.The handouts were helpful and helped me learn the content.

1 2 3 4 0

7.The overhead transparencies (if used) were helpful and helped me learn the content.

1 2 3 4 0

8.I will be able to use what I learned in the work setting.

1 2 3 4 0

9.I will be able to use what I learned away from the work setting.

1 2 3 4 0

Please write additional comments in the space below:

What other learning needs do you have?

23


1.02

Collage as Culminating Activity for 1.02

Picture/activity contributed by Sharon Verdu – Charles D. Owens High School

Directions to Teacher: 1. Provide teacher input for 1.02 2. “Pull sticks” to check for student understanding of the material throughout

the teacher input process. 3. Divide students into groups. 4. Provide magazines, scissors, glue, markers, construction paper, and freezer

paper or some other paper for the background of the collage. 5. Use a rubric for benchmark assessment of this indicator. Go to

http://rubistar.4teachers.org to create a rubric.

Directions to students:

Within each group recall the role of the nurse aide, ethical responsibilities of the nurse aide, legal parameters of nurse aide practice, legal issues related to nurse aide practice, legal issue of nurse aide practice as it relates to the healthcare industry, and team member responsibilities of the nurse aide.

Find pictures that represent the content in 1.02.

Prepare a collage that illustrates understanding of nurse aide range of function and position within the healthcare team.


1.02

Rubric Made Using: RubiStar ( http://rubistar.4teachers.org )

Oral Presentation Rubric :

Nurse Aide Range of Function and Position within the Health Care Team

Teacher Name: Student Name:

CATEGORY 4 3 2 1

Posture and Eye Contact

Stands up straight, looks relaxed and confident. Establishes eye contact with everyone in the room during the presentation.

Stands up straight and establishes eye contact with everyone in the room during the presentation.

Sometimes stands up straight and establishes eye contact.

Slouches and/or does not look at people during the presentation.

Volume Volume is loud enough to be heard by all audience members throughout the presentation.

Volume is loud enough to be heard by all audience members at least 90% of the time.

Volume is loud enough to be heard by all audience members at least 80% of the time.

Volume often too soft to be heard by all audience members.

Enthusiasm Facial expressions and body language generate a strong interest and enthusiasm about the topic in others.

Facial expressions and body language sometimes generate a strong interest and enthusiasm about the topic in others.

Facial expressions and body language are used to try to generate enthusiasm, but seem somewhat faked.

Very little use of facial expressions or body language. Did not generate much interest in topic being presented.

Content Shows a full understanding of the topic.

Shows a good understanding of the topic.

Shows a good understanding of parts of the topic.

Does not seem to understand the topic very well.

Stays on Topic Stays on topic all (100%) of the time.

Stays on topic most (99-90%) of the time.

Stays on topic some (89%-75%) of the time.

It was hard to tell what the topic was.

Uses Complete Sentences

Always (99-100% of time) speaks in complete sentences.

Mostly (80-98%) speaks in complete sentences.

Sometimes (70-80%) speaks in complete sentences.

Rarely speaks in complete sentences.

Comprehension Student is able to accurately answer almost all questions posed by classmates about the topic.

Student is able to accurately answer most questions posed by classmates about the topic.

Student is able to accurately answer a few questions posed by classmates about the topic.

Student is unable to accurately answer questions posed by classmates about the topic.

Listens to Other Presentations

Listens intently. Does not make distracting noises or movements.

Listens intently but has one distracting noise or movement.

Sometimes does not appear to be listening but is not distracting.

Sometimes does not appear to be listening and has distracting noises or movements.

Nursing Fundamentals HN43

Documents

Transcript of Nursing Fundamentals HN43