Case Study-Henry D.
Henry D. was downsized by IBM and took early retirement options. His youngest son was in college and he and his family had assumed financial and social responsibilities for his chronically ill, aged father. Not yet eligible to collect pension or social security benefits, Henry had to find a new career. As a young adult, he considered nursing. However, he did not pursue his interest in nursing because, as he put it, "At that time, male nurses weren't socially accepted."
Now Henry considered nursing again, conducted a career search, and decided to become a nursing assistant. He considered on-the-job training, but decided against this option in favor of entering an accredited nursing assistant training school. This decision was based on family finances and tuition assistance availability.
School Career Plan
Henry had an interview with an adult education counselor. He explained his interest in nursing, and said he had several strengths that would advance his career as a nursing assistant: he had been a corpsman for two years while in the army and had recently updated his advanced first aid skills. Having been a quality-control inspector at IBM, Henry said he could adapt his skills to nursing's quality-control practices. He'd cared for his chronically ill father for several years and enjoyed being with him. Henry pointed out that he liked working with people and got along well with others.
Henry was aware of a personal weakness, but he was confident he could overcome it. He knew he was a person who needed to be needed, and this, unfortunately, attracted people who became dependent on his advice. Henry's goal was to learn to remain empathetic while allowing others to solve their own problems.
School Application Form
During the school interview, Henry completed a school application form. The purpose of this form is to gather information that aids career counselors in assisting students with their educational goals. The application form asked for the following information:
- Name, address, telephone number: home/business Educational goal
- Education
- Work experience
- Hobbies and interests
- Completion of an essay about why he wanted to become a nursing assistant
- Class availability
- Financial arrangements: personal payment, tuition assistance, etc.
Job Application Process
At the completion of his training class, Henry attended a school-sponsored meeting with representatives of area health care employers. He talked to each one and decided to seek employment at a large area hospital because it had a tuition assistance program and opportunities to work flex-time, both of which were job benefits that would help him realize his future career goals.
He gave his resume to the hospital's representative, and she gave him a job application to complete and return to the hospital's human resource department.
Cover Letter
Job applications are usually accompanied by a cover letter, which is a business letter that introduces a job applicant to an employer and informs him or her that a resume is included. Henry did not include a cover letter because his prospective employer knew who he was. A cover letter is necessary when an applicant sends a resume by mail. Cover letters and resumes always should be addressed to a particular human resource professional.
Resume
Resumes are professional portraits. Job applicants write resumes to explain why they will be assets to employers and to highlight good skill matches. Resumes should include the following information:
Name, address, telephone number: home/business Work objective /desired job title
Job Aptitude
Nursing assistant skills: Baby-sitting experience, caring for an elderly relative at home, first aid course certificate, candy stripper experience, special awards in school that could relate to the job. People skills: Boy Scout leader, den mother, car pool organizer. Related skills: Equipment organization as a stock clerk at Walmart, sales and services as a Girl Scout cookie coordinator, and Avon representative.
Job experience: starting with last employer and recording job experiences for up to 10 years.
Job Interview
The job interview has a two-fold purpose. It gives an employer an opportunity to assess an applicant for suitability and ability to fit into the business culture (way of doing things). Job interviews give prospective employees the chance to assess employment opportunities and to think about whether they want to accept the job, should it be offered to them.
Prior to a job interview, job applicants should plan their attire and develop written questions they want to ask the human resources specialist. Health care businesses expect job applicants to dress in a conservative manner. Applicants should wear clean, pressed clothing they would probably wear to church or synagogue. Men should shower and shave prior to a job interview. Their attire should consist of dark suits or conservative sport jackets and dark slacks, clean and shined shoes, and matching socks. Women should prepare by showering and wearing conservative attire: dresses, blouses, dress slacks, or skirts that come just above, at, or just below the knee. They should wear minimum jewelry and makeup and either omit or limit perfume (interviewers could be allergic to perfume).
Applicants should arrive on time and prepared for the job interview. They should greet the interviewer with a firm handshake and a smile and sit when they are asked. Interviewer's questions will relate to what the job applicant can do for the employer. What would make him or her a valuable asset to the employer? When interviewers ask applicants to "tell me about yourself," they are really asking for an account of their suitability as employees.
At the completion of the job interview, the interviewer either will say that she will be in touch or will refer the applicant to a supervisor for a second interview.
Nursing assistants often are interviewed for the second time by the assistant DNS, who poses questions that relate to nursing department operations, the nursing assistant job, and the applicant's ability to perform job tasks. Here are some questions a DNS might ask:
Why do you want to become a nursing assistant?
Do you like people? Give me some examples that show you like people.
Do you like being with elderly people?
How do you think elderly people behave?
What shift do you want to work?
What about work schedule preferences, full or part-time, or per diem work?
How do you feel about working weekends?
Are you willing to float to other units?
Do you like to work alone, or do you enjoy being part of a team?
How soon can you start work?
What are your career goals?
Where do you think you'll be working next year?
Job applicants should think about their answers before responding. If unsure about a question's meaning, ask the DNS for clarification.
The second interview is also a good time for you to ask the DNS about the job benefits and career advancement opportunities as well as questions that concern the nursing department. For example, you might ask:
What would my job responsibilities be? Who would be my immediate supervisor? Who is my training class instructor? How long does the training class last? What are the general subjects of study? Will I have homework assignments?
How will my job performance be assessed during the evaluation period?
Does my assigned nursing unit experience short-staffed working conditions?
What are the immediate supervisor's expectations during short-staffed working conditions? What is your floating policy?
Will I receive buddy assist when I float to another nursing unit? What job advancement opportunities are available? What do I need to do to advance at work? Will I be eligible for raises? When?
At the end of the interview, thank the DNS talking with you about job possibilities. Then go home and write a note thanking him or her for the interview.
Successful job applicants are contacted by telephone. Unsuccessful job applicants usually receive a letter from human resources personnel stating they did not get the job. If this happens, call the human resources department interviewer and ask him or her why you did not get the job and what you can do to qualify for a future job opportunity.
Case Study-Nancy R.
Nancy R., a twenty-three-year-old displaced homemaker, had been subsidized through public welfare funds since her boyfriend abandoned her and their two preschool children. She had few job skills and was therefore unable to secure a good paying job. Nancy called her social worker and asked about job training opportunities. Her job aptitude test showed she had a strong interest in nursing, so she began to scan the job ads in her local newspaper to find employment as a nursing assistant.
Checking the Want Ads
Job ads often answer the questions who, what, when, where, why, and how. Here is the information provided in an ad Nancy saw in her local newspaper. It was in the employment section under "Health Care."
Who: Interested applicants
What: a C.N.A. training class
When: July 10, 1998
Where: Marcy Nursing Home
Why: Opportunity for free C.N.A. training, learn while you work
Nancy called and was advised to come to the home's human resources department. She dressed in conservative attire and presented herself the next day. At that time, she filled out a job application form. (Prior to this, Nancy called a friend who worked at the home to ask what questions might be on a job application form. She brought along a ballpoint pen in anticipation of this activity.)
The department secretary noted her well-groomed appearance and friendly demeanor and gave Nancy the job application to complete and return to her. Nancy carefully completed the form and returned it to the secretary. The secretary advised her that she would be contacted regarding a job interview.
Nancy's Job Interview
Nancy was contacted by telephone and asked to return for a job inter-view. She arrived on time, dressed appropriately, and was prepared for an interview with a human resources specialist. She answered the inter-viewer's questions candidly and shared the results of her aptitude test.
The human resources specialist advised Nancy that the assistant DNS could interview her after lunch. Nancy called to make arrangements with her baby-sitter, ate her lunch, and was on time for the second interview. The DNS noticed that Nancy had a calm demeanor, interacted with her in a friendly, businesslike way, and seemed to be a friendly person genuinely interested in a trainee position. She decided to offer her a position as a C.N.A. trainee.
Deciding on a Job
Job interviews produce different outcomes. Some interviews result in positive results for the employee/applicant. Sometimes the job does not suit the applicant or vice versa, and in some instances, job applicants are unable to start training classes on the appointed day. If this happens, applicants should be honest and ask to be included in the next class. Future trainees are wise to keep in touch to let employers know they are still interested.
Pre-Employment Screening Processes
Pre-employment screening processes take place prior to employment. Employers usually contact an applicant's references and former employers to gain input about him or her. Some screening processes happen at the time of hire, when new hires are requested to provide a social security card, a driver's license, and one other form of identification. Employers ensure that applicants are United States citizens or have legal work permits.
Drug and alcohol screening happens after hire and is an ongoing business process. Drug abusers are protected by the Americans with Disabilities Act of 1992. However, statistics show they are often undependable workers who interfere with production due to tardiness, absenteeism, and inability to perform job tasks in a safe way. Patient safety is a paramount concern within health care occupations.
Age discrimination has been prohibited by federal law since 1967, but studies show that older job applicants are routinely discriminated against by some employers who circumvent the law to suit themselves. People with existing health conditions cannot be discriminated against. An applicant known to have AIDS cannot be denied employment because of this health condition. However, employers can question him or her about abilities to perform job tasks, and federal laws prohibit the hiring of people with AIDS as food handlers.
Nursing assistants who keep their jobs tend to research and select positive workplaces, value the work ethic, and behave as mature adults.
Positive Workplaces
Positive workplaces enable people to learn and grow and be them-selves. Prior to accepting a job, network with others and request nursing unit visits to assess how well the staff work together. These observations will give you either a good or bad feeling about the job.
A study showed that nursing workplaces became positive environments whenever nurses had opportunities to learn and felt valued by their employers. Feelings of personal value were enabled through discussion at forums where staff members asked questions and dialogued with others. Dialogues are thoughtful conversations that should occur when nurses disagree about patient care issues. Disagreements result in learning and better understanding among people. Positive workplaces encourage discussions and dialogues and support the learning process by diminishing fears about reprisals.
Reprisals are sometimes necessary when nursing assistants are per-forming tasks in unsafe ways. Verbal and written warnings are examples of reprisals. Positive work environments encourage people to learn from their mistakes through corrective efforts that don't exclude reprisals. Some corrective efforts include supervisor counseling and review of job skills. Nursing assistants who make mistakes are given every chance to correct them. Should they continue to engage in poor work performance, a written warning is justified. Irresponsible work habits and performance are unacceptable in nursing because patient safety is compromised.
Some nursing assistants choose workplaces where they are not valued as assets and are considered to be expendable. Therefore, they fear making mistakes, asking questions, or disagreeing with their peers or supervisors about patient care issues or work practices. Studies show these types of workplaces produce high turnover, disgruntled and unhappy staffs, and poor quality nursing care services.
Good Work Ethics
The work ethic refers to a moral code of right and wrong that concerns ethical behaviors at work. Prior to the first day of employment, nursing assistants know the type of clothing to wear, the work hours, and the work unit assignments. They are expected to show up on time, dressed properly, and ready to work. Employers are considerate of occasional excuses for tardiness, for example, call-ins due to car malfunctions or other personal problems that happen to everyone. When problems occur on a weekly, biweekly, or monthly basis, however, employees are counseled and might be referred to employee assistance programs to help them solve their problems. Counseled employees are advised that they are expected to take corrective actions about their problems.
Personal Maturity is the Key to Success
Personal maturity is a human trait that is valued and sought after by many employers. They expect mature people to behave in positive ways and to complete tasks in an intelligent and competent manner.
Positive Work Behaviors-All adult workers share similar feelings on days when they do not want to get out of bed to go to work. Mature adults engage in self talk, adjust their attitudes, and present themselves at the workplaces in a cheerful and friendly frame of mind. Friendly people are pleasant to work with and attract others by their positive outlook on life. People who come to work and respond to "good morning" with "what's good about it" cause others to practice avoidance behaviors toward them whenever possible. Getting along well with people is a valued work behavior in nursing, an occupation dedicated to caring for people who are unable to care for themselves.
Work Skills Competency-Nursing assistants often complete repetitious but necessary tasks during their daily workday. Successful employees strive to complete tasks accurately every time they perform them by using intelligent, attentive concern when caring for patients. Sometimes new innovations are introduced into work processes and job tasks. The dual responsibility to keep up-to-date is shared by employers and employees.
In-Service Education Programs-In-service education programs are teaching/learning experiences conducted at a facility. An in-service program might be scheduled to update C.N.A.s about a new work process. It is each aide's responsibility to attend the training session. It is the responsibility of the training instructors to prepare teaching content and inform staffs about scheduled training sessions; it is not their responsibility to personally cajole immediate supervisors to allow C.N.A.s to attend training sessions or to personally invite aides to attend them.
Job Advancement Strategies
Opportunities for advancement are often present in many good work-places. Some nursing assistants miss them because they are unaware of their career goals or are preoccupied with personal problems that limit their ability to look for career advancement opportunities. As we have seen, both Henry and Nancy had a life plan that enabled them to use job advancement opportunities to further their career goals.
Henry, a new C.N.A., was assigned to a hospital-based geriatric care unit, but he wanted to work in the hospital's emergency room. Henry re-viewed his goal during work-review meetings with the unit head nurse. She let him know his work was excellent and recommended his reassignment to the DNS. Henry continued to perform his tasks well, and after several months was reassigned to the ER.
Nancy began her career as a C.N.A. trainee. After completing training and certification requirements, she was assigned to work on a dementia unit. Nancy was pleased with her assignment because she was interested in learning more about dementias. Her grandmother had Alzheimer's disease, and she remembered the pain she felt when her grandmother no longer knew who she was. During her first work evaluation interview, Nancy explained to the unit head nurse that she would like to work at an Alzheimer's mental health center. The head nurse informed her that the home's administration was associated with an Alzheimer's center in a nearby community. Nancy's work evaluation record was very good, and the head nurse said she was impressed by her ability to deal positively with residents diagnosed with dementias.
The head nurse told the shift nursing supervisor and the DNS about Nancy's work progress and her future goal. The DNS contacted the Alzheimer's center and spoke to a colleague about Nancy's potential. Within a year, the DNS told Nancy there was a job opening at the Alzheimer's center, and she would recommend Nancy for the job. The pay was higher, and tuition assistance and flex-time work hours were in place, systems designed to support C.N.A.s who wanted to further their careers in the field of mental health. By this time, Nancy had looked at her personal life, saw potential problems that could occur, took corrective action, and was ready for the job opportunity when it came.
Henry and Nancy met initial career goals by doing their jobs well, by networking with others, and by being prepared to move on when job advancement opportunities happened.
Successful careerists use the right forums to express their career goals. Henry and Nancy communicated their goals at work evaluation inter-views. Others are aware of job announcement bulletin boards and check them frequently for information. Successful careerists get along well with others and tend to be considered for promotions and job changes because of their positive attitudes and mature behavior.
There are some health-care employers who create dead-end jobs. These jobs are not designed to assist people to develop themselves through job advancement opportunities. Successful nursing assistants find ways to change their job situations and quit when they find jobs with better employers.
Feelings of persistent stress and disinterest in job tasks might mean that people are getting tired of their jobs and should look for advancement opportunities or alternative work experiences elsewhere.
Nurse Assistant Support Groups and Networking Systems
Support groups exist through networking systems that link, inform, update, and educate nursing assistants about important job issues and concerns. Network systems are nursing assistant group organizations that link communication among peers through local, regional, and national groups. Support groups operate to provide informational and educational services for nursing assistants. They are often sanctioned by large corporate employers who own and run many nursing homes, as well as some local nursing homes without corporate ties. Joining fees are often subsidized by employers who encourage nurse assistants to participate in support group activities through reading newsletters, attending educational seminars, and participating at informational meetings.
The goal of nursing assistant support groups is to empower nursing assistants to become self-assured, positive workers with possibilities to earn respect and be recognized for their valued contributions. Job recognition tends to create feelings of job enjoyment and satisfaction.
