By choosing to work in long-term care, you have made the decision to work in an environment that constantly changes, much like the weather. Hopefully, your days are filled with calm and inviting conditions, without the threat of inclement circumstances. But in reality, working with people, especially those of whom are ailing, the days aren’t as predictable as we would like them to be. Do you know if there is a storm brewing in your care center and can you identify what changes may precipitate a storm?
Unit rounds and stand-up meetings occur routinely throughout the workweek. These activities are there to keep staff apprised of the progress of the residents. When assessing staff members around you, do you know who can identify a change in condition in one of your residents? All nurses should be able to do this, however, wouldn’t you feel more comfortable and secure if more individuals were trained in observing and documenting a change of condition in a resident?
By providing a “storm-proof solution,” you can train your staff to be accurate observers of any changes in condition that may occur with your residents. The observations are factual findings that are free of judgment and opinions that are based on utilizing their keen senses of sight, hearing, touch and smell.
Teaching staff members to utilize their senses is a way of being proactive and prepared. Having a staff that is trained in using their senses will benefit the residents, the team and the whole care center.
The first part of training can include how to make objective observations. A few examples include asking staff to observe the following:
- What do you see?
- Ambulation – Has your resident changed how he/she moves?
- Posture – Is your resident leaning?
- Eating Habits – Has there been a change in appetite or difficulty with swallowing foods?
- Appearance – Is there any swelling, or possibly a reduced range of motion?
- What do you hear?
- Listen at mealtime – is there increased coughing?
- Listen during transfers – is there more moaning or sounds of struggle?
- Is there increased crying or slurred speech?
- What do you feel?
- Does the skin feel different? Is it moist or cool to the touch?
- What do you smell?
- Is there a change in the overall smell of the resident? Is there is sweet, sour or foul odor that is different from normal?
After informing your staff members how to objectively identify areas of change, the next step is teaching them how to respond. One way to train staff in how to respond is to create an action plan called I.S.L. By identifying what to do immediately (I), in the short term (S), and what to do just before leaving for home (L), staff members will be feel comfortable with their observations, and assure proper follow-up when a change of condition happens to a resident.
Finally, proper follow-up is essential. By having a good communication plan, all members of the staff will know what to do if a change of condition does occur with one of your residents. Being prepared and having a solid plan will help your whole care center weather any storm.