ask the questionOkay, I’m 12 years old again and I’m riding in the back seat of the family car. My mom has just picked me up from a friend’s house and I am dying to ask permission to go to the school dance in a couple of weeks. The words are stuck right in my throat. I am so terrified that she will say “no” that I cannot make myself ask the question. And so there I sit… trying to muster the courage to ask my mother if she will let me go to the dance…

Wimp Junction

Have you ever done that? Get to “wimp junction” and then wimp out? At wimp junction you have a choice. You can take action… or wimp out. Taking action usually requires a bit of courage, and of course wimping out seems the easier thing to do.

In my case, the action I wanted to take was simply asking my mother for something. It may seem a simple thing, asking a question. But my 12 year old self would have told you it was a superhuman feat. Why? Fear.

We are all afraid to ask for things we want. And asking for what we want is critical to our well being. It’s as simple as this: If you don’t ask, the answer is always no. If you don’t ask questions, you are making assumptions based on nothing. You miss out because you wimp out.

If YOU don’t ask, nobody will

Now really, think about it. What is the worst that would happen if you asked your boss for a promotion, or applied for that job you’ve always wanted? What if you actually asked for a discount at the department store or when renting a car? What would happen if you took that “empty-handed leap into the void” and asked your spouse to take out the trash or wash the dog? I can tell you what might happen… you might GET what you are asking for!

The flip side to this is that when you don’t ask, you just end up taking what you get. When we don’t ask, we lose before we even begin because we assume the answer will be NO. When we do this we are denying ourselves something that we (think anyway) we deserve. Ouch! Oh the pain that resides at wimp junction!

Asking means receiving

Simply asking questions can deliver the things that we require and desire. Having the courage to ask for what we want puts us squarely in charge of getting what we get. In a crazy way it makes us actually think of what we want instead of thinking about what we have and whether we want it or not. Make Sense?

And consider this. When other people are clear about what you want, they are less likely to make assumptions about what they think you want. When you take action in the form of asking for what you want, you also create openings for yourself that people around you might have never seen otherwise. This can be inspirational to others, as they may choose to follow your lead and empower themselves as you have!

Asking takes courage, yes. But you can do it. When you get to wimp junction, just take the plunge! The 12 year old me who sat with a question stuck in her throat, learned something that day. When I did finally manage to ask permission to go to the dance, without hesitation my mother said YES! “Well,” I thought. “That was easy!” In a single moment of being brave and vulnerable I had instantly been rewarded with the prize I was seeking. All I had to do was ask! What will YOU ask for today?



comfortzoneIf you want to be successful, you can expect to be in new situations. Whether you are adjusting to new responsibilities, a new position or even an entirely new job, your learning curve will be quicker and easier, and success will be yours if you remember the basics of getting to know people. Be ready to move out of your comfort zone to master three basic people skills: introducing yourself, remembering  names, and asking questions.

Believe it or not, even successful people under perform because of the anxiety they feel in new situations. We all feel it, but the most successful among us has learned how to put our ego aside so that we can effectively introduce ourselves, reliably remember names, and overcome the fear of asking questions.

These three basic yet critical get-to-know-you skills can be learned, but to practice them we must push ourselves out of our comfort zone. Our confidence level in new situations will grow as we practice these people skills and we will realize success building upon success!

Introducing Yourself

It is important to push through feelings like fear of making mistakes or being rejected when it comes to meeting people. And you will get farther faster if you go up to people and introduce yourself rather than waiting for them to come up to you. All you have to do is learn how to get better at it.

Don’t hesitate to introduce yourself people, just go for it. Whether you are at a networking function to meet people, or at a meeting and your new CEO is there, don’t assume someone isn’t interested in meeting you. Be prepared by having an “opening line” about yourself and a firm handshake. The first few times you stretch out of your comfort zone to do this it will feel awkward, but with some word tweaking and continued practice your opening line will be great.

Then pay attention to what they tell you about themselves. Listen intently so that they feel heard, valued and respected. First impressions don’t have as much to do with what you say, but rather how you made them feel. It is a really, really good idea to write down details about them as soon as you can. Don’t rely on your memory, especially if you are in a setting where you are meeting more than one person. This will help you remember someone the next time you see them, which brings us to our next basic people skill.

Remembering Names

We all are challenged to remember the names of people we meet, but remembering names is a skill that you can master with practice. When you remember someone’s name you are likely to feel much more comfortable with them which will lead to trust that will pay dividends in your future endeavors. Here are a few tips about how to remember names.

Firstly, before the end of your first conversation with someone you have just met, use their name a couple of times. If their name slips your mind, just ask them. Don’t wimp out here. Remembering people’s names is a skill that will serve you almost more than anything else in life. As soon as possible, write down their name, or put it in your cell phone or other device. Go back later, look at their name and purposely bring their face up in your mind’s eye. Go through your list of new acquaintances from time to time to test your recall, and when you do, associate something in their name with something you remember about them such as the way they looked. For instance, Shirley Brown might have long curly brown hair, so you can associate Shirley with curly and Brown with the color of her hair. Association is a proven method of recollection.

Lastly, when you are going to be somewhere you are likely to see someone again, go over your notes so that you will recognize them and remember some things about them. Your commitment to remembering them will not be forgotten.

Asking Questions

Most of us resist the urge to ask questions, but according to studies, the more questions new employees ask, the better they perform. Asking questions shows a commitment to superior performance and organizational success. Overcome the urge to “go it alone” and ask a co-worker or boss for guidance. But before you do, consider what you want, why you want it, and who and when you should ask. Your question should be focused and to the point. Instead of asking “how to” do something, ask to be shown. Avoid multi-faceted questions. Then say thank you.

A good practice when starting something new would be to establish a “go-to” person early on. You can set this up during your introduction to this person by asking them if it is okay to get back with them about questions you might have in the future.

In summary, as you practice these three people skills basics, your confidence will grow as you become more adept at introductions, names and questions. You will become accustomed to being out of your comfort zone as you ramp up your game. Just make a promise to yourself that you will always push yourself out of your comfort zones where ever they are. You will be better for it!

Reference credit: Success in New Situations by Keith Rollag from the December 2015 issue of Harvard Business Review via Hennes Communications on Facebook!

toothbrushesProviding mouth care to the elderly who have dementia, brushing their teeth in particular, is often a challenging task for caregivers. Thanks to Rita Jablonoski, PhD who has 30+ years nursing home experience, we can explain a few things and offer some advice on the topic. If you have encountered someone who is resisting mouth care, even biting during it, this information should be helpful.

First, the best place to do mouth care is at a sink (bathroom is best, but even the kitchen sink will work) because the familiar setting will ease the anxiety being experienced by the person who has dementia. A mirror at eye level, whether the person is standing or sitting, is also helpful as it helps to reinforce self-care memories.

Second, smile a lot! This may sound overly simple, but the mouth care you are trying to give may seem threatening to someone with dementia. If you have a big smile on your face they may be less threatened. Also lower the pitch of your voice because this makes it easier for them to hear you (as we age, it is harder to hear the higher pitches.)

Allow them to do as much as possible. If you are afraid they aren’t doing a good enough job, however, you have a few options. You can guide their hand or pantomime the mouth care to guide them along. Try putting the toothpaste on the brush for them. It may also be helpful to just let them hold a toothbrush while you do the mouth care.

Some things to avoid include trying to reason with someone who has dementia as this will only increase the likelihood of their resistance. Instead, use simple one-step instructions, giving them time to process the request before you repeat it. Resist the urge to talk to them in a baby-talk manner using plural pronouns such as, “It’s time for us to brush our teeth.” This is called “elderspeak” and has been documented by nurse researchers as a guarantee for care resistance. It also raises dignity issues. People with dementia will forget many things, but they will not forget that they are an adult.

Try singing while performing mouth care if you meet with resistance. This will sometimes distract the person with dementia and if they sing along, you will have easier access to their teeth. Giving them something to hold on to such as a stuffed animal may provide comfort and help melt their resistance. Talking about their favorite things also serves to distract and relax someone with dementia. Sometimes getting creative works too. Rita describes an approach that worked for a lady in a wheelchair who clenched her teeth during mouth care. The staff tried sitting her in front of a mirror as they stood behind her, reaching around to do mouth care. This worked like a charm in her case as long as she could see herself in the mirror.

One more thing. Remember to use tepid water as gums recede as we age, making teeth especially sensitive to cold water. And make sure the toothbrush has soft bristles.

An alternative to brushing is flossing, but not with the typical waxed string. This flossing is done best with a small toothpick-like device called a proximal brush or interdentate stick. They can be used like toothpicks to go in between the teeth, and when dipped in mouthwash they are even better. After this type of flossing, tooth brushing may be met with less resistance. Rita recommends having the resident say “EEEEEEEEEEE” during this particular type of mouth care.
Rita admits that there is no sure way to get people with dementia to cooperate with a caregiver’s efforts to brush their teeth, but the advice she offers is to just keep trying. Her decades of experience has proven that eventually resistance will diminish with time.

resume graphicThe typical resume contains information about previous responsibilities, personal attributes and contact information. This traditional format is just not cutting the mustard these days for job seekers who are running into throngs of people all competing for the same job.

Make your resume action and results-oriented. Hiring managers do not want to see a rehash of past duties; they want to know about your successes. If your resume shows action, accomplishments and quantifiable results, you will capture and hold a manager’s attention. Here is how to do it. 

  1. Create a list of your tasks from previous jobs. If you already have an up to date resume, this should be an easy thing to do as your tasks are listed there for you. If they aren’t, take time to make a list of performed tasks for each of your previous jobs.
  2. Consider this list of tasks. Think about the accomplishments associated with each, and write those accomplishments down.
  3. Use these new details to create action/result statements for your resume.

For example, if your former position was as a CNA in a nursing home, one of the things that you were responsible for was taking care of residents. Your action-oriented tasks would be that of assisting residents with their ADLs, observing and reporting, etc. The associated successful result was doing it efficiently and in a timely manner. To quantify the result, you can specify the number residents you typically were responsible for during your shift and how long it took you to perform your tasks. If you received any recognition for your successes, all the better! 

Once you have put together your “numbers” then you are ready to compose your action/results-oriented statements. Using the above example it would be something like, “Delivered quality Restorative Care to 15 (on average) long term care residents and Rehabilitative Care to 4 (on average) short term care nursing home residents per eight hour shift.” 

In addition, including any special recognition you received on the job is a perfect way to demonstrate your success to a hiring authority, and if you have good attendance, claim it! The appropriate action/results-oriented statement in this regard would go something like this: “Have worked six consecutive months with perfect attendance.” 

Keep in mind that your resume is one of several from which a new hire will be chosen. To hiring managers, one resume looks like the rest after a while because most resumes focus only on responsibilities/tasks. Your resume will stand out if it is action and results-oriented. It is likely that the person doing the hiring is already familiar with the requirements of your former jobs anyway, unless you are changing fields. And if you are changing careers, results are results and success is success regardless of the industry. 

Remember that on the quantified job results will lend credence to your claims. This is one reason the action/results-oriented method of resume writing is so effective. Hiring authorities with any experience have learned that a candidate’s past success is often a reliable indicator of their future success. You can make any claim you want on your resume, but showing the results of your successes will bring you successful job seeking results of your own. 

Revising your resume using the action-oriented method may take a bit of time, but it will be time well spent. You will not only have a handful of action and results-oriented statements, you might also come away with a new appreciation of your own special expertise!

interview picHow you handle an interview can make the difference between landing a job and continuing your search. Whether you applying for work in a hospital, nursing home, assisted-living facility, doctors office, or home healthcare agency, there are ways to gain an advantage when interviewing for a position in the healthcare field.

Tip #1 Be Ready to Dazzle
Research the company’s website if they have one and make sure of the location of the interview and allot ample time to get there. Know the name and title of the person with whom you will be interviewing. Gather copies of your current certifications, an exquisite copy of your resume and a list of references and letters of recommendation so you will have it available during the interview. Remember to take a copy of the job listing too.

Presentation is everything. Dress in “business casual” attire rather than scrubs. Make sure you are well groomed from head to toe (double check your fingernails) Men should wear clean trousers and a collared shirt. Women may wear slacks or skirt with a business appropriate shirt or sweater. Also a dress would be okay. Leather shoes are appropriate for men and women rather than the nursing shoes or athletic shoes worn on the job. Hair should be neatly groomed as it would be on the job. Body piercings and tattoos should be covered or minimized. Any jewelry worn should not be distracting. Women should avoid long dangle earrings because they can be distracting to the interviewer.

More than likely you will be meeting with a hiring authority. Depending upon the size of the organization, you may speak with other staff members too, perhaps members of the team you may be working with. You may be given a tour of the facility. While taking the tour, notice whether the staff seems friendly, whether the facility seems clean and well-organized, and whether the patients/clients seem satisfied with their care. After all, you are checking out the employer too.

#2 Exhibit Professionalism
It’s mandatory to be on time for an interview. Leave early enough to accommodate any last-minute problem that you might run into. Don’t chew gum at the interview. More listening and less talking is usually a good approach during a first interview. There is no need to fill an uncomfortable silence with words. Let them do the talking, and answer their questions thoughtfully. Remember good eye contact.

#3 Nail the Interview
You will probably be asked open-ended questions about yourself or past work experience. When answering these questions, remember that they are looking for answers that demonstrate your value to their organization. Provide answers that illustrate a good match between you and the company. It’s okay to ask about their expectations, the shifts you’ll work or the duties you will perform. Describe how you can help the organization meet its needs. Be as flexible as possible.

Also be ready to answer the following questions honestly and completely.
1. May we contact your current employer (and your references)?
2. Have you ever been disciplined or fired from a job (and if so, why)?
3. Why did you leave your past position?
4. What do you hope to be doing five years from now?

Keep in mind that if hired, you will be part of a team. Don’t underestimate the importance of the position for which you have applied. Convey the fact that you think every employee contributes to the success or failure of an organization. Specify your experience. Highlight your expertise and experience working with special cases and needs. Were you known at a past job for being able to do something especially well? If you are inexperienced, communicate your interest and motivation. Share a story that shows how you’ve gone above and beyond in the workplace.

You will be given an opportunity to ask questions. If not previously addressed by the interviewer, ask for such information as advancement opportunities and training/probation period. Things to not ask about during your first interview include questions about vacations or time off. Also avoid any questions about the race/gender makeup of staff or patients/clientele.

#4 Make sure you are making the right choice for yourself
Conditions at medical facilities, especially hospitals and nursing homes, can be vastly different from one shift to the next. Even if you are applying for an afternoon or night-shift position, your interview is very likely to take place during the day shift. Before accepting a position, try to visit the facility during the shift you will be working. Checking the internet for reviews may also give you some insight into a potential employer.

#5 Wrapping it all up
Be sure to thank the Interviewer, shaking their hand (no wimpy grips, please). Inquire as to a time it is appropriate to follow up with them if they haven’t mentioned it already. If they don’t specify a time, suggest a specific day and time in near future. Remember, the more people they are interviewing, the longer it may be before they separate the “wheat from the chaff.” Be sure to get their business card so you can follow up with a personal email, or even better, a handwritten note thanking the person who interviewed you. Mention a point from the interview that will set you apart from other candidates. Keep it short and polite.

Good luck in your job seeking!

Bo Ramsey is a CNA Instructor at Express Training Services, LLC at the Destin Training Center. ETS is home based in Gainesville, Florida and has several other training centers in Florida that offer fast-track instruction for certification in many healthcare occupations. For more information call 866-346-0660 or go to

pain elderlyApproximately 88% of seniors experience chronic pain. [1] The simple process of aging leads to conditions (the most common being arthritis) that can cause chronic pain. Seniors are typically less active which makes them vulnerable to muscle rigidity and joint calcification, all potential pain makers. As we age, because our sensation decreases, we become less coordinated and our movement (mobility) less fluid. This dynamic of aging greatly contributes to the statistic that one in three adults age 65 and older experience a fall each year. [2] And unfortunately as we age, healing from injuries takes longer.

About 20% of older adults take pain medications several times a week, usually for joint or muscle related pain. But, there are many other types of pain experienced by the elderly, especially those who live in nursing homes.

Nursing home residents typically have suffered many losses. Home, career and an independent lifestyle are given up to satisfy their need for 24-hour care. Pile on just a tad of chronic pain and you’ve got a recipe for a downward spiral into helplessness, anxiety and depression.

And nowhere is this dynamic more prevalent that in the nursing home setting.

If not taken seriously by caregivers, reports of pain by an elderly person can be discounted. When reports of pain are not taken seriously, it can be very upsetting to the person in pain which in turn makes their pain management more challenging as pain levels may be reported inaccurately or not at all.

It is the person experiencing the pain who knows just how much of it they are feeling. Pain is whatever the (older) person says it is, and exists whenever they say it does. But if on older person stops reporting pain to their caregivers, it is difficult to help them. Here are the signs to look for when someone is in pain: [3]

  • Facial expressions such as grimacing, breathing changes or sighing heavily are signs of pain or distress.
  • So are unusual body movements such as wincing or limping.
  • Behavioral changes such as not wanting to eat, sleep or socialize can be signs of pain.
  • Also emotional changes such as crying or irritability may be a sign that someone is experiencing pain even though they are not admitting it. 

Certified Nursing Assistants (CNAs) are trained to report any unusual change in their nursing home residents, especially signs of pain. And CNAs routinely report unusual pain to their charge nurse, but the savvy CNA knows that there are also other ways to help their residents who are experiencing pain.

Many pain-relieving alternatives may be included on a resident’s care plan such as a warm shower or bath, the application of heat or cold, or regular repositioning. But because CNAs spend so much time with nursing home residents, they can do other things that will encourage relaxation and perhaps even relieve pain. The following activities can be carried out by a CNA or any other caregiver in any setting, because they are techniques that utilize simple kindness and gentle human touch.

Listening is first

In the CNA world, we call it Therapeutic Communication. It bears repeating that senior citizens who live in nursing homes have, for the most part, experienced many losses. At a minimum they have given up their independent lifestyle. Compound the sadness they may be feeling, with the chronic pain that typically accompanies old age and you have a double dose of pain.

CNAs are taught to encourage residents to talk by asking open ended questions and then listening. CNAs know how important it is to be authentic when listening to a resident who is sharing their feelings. When a CNA is truly listening to a resident, the result is validation for the resident. This feeling of validation for someone who may be feeling disenfranchised can be a great source of comfort and a miracle pain reliever – at least in an emotional sense.

Empathy is Essential

It is not enough to just “feel sorry” for someone who is suffering if you want to help ease their pain. The empathetic CNA is able to “feel” their residents’ pain (while not taking it own as their own) in a way that enhances the care they give. This empathetic approach to caregiving shows in ways that only the nursing home resident can feel. When a CNA delivers daily care with empathy (vs sympathy) the result for the resident spreads across the board into all areas of their life in the nursing home – and makes it better, therefore helping with any pain they may be feeling.

Restorative Care Helps with Chronic Pain

People who live in nursing homes, as opposed to those who are there for short term rehabilitation from an injury or illness, receive Restorative Care. Restorative care is designed to optimize a resident’s experience in the nursing home by involving them in as many aspects of their activities of daily living (ADLs) as is possible, with independence fostered in every aspect of their care. Involvement in social activities is encouraged. Choices abound. It would be easy for a resident in a nursing home to feel as if they are giving up control, but with the right recipe of Restorative Care, they will feel empowered by the choices and decisions they are making for themselves. Good Restorative Care makes for a happier resident. A happier resident naturally experiences less pain.

Simple Ways to Help with Physical Pain

A soft, gentle touch in the form of a hand, foot or back massage can also help to alleviate physical pain. The benefit of gentle, relaxing massage is well documented. [4] Gentle stroking, kneading and light pressure can lubricate joints and assist in the pain management of people who suffer from the stiffness of arthritis according to the Touch Research Institute. Massage for the elderly also has physical and mental benefits that can improve their health and general well-being. At a minimum, a gentle massage of the hands, feet or back can result in a deeper, longer and more regenerative sleep and an overall state of greater well-being. A therapeutic massage given by someone trained in the treatment of the elderly can result in increased range of motion, strengthening of muscles and improved posture. But a soothing massage from a caregiver can go a long way in improving the quality of life for someone living with chronic pain.

Most nursing home residents who live with chronic pain are under the watchful eye of a physician and nursing staff who know the benefits of pain medication. And every nursing home resident benefits from being under the watchful eye of a caring CNA who listens to them and from time to time administers a kind and gentle human touch.

Bo Ramsey is a CNA Instructor at Express Training Services, LLC at the Destin Training Center. ETS is home based in Gainesville, Florida and has several other training centers in Florida that offer fast-track instruction for certification in many healthcare occupations. For more information call 866-346-0660 or go to





ImageRow, row, row your boat gently down the stream… Sing it twice as you wash your hands, working up a good lather as you go, and you will be practicing one of the most effective ways to prevent the spread of many types of infection and illness in all settings from your home and workplace to healthcare facilities.

It’s just common sense, really. Consider all the surfaces we come in contact with throughout the day – hand rails, door handles, ATM buttons and the like. What do all these things have in common? The human touch. We move about our day touching things everywhere we go.  

Imagine what it would be like to be a simple cold or flu germ.  Influenza viruses can survive on hard surfaces such as books or doorknobs between two and 8 hours. [1] Now, that may not seem like a very long time, but in “virus years” it can be an eternity.

Let’s say you are coming down with a cold and have decided to “gut it out” and go to work. With only a sore throat and a stuffy nose, you don’t realize that you are a veritable germ factory, and the first time you blow your nose and fail to wash your hands right after, you will soon be sharing your cold germs with everyone around you via everything you touch. Cold and flu germs can survive on some surfaces for up to 48 hours [2] and so the calling cards you leave behind when you handle things can be transferred by contact to anyone coming along behind you who touches it. This can include the telephone at the reception desk, the buttons on the copy machine or the handle of the coffee pot in the employee lounge. And as you run errands on the way home from work you are leaving cold germs along the way on the handle of the cart at the grocery store and the ballpoint pin you used at the bank teller’s window. 

Yes, germs are lurking around us all the time. They hitch a ride on us when we touch a surface on which they have been left. And if they make it to our eyes, nose or mouth, their most common entry point into the body, they will invade our body and perhaps make us sick. But there is a fast and easy way to defend ourselves against the spread of germs. Handwashing. 

According to the CDC (Centers of Disease Control) we should wash our hands before, during and after preparing food, before eating and before and after caring for someone who is sick or taking care of a cut or wound. Of course we all know to wash our hands after using the bathroom or changing a baby’s diaper. Hand washing is advised after taking out the trash or touching an animal, feeding it, or cleaning up after it. And of course it is especially important to wash our hands after blowing our nose, coughing or sneezing. [3] 

Now that we know when to wash our hands, let’s take a look at just how to do it. The CDC advises that we first wet our hands with warm or cold clean running water. Then apply soap. Next, rub the hands together to make a rich lather and scrub them well. Remember the backs of the hands, between the fingers and under the nails. This vigorous scrubbing should last at least 20 seconds. (Twice singing the song, Row, row, row your boat.) Then a good rinse under running water and a clean towel or air dry is the recommended finish. [3] 

As a side note, the use of waterless hand sanitizers is also addressed by the CDC. When soap and water are not available, an alcohol-based hand sanitizer containing at least 60% alcohol can reduce the number of germs on hands in some situations. Follow manufacturer’s recommendations when using them and know that they will not eliminate all types of germs. [3] 

Simple handwashing is truly the vanguard of infection control. No other infection control measure goes further in protecting us against the spread of germs. So row, row, row your boat gently to the closest sink and wash your hands. See you there!

Bo Ramsey is a CNA Instructor at Express Training Services, LLC at the Destin Training Center. ETS is home based in Gainesville, Florida and has several other training centers in Florida that offer fast-track instruction for certification in many healthcare occupations. For more information call 866-346-0660 or go to





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