Margaret Casey-Mederios, RN and Kathleen Masucci, RN
Philosophy of the Book
For those of you unfamiliar with How To Be a Nurse Assistant, it is a nurse assistant training book that goes beyond the usual “how to” approach. The focus is constantly on the resident. “Mindfulness” is stressed as a state of constantly being aware of the resident as a person, what the resident is saying, and how the physical and mental state of the resident might be changing. The tasks of a nurse assistant are not just automatic, repetitious activities. Every task must engage the resident while simultaneously keeping in mind the “themes” stressed in Chapter 12 (communication, autonomy, respect, maximizing capabilities, safety, infection control, and observation). Nurse assistants are constantly asked to put themselves in the place of the residents: “How would you feel if…” To reinforce these ideas, case studies and examples are found throughout the book.
To see a more complete description of the book’s philosophy, download Chapter 2 (see especially the first seven pages) and Chapter 12, Themes of Care.
The General Layout of Each Chapter
a short introduction ties the chapter to OBRA 87 or other reasons to learn the material
list of objectives
list of medical terms—medical terms are highlighted in orange when they are first used and defined in footnotes (they are also collected in Appendix A)
The text itself begins with an invitation to put yourself in the resident’s place: “Have you ever noticed….” “How would you feel if….”
The text is fully illustrated with over 500 photos (many of them new for this edition) and over 200 drawings.
Short case studies and examples are highlighted with yellow background.
Boxes and tables summarize information (also highlighted with yellow background).
Each chapter ends with three sections:
“In This Chapter You Learned” reviews the objectives;
“Summary” is exactly that, and repeats the nurse assistant’s role;
“Pulling It All Together” is usually a short case study illustrating what you should have learned from the chapter.
“Check What You’ve Learned” is a 10-question multiple choice quiz at the end of each chapter (answers are in the instructor’s manual).
Procedures
In this book, a “procedure” is a multi-step activity that includes the “common preparation steps” and “common completion steps” that are found in Chapter 12 (you can download that chapter). Procedures always have a blue background. Each step is explained, and often illustrated. “Why” you do something is put in parentheses.
There are many other multi-step activities (putting on gloves, mask, and gown, for example) that do not include the common preparation and completion steps, so we do not consider them procedures. Some other books do. There are other multi-step activities (making a bed, for example), where a simple change in one step (for example, turning down the top sheet or not) creates an entirely separate procedure in some books. We don’t think you need an entirely new set of steps to turn down a sheet.
What’s New in the Fourth Edition?
Besides general updating of material, we have added 85 more pages and three more chapters. Mainly this concerns subacute care. Here are the main additions:
Summary of the November 2002 OIG Report, which advocated nurse assistant training along the lines of How To Be a Nurse Assistant. (front matter)
CMS requirements for quality care (end of Chapter 12)
Role of the nurse assistant in the survey process (Appendix F)
Assisting with the physical exam, including taking a patient history (Chapter 13)
Wound care (Chapter 19)
Various types of care in subacute settings (Chapter 24)
Oxygen therapy
Positioning for easier breathing
Hot and cold applications
Dialysis
Enteral and parenteral nutrition
Care of the person having surgery (Chapter 25)
Babies, mothers, and growth & development (Chapter 26)
If you have used How To Be a Nurse Assistant before, you will also notice we have moved some things around. This is explained in a chart at the end of the Detailed Table of Contents.
Readability
The readability of the student text, as measured by the Flesch-Kincaid formula, is a low grade 8. The 30 chapters break down by grade level as follows:
- grade 6 2 chapters
- grade 7 12 chapters
- grade 8 13 chapters
- grade 9 3 chapters
In the 4th edition we have also changed several lists from pure text into bullet points to help the reader.
We understand that a great many students do not speak English as a native language. We have tried to make this book as reader-friendly as possible by:
- providing a list of medical terms at the beginning of each chapter (these are repeated in footnotes as they occur and are gathered together in Appendix A, which can be used as a mini-dictionary).
- footnoting words that are used in a special sense in long term care (“Autonomy,” for example is not a medical term, but it is a term used in a technical way in long term care, and it is a word that non-native speakers might not know).
- providing a list of words in the Instructor’s Manual that non-native speakers might find difficult (similar to the footnoted non-medical terms, but easier).
- providing glossaries of medical terms and English-Spanish/Spanish-English words.
Finally, we often faced the issue of either repeating an explanation given elsewhere or simply referring to it (for example, “See page 243”). Generally, we decided to repeat information rather than simply referencing it. Since this is a textbook for students, we felt that constantly turning back and forth would be distracting, and as the Romans said, “Repetition is the mother of education.” Except they said it in Latin!