Pete Skorcz taps into a patient's sense of humor to help him relax during a photo session.
Taking the first step toward making a difference in the care of the elderly:
Hands-on care through CNA certification
Pete Skorcz has a great concern for the elderly population, a concern he discovered when he first took a CNA (Certified Nurse Aide/Assistant) class. He landed in that class as a result of being disillusioned with his original college plan of going into medicine and becoming a physician. After shadowing doctors, he realized the profession was not what he had imagined it would be. He wanted to be involved in all the aspects of patient care, not just diagnosing and prescribing. So a pre-nursing friend of his suggested he take a CNA class with her that she needed as prerequisite for the UW nursing program.
CNA classes have a clinical component, where students work with the elderly in the nursing home. After the first day of clinical, Skorcz found himself stunned: "I had to ask myself, 'What did I just experience?!! I had never been exposed to the breakdown of the human body in aging. And the work of a CNA is not clean work. Not many want to do it, but it has to be done. Do I want to do this kind of work?? I could see that this population needs so much help; they can't defend themselves. Many cannot complain or explain what might be wrong. I had to decide 'Yes,' I do want to help."
Skorcz found that he had an easy rapport with the folks in the assisted living and nursing homes. He has a particular sensitivity for the residents who suffer with dementia. "I've learned to role-play, to be who they think I am." He also seems to have a sensitivity as to what is needed for the moment, as pictured above.
So Skorcz took his first step in making a difference by signing up to be a CNA, subsequently working as a CNA for three years in his home town of Rock Springs, Wyoming.
Second step:
Increased knowledge
Skorcz' ability to effectively help the elderly population took a crucial step forward when he changed his major to nursing and started classes in the UW nursing program. "I didn't know how much I didn't know!" says Skorcz. He learned more about health and geriatrics, important information that went way beyond what he had learned through the CNA program. Although that kind of education would be expected in a nursing program and not in a CNA program, he felt some of the education was vital to a CNA's role in adequately caring for geriatric patients. "I could have helped the residents of the assistant living center sooner if I had been equipped with this information," says Skorcz. "Many nurses in skilled nursing facilities rely on CNAs and the information they report and the tasks that they do. CNAs are more likely to notice minor changes in behavior, skin condition, ability to complete ADLs [Activities of Daily Living], and other subtle changes in a client’s health that should warrant an in-depth assessment by a nurse. Were CNAs educated to better recognize the subtle changes or risks to client health, there would be more prompt assessments, interventions, and better health outcomes for the clients."
Below Skorcz shares some of what he wished he had known as a CNA that he did not learn until he was a nursing student:
- Being able to differentiate Dementia, Delirium, and Depression
- Recognizing prominent or dangerous drug side effects (the risk for Digitalis toxicity is increased in older adults)
- Knowing what is considered 'normal' changes with aging as opposed to abnormal or disease changes
- Acquiring a knowledge of current alternative medicines (CAMSs) and their interactions with prescription drugs
- Understanding dementia progression staging
- Knowing the stages of pressure ulcers
So how could Skorcz be a catalyst for change?
Third step:
Plan of action
Skorcz is also a University of Wyoming Honors Student. One of the expectations of the Honors Program is for students to complete a senior project in their last semester. Skorcz knew he wanted to focus on Geriatrics, but that is a "pretty wide field," says Skorcz. "I had a stack of papers this high," spreading his hands several inches high to describe the data he had on Geriatrics. So how could he narrow the focus? As he visited with friends and coworkers who were also working as CNAs, he started asking them what they had learned and what they wished they had known in order to be more effective in their positions. Skorcz' project started taking shape. He decided it would be best to focus on finding the weaknesses/gaps in the education of CNAs for his project focus.
Skorcz says, "I currently am in the fairly early stages of the project. I have been polishing up the rough edges before I begin collecting data. Up until now, I have been searching for other research done on the topic." Skorcz has also put together a questionnaire with which he will survey CNAs, once the IRB (Institutional Review Board) form is completed and sent through the proper channels. The IRB is a check to ensure that he is doing an ethical study. At the same time, Skorcz is finalizing a base survey - a ten-minute quiz - that should gauge lapses in CNAs' knowledge. He will write a 35-40 page paper and will give a 15-minute presentation to his faculty advisor and panel. His presentation will be in April or May, before finals.
Fourth step:
Implementation
"Forming a full-scale intervention, via in-service training sessions for CNAs in nursing homes and assisted living facilities," says Skorcz, "will be a future project to continue my work later on in my career, provided that my research proves the need for an intervention."