On-the-Job Training

Abstract

This chapter talks about the different teaching strategies nurses employ to train caregivers, and the different ways in which caregivers learn in training. Nurses develop strategies based on caregivers' and care recipients' readiness and different levels of knowledge. One of the first things they report doing when making initial contact is to find out what the expectations are, and manage them. Another strategy nurses say they use, especially if someone is hesitant or has anxiety, is to give emotional reassurance, including “lots of praise,” positive reinforcement, and encouragement. In terms of hands-on work, all nurses state that the general process is to demonstrate to the caregiver and/or care recipient exactly what they are going to do, allow them to watch and ask questions, and then observe a return demonstration. It is evident that there is a great deal of variability in how home health nurses convey information. While some of this may be due to agency policies or norms, nurses have different teaching philosophies and styles and are often given much leeway as to how they transmit information. The fragmented nature of the system means that caregivers may experience vast differences in communication processes and in the training they receive. The chapter discusses how caregivers train in three different conditions: caregivers who received prolonged training in rehabilitation facilities and hospitals, caregivers who received some training in hospitals, and caregivers who received little or no training in hospitals.