CNA Instructors Must Invest In Life-Builders  

By Paul M. Dohse, RN, CDP

As a CNA instructor, I fancy myself as being good at sizing up a new cohort and reading the room of students when I first meet them. I always assumed it was my prior business experience, which included managing hundreds of employees over the years. That may be helpful, but the primary way we read the new room of students is through philosophy.

Ordinarily, this would be a deep subject, but it isn’t. Any CNA instructor can easily read the room and know what they have out of the gate. We don’t need the ability to read minds or look at the heart; all we need to know is what to look for. This is metaphysics made easy.

The human mind and body are made to accomplish. We know what happens to people who live a sedentary lifestyle. Cells exist for the sole purpose of dispensing energy.  Hence, common sense and experience teach us that the gateway to wellbeing is to be all we can be as individuals. And of course, every human being is individually diverse and born with different strengths and weaknesses, so the goal is to maximize individual capabilities. This is sufficient to obtain wellbeing, or self-actualization according to Abraham Maslow’s Hierarchy of Needs. I like to refer to these people as “Life-Builders.” Now, life-builders, in many cases, are functioning towards self-actualization intuitively, and haven’t articulated their journey through frameworks like Maslow’s hierarchy, but they are easy to spot.

Their overall demeanor and speech expose them demonstrably. They are life-builders. When you walk into the room, they are sizing you up, trying to ascertain your ability to help them on their journey, and not on their phones surfing social media. When they ask a question, it’s an honest attempt to gain knowledge, not a challenge. They are active listeners, and respectful. They will rarely argue with you because their primary concern is what you can teach them, not what they already know, which is the lower floor of the building and water under the bridge. They are always working on the next floor of the building. In short, they are there to take care of business. They define professionalism.

In contrast, there are students who are not life-builders. They are also evident. In many instances, they are merely living for the weekend. Of course, life-builders understand the need for leisure in pursuit of a balanced life, but non-life-builders would live a life of leisure full time if they could. They are hedonists. Primarily, they are in your class to get certified for purposes of making more money. In other words, they are functioning primarily on Maslow’s foundational level of physiological needs and think they are entitled to the upper levels without working for them. In their minds, they have already achieved self-actualization and are legends in their own mind. Remember, hedonism goes hand in hand with narcissism, and they are both. And they are also immediately evident. Their demeanor and attitude will be the antithesis of the life-builders. They will argue with you. They will attempt to manipulate you. They will disrespect you. They are always the smartest person in the room. They come adorned with cheap substitutes that are attempted shortcuts to valid self-actualization. They are professional victims who blame others for their failures. They don’t follow rules, and consequently, cause unnecessary confrontation. In short, they are a hot mess and a nightmare for the instructor. And worse yet, they obstruct the life-builders.

Religion doesn’t have the market cornered on persecution. Wellbeing comes with a price. Dilapidated shacks don’t like to exist next to shiny, tall, skyscrapers that reflect the morning sun. Invariably, non-life-builders will persecute the life-builders through criticism, antagonism, and false accusations; the goal is to tear down other buildings to their level and veneer. And regarding religion, it would seem God expects us to live up to all the potential He has created within us. Maslow was not a Bible-thumping Baptist, but God is all-in for practical commonsense, which He also created.

So, what does all of this theory look like when we put feet on it at clinicals? That is, hands-on experience at a facility. As an instructor, a group of life-builders will run you ragged running from one experience to the next. Each team has a walkie-talkie to contact the instructor because the instructor must be present for certain aspects of care (patient safety concerns). Also, a process of care can be halted because there are questions about what to do next. A group of life-building students will have the instructor running from floor to floor and room to room non-stop. Life-builders are diligent hard workers, even when they are not being paid for it. Life-builders see benefit and purpose in things that sometimes do not yield money. They understand that obtaining self-actualization is a multi-faceted process that results in things you can’t put a price on. So, do the non-life-builders resent the fact that they are “working for free” at clinicals? Yes. Money often follows life-building, but money can’t buy wellbeing. Take note that many rich people are miserable and insufferable, while many wealthy people are also happy because money was merely one of the results of their life-building.

Though life-builders are only striving for self-actualization, and free from the bondage of competing with others, they will often be marked as the best in their field. Why is that? A good answer can be borrowed from football legend Tom Brady. “To be successful at anything, the truth is, you don’t have to be special. You just have to be what most people aren’t: consistent, determined, and willing to work for it. No shortcuts.” In other words, every person is created special in their own right, but must seize it through the self-actualization process. Also, Maslow himself stated, “The story of the human race is the story of men and women selling themselves short.”

And why do they sell themselves short? Because of what others tell them about them, as if others know us better than we know ourselves. In most cases, the narrative about you as presented by others is an attempt to control you through condemnation and limit your building program. After all, the essence of all sin is a desire to control others. This dynamic is true and displays itself everywhere in reality from the elementary school playground to the world politics of wars and slavery. NEVER let others define you. NEVER let others determine your self-esteem. Self-esteem is determined by your own fact-based assessment of yourself and the ability to effect change where needed. Beware of so-called “constructive criticism,” which is a soft term for condemnation. File it away for consideration in honing your own self-assessment, but it should be no more than that.

Here is what business and industry need to realize in general, and healthcare in particular; life-builders are by far the majority. Particularly in healthcare, catering to the minority narcissists and those living for the weekend is poisoning staffing levels.

And as CNA instructors, why is it ok to have a two-tiered justice system? Why are we passing life-builders and narcissists alike according to the same bar for purposes of putting warm bodies on healthcare floors because of a supposed healthcare staffing crisis? How is it moral to give a pass to individuals that are unprofessional?

Lastly, consider the reason that the San Francisco 49ers didn’t draft Tom Brady according to their coach, Steve Mariucci: “We didn’t open up his chest and look at his heart. We didn’t look at that. I don’t know if anybody did. What kind of spine he had. And resiliency, and all the things that are making him really great right now.”  We don’t need access to the heart. We only need to observe the outside behavior to know if a student is a Life-builder. The 49ers focused on athletic ability rather than Tom Brady’s work ethic and other things that reveal what kind of heart a person has. Many students have the skills, but not the heart, and we know the heart by their actions.

This is a matter of wise investment. Moving forward, we must invest in life-builders and protect them from narcissistic persecution. Time spent dragging others over the finish line is a misguided investment of time and resources. Life-builders are a precious commodity that healthcare desperately needs. They are professional, empathetic, and diligent. We must focus our investment on them.

This is our moral duty.