Health care careers Therapeutic services nursing

Unlicensed nursing personnel… Persons who are trained to do basic nursing tasks but who do not require a license are called unlicensed nursing personnel. State laws vary, but the title of Certificated or Certified Nursing Assistant (CNA) is most often used. This does not require a high school diploma, but does require 75 hours of training and passing a competency evaluation of knowledge and skills testing.

Unlicensed nursing personnel… The CNA may work in a hospital, nursing home, or residential care facility. They take orders and are supervised by licensed nurses. They tend to have more personal contact with clients than any other care provider. Client safety and confidentiality are primary concerns. Accurate written and verbal communication are very important.

Unlicensed nursing personnel… CNAs sometimes work in acute care facilities such as hospitals, where the client’s stay is usually short-term. They answer call lights; get rooms ready for new admissions; tidy patient’s rooms and make beds; deliver messages, supplies, and equipment; serve and assist with meals; assist with personal care, toileting, bathing, oral care, skin care, and shaving; take and report vital signs; and help with patient ambulation.

Unlicensed nursing personnel… CNAs sometimes work in long-term care facilities. A nursing home would be an example. Additional duties in this type of facility may include emptying bedpans, cleaning incontinent patients, reporting changes in mental status or self-care capabilities.

Unlicensed nursing personnel… CNAs sometimes work in residential care facilities. The clients here are able to take care of many of their own needs. An assisted living facility would be an example. In this setting, the CNA may be responsible for assisting with medications, assisting with client outings for shopping or appointments, or providing transportation to appointments.

Unlicensed nursing personnel… Home health aides or CNAs sometimes provide home health care. The client can still live safely in their own homes, with some assistance. The home health aide may do all tasks of the CNA, assist with medications, assist with personal care such as cooking, eating, bathing, dressing, light housekeeping, laundry, changing linens, shopping, or driving to appointments.

Unlicensed nursing personnel… Technicians work primarily with equipment; technologists work primarily with people. One example of an technician would be the dialysis technician. This person operates kidney dialysis machines that artificially filter a client’s blood in the case of kidney failure. They would set up, operate, and clean the machine, be exposed to blood, work with seriously ill clients, administer local anesthetics, etc.

Unlicensed nursing personnel… A surgical technologist may work as part of a team, performing sterilization procedures, setting up equipment, preparing the surgical site on the patient, handing instruments to the surgeon or their assistant, transporting patients to recovery, restocking surgical suites, etc. They would be exposed to unpleasant sights, odors, and materials during procedures.

Licensed nursing personnel… Licensed nursing personnel complete post-secondary training and pass a test. They are licensed through a state agency; they are held accountable through standards; they belong to professional groups; the more training they have the more duties and higher pay they have.

Licensed nursing personnel… The Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) completes 1-2 years of classroom and clinical training. They practice under the supervision of a physician or registered nurse. An LPN takes vital signs, treats bedsores, administers injections and medications, gives enemas, applies dressings, icepacks, and hot water bottles, and inserts and cares for urinary catheters.

Unlicensed nursing personnel… The LPN also assesses clients for effects of medications and treatments, assists with meals, records intake and output, helps with personal needs, helps with emotional needs of patients, assists with the delivery of infants, cares for and feeds infants, supervises CNAs, evaluates client needs, makes appointments and keeps records, and teaches patients how to care for themselves.

Licensed nursing personnel… Registered nurses (RN) must complete a pathway of study, getting a diploma in 2-3 years, an Associate degree in 2 years, or a Bachelor of Science degree in 4-5 years. Each state has its own licensing requirements, but the RN passes a national licensing exam. Advancement, management, and teaching positions may require a Bachelor’s degree.

Licensed nursing personnel… RNs work independently or in team settings with the physicians, therapists, medical social workers, aides, and dieticians. RN responsibilities range from basic client care to administrative duties. The RN is always a patient ‘advocate’… meaning they represent the needs of the client. All communication skills, including speaking, listening, and writing, are critical.

Licensed nursing personnel… Hospital RNs provide the same patient care as LPNs; provide bedside nursing care; start IV infusions, carry out medical procedures and regimens as ordered by physicians; and supervise LPNs and unlicensed nursing personnel.

Licensed nursing personnel… Physician office RNs provide care for clients in an outpatient setting; prepare clients for examinations; assist physicians with examinations; administer injections and IV solutions; perform wound care; assist with minor surgeries; maintain documentation, and perform routine specimen collection and lab work.

Licensed nursing personnel… Nursing Home RNs manage the nursing care for the patients; fill management positions, participate in staff education; handle administrative and supervisory duties, and assess clients’ medical conditions.

Licensed nursing personnel… Home Health Care RNs provide periodic care to clients in their home; assess the home environment for safety, teach clients and their family members how to care for themselves; supervise the home health aide or LPN.

Licensed nursing personnel… Public Health RNs work in a community setting; they work with selected populations to improve the health of the community at large, educate family members in health maintenance, disease prevention, nutrition, and child care; and provide health screenings.

Licensed nursing personnel… Occupational or Industrial RNs provide workplace care to employees and customers; assess and educate workers and management on health hazards found in the workplace; and assist with health examinations for employees.

Licensed nursing personnel… Head nurses or supervisory RNs manage nursing departments; plan work schedules and assign duties; plan and monitor the budget; supervise all personnel; maintain all required records.

Licensed nursing personnel… Registered nurses who successfully complete additional training may obtain an advanced practice certificate or degree. They provide basic medical care, diagnosing and treating common ailments. Nurse practitioners are allowed to prescribe medications with the approval of a physician.

Licensed nursing personnel… Clinical nurse specialists are RNs who specialize in a specific nursing area such as gerontology or neonatology.

Licensed nursing personnel… Certified RN anesthetists have additional training in the use of anesthesia. They work in surgical settings under the supervision of an anesthesiologist or physician.

Licensed nursing personnel… Certified nurse midwives are RNs who assist with the delivery of infants, having training and expertise in the delivery process.

Qualities of a good nurse… The patient comes first. Willingness to be a lifelong learner. Compassion for others. Nurturing. Empathetic. Able to observe confidentiality. Skillful. Confident. Does not judge people with different lifestyles, income levels, and beliefs. Professional demeanor. Excellent personal hygiene. Ability to work with people who are not at their best, because they are afraid, ill, or injured. High tolerance for unpleasant bodily sights, odors, and functions. Able to follow directives.

Effective communication skills… Communication is the exchange of information, ideas, feelings, and thoughts. Communication helps us know what the needs of others are and how to meet those needs. Healthcare workers must be able to communicate with patients, families, co-workers, other professionals, and supervisors.

Effective nonverbal communication… Nonverbal communication is important: Eye Contact – lets others know you’re listening Facial Expressions – match your facial expression to the verbal message Gestures – shrugging your shoulders, turning your back, or leaving the room while someone is talking all convey lack of interest. Touch – conveys great caring or rejection

Good listening skills… Reflect on what the sender is trying to say – think about the message, and avoid thinking about your response. Restate (paraphrase) back to the sender to let them know they are being heard and understood. Ask for clarification if you do not understand part of the message.

Barriers to good communication… Prejudices - biases Frustrations - Impatience, annoyance, anger, irritation. Attitudes - Disinterest, bored, bad moods. Your own Life Experiences Labeling people – lazy, stupid, complainer, etc. Sensory Impairment – deaf, blind, speech impaired Talking Too Fast

5 Fundamentals of customer service… Acknowledge (greetings, eye contact, smile) Introduce (give your name and role) Duration (inform patient of anticipated wait times) Explanation (what can patient expect) Thank You

Making observations… Use your senses to make observations. Sense of sight: color, swelling, a rash or sore, amount of food eaten Sense of smell: body odor, unusual breath, wound, urine, or stool odors Sense of touch: pulse, dryness or temperature of the skin, perspiration, swelling Sense of hearing: listen to respirations, abnormal body sounds, coughs, and speech.

Making observations… Subjective Observations are those that cannot be seen or felt. They are ideas, thought, or opinions. They are commonly called symptoms, and are usually statements or complaints made by the patient. (report them in the exact words used by the patient). Objective Observations can be measured, seen, felt, heard, or smelled. They are commonly called signs.

Documentation… Documentation must be accurate, concise, complete. Writing should be neat and legible. Spelling and grammar should be correct. All documentation must be signed with the name and title of the person recording the information. Errors should be crossed out neatly with a straight line, have “error” recorded by them, and show the initials of the person making the error. Patient documentation is a legal record, admissible in a court of law. If you do not write it down, it did not happen! Use ink for all documentation. Entries should be in short phrases. No need for complete sentences. Use technical writing. Time should be recorded in military (24 hour) time. Complete an entry by drawing a line to the end.

Health care careers Therapeutic services nursing The end

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