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Role of the Nursing Assistant
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Interdisciplinary Health Care Team Includes: Includes: Patient, family members, physician, nursing team, & specialists Patient, family members, physician, nursing team, & specialists Nursing team provides: Nursing team provides: Skilled nursing care Skilled nursing care Plans & directs physicians orders Plans & directs physicians orders
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Training period Trained to assist with patient care Trained to assist with patient care Short time frame because the NA responsibilities and skills are not as great Short time frame because the NA responsibilities and skills are not as great Growth and learning will continue throughout the career Growth and learning will continue throughout the career
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Registered Nurse Passes national licensure exam Passes national licensure exam Associate or bachelor degree Associate or bachelor degree Duties are to assess, plan, evaluate and coordinate patient care Duties are to assess, plan, evaluate and coordinate patient care
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Licensed Practical Nurse 1 yr – 18 month program 1 yr – 18 month program Pass national licensure exam Pass national licensure exam Works under supervision of RN, physician or dentist Works under supervision of RN, physician or dentist
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Nursing Assistant Trained to assist with patient care Trained to assist with patient care 90 hours training 90 hours training
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Organization Primary nursing Primary nursing Functional Nursing Functional Nursing Team Nursing Team Nursing Patient Focused care Patient Focused care
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Primary Nursing Care is given by the registered nurse Care is given by the registered nurse Assigned to that patient for the entire hospitalization Assigned to that patient for the entire hospitalization LPN/LVN & CNA’s help w/ care and follow directions of the RN LPN/LVN & CNA’s help w/ care and follow directions of the RN Enables patient to relate directly to one specific nurse Enables patient to relate directly to one specific nurse May be responsible for 6-8 patients May be responsible for 6-8 patients
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Functional Nursing Task-oriented care Task-oriented care Nurse in charge is the person responsible for all patients Nurse in charge is the person responsible for all patients Staff is assigned specific tasks: Staff is assigned specific tasks: Giving meds; providing tx’s; providing hygiene care Giving meds; providing tx’s; providing hygiene care Patient’s may find it confusing because many people are involved in the care Patient’s may find it confusing because many people are involved in the care
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Team Nursing Most common method Most common method RN team leader determines the nursing needs of all the patients assigned to the team RN team leader determines the nursing needs of all the patients assigned to the team Team members receive their instructions and report back to the team leader Team members receive their instructions and report back to the team leader Includes family in the planned care for the patient Includes family in the planned care for the patient
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Patient Focused Care Goals are: Goals are: Limits the number of people involved in patient care Limits the number of people involved in patient care Contains cost Contains cost Meets patient’s needs efficiently Meets patient’s needs efficiently Staff members are prepared as multi-skilled workers by cross- training them to perform special duties that are normally carried out by someone else Staff members are prepared as multi-skilled workers by cross- training them to perform special duties that are normally carried out by someone else Ie: drawing blood, obtaining statistics, etc. Ie: drawing blood, obtaining statistics, etc.
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Regulation NA’s must understand the scope of practice NA’s must understand the scope of practice All states required to specificially address duties & responsibilities of NA as well as education All states required to specificially address duties & responsibilities of NA as well as education OBRA – Federal law that regulates the education & certification of NA’s (falls under DHHS) OBRA – Federal law that regulates the education & certification of NA’s (falls under DHHS)
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continued... Effective 1990, anyone working as NA must complete a competency evaluation program (state approved course) Effective 1990, anyone working as NA must complete a competency evaluation program (state approved course) Actual training/education of NA is under individual state jurisdiction guided by federal regulations Actual training/education of NA is under individual state jurisdiction guided by federal regulations
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NACEP Nurse Aide Competency Evaluation Program Nurse Aide Competency Evaluation Program Guide for individual programs that register and awards credentials to NA Guide for individual programs that register and awards credentials to NA Specifies minimum skills to be achieved Specifies minimum skills to be achieved Meets the requirements of OBRA Meets the requirements of OBRA
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continued... Georgia requirements: Georgia requirements: Minimum 90 hours classroom time Minimum 90 hours classroom time Minimum 24 hours clinical practice Minimum 24 hours clinical practice Passing written exam score of 75 or better Passing written exam score of 75 or better Skills practicum Skills practicum Randomly chosen by evaluator Randomly chosen by evaluator One must be vital signs One must be vital signs
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Guidelines for NA Only perform tasks you have been trained to perform and are legally within your scope of practice Only perform tasks you have been trained to perform and are legally within your scope of practice Better to ask for clarification or help than to make an error and cause an injury Better to ask for clarification or help than to make an error and cause an injury
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Personal Adjustments Certain amount of adjustments may be needed due to work situations Certain amount of adjustments may be needed due to work situations Following orders promptly Following orders promptly Ensuring rules are followed Ensuring rules are followed Accepting criticism Accepting criticism Willing to learn and grow Willing to learn and grow Dependability Dependability Respect for co-workers Respect for co-workers Learning to be tactful Learning to be tactful
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Interpersonal relationships Interactions between people Interactions between people Warm; accepting Warm; accepting Positive attitude Positive attitude Smiling at others when you don’t feel like it Smiling at others when you don’t feel like it Cooperative Cooperative
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Attitude Most important characteristic Most important characteristic Shown through behavior Shown through behavior Attitude should reflect: Attitude should reflect: Courtesy Courtesy Cooperation Cooperation Emotional control Emotional control Empathy (understanding) Empathy (understanding) Tact Tact Sympathy Sympathy
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Patient relationships All ages become ill All ages become ill Good NA shows empathy for patient by being gentle and kind even when they may be nasty and mean Good NA shows empathy for patient by being gentle and kind even when they may be nasty and mean When person is ill, they are frightened – personalities change When person is ill, they are frightened – personalities change
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Meeting patient’s needs Patient may have difficulty meeting social, spiritual and physical needs due to limits of illness Patient may have difficulty meeting social, spiritual and physical needs due to limits of illness Offer emotional support, listening skills and meeting patient’s needs as best you can Offer emotional support, listening skills and meeting patient’s needs as best you can
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Family’s needs Concern for family members adds stress to their lives Concern for family members adds stress to their lives Need reassurance that person is being cared for Need reassurance that person is being cared for Co-workers who are ill add stress Co-workers who are ill add stress Need patience and tact Need patience and tact Be aware of body language, not just words Be aware of body language, not just words
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Staff relationships All staff members share same goal – to help patient All staff members share same goal – to help patient Good interpersonal skills Good interpersonal skills Do not criticize others Do not criticize others Cheerful, positive attitude Cheerful, positive attitude Watch body language Watch body language
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Personal grooming Essential because of close contact w/ patients Essential because of close contact w/ patients Includes: Includes: Daily showers Daily showers Mouth care Mouth care No strong perfumes/lotions (can make patient sick) No strong perfumes/lotions (can make patient sick) Keep hair/nails clean Keep hair/nails clean No dangling jewelry No dangling jewelry
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Stress !!!! Work is physically and mentally demanding. To stay healthy: Work is physically and mentally demanding. To stay healthy: Sufficient rest Sufficient rest Good nutrition Good nutrition Satisfying leisure activities Satisfying leisure activities Burnout is total mental, emotional, and sometimes physical exhaustion Burnout is total mental, emotional, and sometimes physical exhaustion
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