1. Role of the Nursing Assistant

2. Interdisciplinary Health Care Team
Includes:
Patient, family members, physician, nursing team, & specialists
Nursing team provides:
Skilled nursing care
Plans & directs physicians orders

3. Training period Trained to assist with patient care
Short time frame because the NA responsibilities and skills are not as great
Growth and learning will continue throughout the career

4. Registered Nurse Passes national licensure exam
Associate or bachelor degree
Duties are to assess, plan, evaluate and coordinate patient care
Writes and develops care plans

5. Care Plan Created for each resident
Outlines the steps and tasks the care team must perform
States how often and specifications of steps
Helps resident achieve goals
Resident is involved in development of care plan

6. Licensed Practical Nurse
1 yr – 18 month program
Pass national licensure exam
Works under supervision of RN, physician or dentist
Gives medications and treatments

7. Nursing Assistant Trained to assist with personal care
90 hours training
24 hours clinical training required
Help residents with toileting needs, to move around safely, to eat and drink, and promote self-care and independence

8. Nursing Assistant
WILL NOT give medications or insert or remove tubes!!

9. Additional members of the Care Team
MD – diagnose disease and prescribe treatment
Physical Therapist- gives therapy in the form of heat, cold, massage, ultrasound, electricity, and exercise
Occupational Therapist- helps with compensation of disabilities

10. Cont.
Speech Language Pathologist- teaches exercises to improve or overcome speech problems
Registered Dietitian- creates special diets
Medical Social Worker- helps with support services such as counseling

11. Cont.
Activities Director- helps with socialization and active lifestyle
Resident & family – The care team revolves around this person and his/her condition, treatment, and progress. The resident is the focus of the care team.

12. Organization Primary nursing Functional Nursing Team Nursing
Patient Focused care

13. Primary Nursing Care is given by the registered nurse
Assigned to that patient for the entire hospitalization
LPN/LVN & CNA’s help w/ care and follow directions of the RN
Enables patient to relate directly to one specific nurse
May be responsible for 6-8 patients

14. Functional Nursing Task-oriented care
Nurse in charge is the person responsible for all patients
Staff is assigned specific tasks:
Giving meds; providing tx’s; providing hygiene care
Patient’s may find it confusing because many people are involved in the care

15. Team Nursing Most common method
RN team leader determines the nursing needs of all the patients assigned to the team. Does not determine the legal responsibilities of team members.
Team members receive their instructions and report back to the team leader

16. Team Nursing cont. Includes family in the planned care for the patient
Improves communication and continuity of care

17. Patient Focused Care Goals are:
Limits the number of people involved in patient care
Contains cost
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
Ie: drawing blood, obtaining statistics, etc.

18. Regulation NA’s must understand the scope of practice
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)

19. continued . . .
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

20. NACEP Nurse Aide Competency Evaluation Program
Guide for individual programs that register and awards credentials to NA
Specifies minimum skills to be achieved
Meets the requirements of OBRA

21. continued . . . Georgia requirements: Minimum 90 hours classroom time
Minimum 24 hours clinical practice
Passing written exam score of 80 or better
Skills practicum
Randomly chosen by evaluator
One must be vital signs

22. Guidelines for NA
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

23. Personal Adjustments
Certain amount of adjustments may be needed due to work situations
Following orders promptly
Ensuring rules are followed
Accepting criticism
Willing to learn and grow
Dependability
Respect for co-workers
Learning to be tactful

24. Interpersonal relationships
Interactions between people, tact
Warm; accepting
Positive attitude, patience
Smiling at others when you don’t feel like it
Cooperative
enthusiasm

25. Attitude Most important characteristic Shown through behavior
Attitude should reflect:
Courtesy
Cooperation
Emotional control
Empathy (understanding)
Tact
Sympathy

26. Patient relationships
All ages become ill
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

27. Meeting patient’s needs
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

28. Family’s needs Concern for family members adds stress to their lives
Need reassurance that person is being cared for
Co-workers who are ill add stress
Need patience and tact
Be aware of body language, not just words

29. Staff relationships
All staff members share same goal – to help patient
Good interpersonal skills
Do not criticize others
Cheerful, positive attitude
Watch body language

30. Personal grooming Essential because of close contact w/ patients
Includes:
Daily showers
Mouth care
No strong perfumes/lotions (can make patient sick)
Keep hair/nails clean
No dangling jewelry

31. Stress !!!!
Work is physically and mentally demanding. To stay healthy:
Sufficient rest
Good nutrition
Satisfying leisure activities
Burnout is total mental, emotional, and sometimes physical exhaustion