The role of a nursing assistant is to provide basic care to patients, as well as assist them in daily activities they might have trouble with on their own such as bathing, eating, ambulation, and monitoring of vital signs.
They should have phenomenal communication skills since it's their job to bring all patient concerns and issues to the supervising Nurses.
The nurse assistant or (nurse aide) may work in various health care settings and is usually the primary “hands on” caregiver.
It is where most healthcare workers start and possible progress to other health care professions.
The importance of their job and the skills they provide are essential to improved quality of life for those they provide care to.
Qualities of an Effective Nursing Assistants:
Professional and compassionate attitude
Responsible nature
Ability to communicate effectively
Maintenance of high ethical standards
being positive
Basic Responsibilities of a Nursing Assistants:
keeping resident information confidential
following policies and procedures
documenting and reporting care
communicating problems and asking questions
being on time clean and neatly dressed
being a role model to the facility
There are some tasks that NA’s are generally not allowed to do:
giving medication
inserting or removing tubes
changing sterile dressings
Remember
nurse assistants are the “eyes and ears” of the healthcare team, patients will usually feel more comfortable speaking about their problems to a Nurse Assistant. It is the duty of the Nurse Assistant to report all patient concerns
Long Term Care Facility
Nursing homes, skilled nursing facilities, or long-term care facilities (LTCFs) are centers that provide a variety of services in both medical and personal care to patients who are unable to manage independently in the community.
The purpose of LTC facilities is to meet the needs of persons who cannot care for themselves but do not need hospital care.
LTC facilities meet the needs of those who may be:
Alert and oriented
Confused and disoriented
Needing complete care
Geriatric
Disabled Physically or Mentally
Requiring skilled nursing care (short-term care)
Terminally ill needing hospice care
Other
The following services are commonly provided at long-termcare facilities ( LTCFs)
Activities of daily living ( ADLs) or personal daily care tasks, such as bathing, dressing, caring for teeth and hair, toileting, and walking
Dining and Nutrition to ensure that the resident is provided with the food that he/she wants to eat, when to consume each meal, and whether or not to eat in the dining room or his/her personal room.
LTCF’s often have assisted living, subacute care and specialized care units such as an Alzheimer’s Wing
The management of chronic disease is the most common reason a patient is admitted to LTCF’s
Relationship of the Nurse Assistant and the Healthcare Team
All members of the health care team focus their efforts on a care plan devised to meet the needs of the individual.
The Resident Care Plan
The resident’s care plan is a working document that details all of the nursing care that the resident should receive. It is developed for each resident to achieve certain goals; it outlines the steps and tasks that the care team must perform.
The information that is in the resident’s care plan comes from an assessment that is made for each Resident.
The care plan is designed to assist all those who are caring for the resident to provide the highest level of care and consistency possible.
The Nurse Aide is required to provide all care to the resident that is listed on the care plan.
Depending on the resident, the care plan may include:
What kind of personal or health care services are needed
How often the services are needed
The diet that the resident is prescribed (if there is a special one) or the resident’s food preferences
Scope of practice
defines the things that you legally allowed to do and how to do them correctly
Remember:
some tasks are never performed by nursing assistants. Nursing assistants must never honor a request to do something outside of their scope of practice.
Policy
a course of action that should be taken every time a certain situation occurs
Procedure
a method, or way, of doing something
These are common policies and procedures in facilities:
all resident information is confidential
residents care plan must be followed
nursing assistants only perform tasks that fit into "NA's" job description
nursing assistant report changes or observations to the nurse
personal problems are not discussed with residents
gifts and money cannot be accepted from residents or family members.
Guidelines for legal and ethical behavior:
be honest at all times
protects residents privacy
Report abuse or suspected abuse of residents
do not perform any task outside your scope of practice
performing tasks that are not assigned to you will put patients in danger
Report all resident observation and incidents to the nurse
Nursing assistants must always be:
compassionate
honest
dependable
respectful
patient
tolerant
Omnibus Budget Reconciliation Act (OBRA)
The Omnibus Budget Reconciliation Act (OBRA) of 1987 is a federal law that establishes regulations for nursing facilities and nurse aide training in facilities.
Nurse assistant Students must complete 100 hours of training (including 60 classroom and 40 clinical training hours) before taking state certification exam.
The intent of OBRA is to improve the quality of life for residents in nursing facilities.
OBRA also implemented the Resident Rights.
List of residents rights
The right to be treated with dignity and respect.
The right to privacy, and to keep and use their personal belongings and property as long as it doesn't interfere with the rights, health, or safety of others.
The right to be informed about their medical condition, medications, and to see their own doctor.
They also have the right to refuse medications and treatments.
The right to have a choice over their schedule (for example, when they get up and go to sleep), their activities and other preferences that are important to them.
ROLE OF THE NURSE AIDE IN PROTECTING RESIDENTS FORM ABUSE, NEGLECT, AND MISAPPROPRIATION OF RESIDENT PROPERTY
Nurse assistants must never abuse residents in any way, and must try to protect residents from others who abuse them.
Reporting abuse is not an option, it is the law!
As members of the health team, nurse aides are legally and ethically responsible for reporting actual or suspected abuse, neglect, or misappropriation or resident property.
You must report suspected findings to the nurse and provide factual information requested for filing reports.
The Complaint Hotline at HHSC is (800) 458-9858
Always follow the chain of command when reporting abuse.
If you walk in on an incident that has already occurred, but has not been addressed, you are required to report the incident none the less
Nursing assistants must report changes and problems to the nurse so that the care plan will be updated as the residents condition changes.
Ombudsman
The person designated to represent the residents in a facility; helps resolve disputes and settle conflicts within the residents and administration
SAFETY IS EVERYONE’S CONCERN
Some older individuals may not realize that some activities may be harmful to them. Communicate with residents about safety while maintaining his/her right to choices about care and activities.
The resident has the right to a safe environment. Think about safety first when you enter an area and last when you leave the area.
POTENTIAL PHYSICAL CHANGES IN THE ELDERLY THAT INCREASE THE RISK OF ACCIDENTS ARE:
Decreased vision
Impaired hearing
Slower reflexes
Mental changes such as forgetfulness or confusion
Weakness due to illness, injury, or shrinking of unused muscles
The most common cause of accidents for LTC residents is falls
GUIDELINES FOR PROVIDING A SAFE ENVIRONMENT
Recognize and report unsafe conditions that nurse aides are unable to correct.
Keep hallways and resident rooms clean, dry, and free of obstacles.
Keep equipment and supplies on one side of the hallway so that residents have an unobstructed path
Keep beds in prescribed position and wheels locked
Maintain adequate lighting
Provide call lights to all residents and remind residents to call for help
Report all equipment not in proper working order and use it according to facility policy and manufacturer’s directions.
Unsafe or broken equipment should be identified and removed from service according to facility policy.
ACCIDENT AND INCIDENTS
Incident
an accident or an unexpected event during the course of care that is not part of the normal routine in a healthcare facility i.e. falls, lacerations, burns
Accident
An unexpected, undesirable event
The following events are considered incidents:
falls
equipment broken or damaged
minor injuries
accusations against staff
Your role as a nurse aide is recognizing and reporting incidents and accidents, UNSAFE OR BROKEN EQUIPMENT should be “locked out” so that it cannot be used. The person who discovers broken equipment should “tag” and remove the equipment as per facility policy.
Remember these guidelines for incident reporting:
explain what happened
state only facts
describe what you did in the situation
Summary
In this chapter we discussed some of the basic terminology, policies, and procedures used by healthcare professionals along with patients rights, abuse and neglect scenarios, take the time to review these slides as they will serve as future reference.
