DAY 9
#GOALS: IWBAT...
Make the correct decision
Define NA related terms
Describe the history of nursing
describe laws/regulations related to NA
WARM-UP (6min)
Your nursing assistant certification can be revoked for:
A. refusing a nursing task
B. asking the RN questions
C. performing acts beyond your role
D. keeping the patients information confidential
As a nursing assistant, can you ignore a nursing task if it's not in your job description.
What should you do if given such a task?
CLASSWORK
Intro to Nursing Assistant. (5 min)
What does an hour on the job look like? LINK
Terminology (12 min)
In your notes, copy and define the following:
accountable
delegate
job description
nursing task
responsibility
History of the Nursing Assistant position
Pre 1980's
Nurse's Aides
no training was required
RN's trained NA's on the job
Team nursing was common
1980's
Primary Nursing
Most hospitals hired only RN's
Most NA's worked in nursing homes (long term care)
too expensive!
present day
Patient-Focused Care
specialized team-members who focus on certain tasks
RN --> IV
NA --> bedpan
phlebotomist --> blood draw
This saves money
Nurse Practice Acts
Look up the following:
OBRA
sets minimum training requirement
defines job descriptions (NA, LVN, RN, etc)
requires licensure
NATCEP (nursing assistant training and competency evaluation program)
List 10 ways a NA could lose their license
What is the trend? When compared to the past, does the NA profession have more or less regulation now?
Other examples of how NA's are regulated
Nurse Practice Act
Google the NPA for CA.
Choose "Article 4: Nursing Schools
For a RN, topic 2786 describes the minimum number of years allowed
for schooling. What is that number? 2
The training program
60 hrs classroom
100 hrs supervised clinical
Competency Evaluation (test)
pg 836
Registry
Name, DOB, registry # & expiration, employment history, date test was passed, information of offenses/abuses
Any health care agency can verify your info here
Re-training
12hrs of training are required each year to keep skills fresh/current
required after two years of not working
Working in another state
regulations may be different. You may need to retest, take add'l training.
Rules for Nursing Assistants
Review pg 25 Box 3-2
Who is your direct supervisor?
To whom do you report your observations?
Who decides what is done for a patient?
If you are not comfortable performing a task, who do you ask for help?
Who decides which tasks you're allowed to do, your RN or state laws/job description?
HOMEWORK
Whose Job is it?
Copy the limits from pg 26 Box 3-3 into your notes. While doing so, state whose job it is to complete each task related to the limit
Read the section on "Delegation" pg 27 & 30-33.
Copy the Five Rights of Delegation into your notes
Answer pg 33 1-15
Delegation
The scenario is below in fuscia.
You are a RN and have a two-patient assignment. It is 0900, and you have completed your initial assessments. You are working with a nursing assistant. The nursing assistant has 10 patients and is working with three nurses. You want to delegate some tasks to the nursing assistant. Select tasks that you might delegate. Briefly explain your rationale.
Your patients
Mr. Black (70-year-old male, diagnosis: urinary tract infection). Mr. Black is alert but is experiencing some confusion. Vital signs are ordered every four hours. He is experiencing urinary frequency. He needs to be reminded to use the urinal rather than getting out of bed on his own to use the bathroom.
Mrs. Tolento (66-year-old female, diagnosis: congestive heart failure). Mrs. Tolento is a new transfer to your unit. She was admitted four days ago with -fluid overload. She has history of CHF and takes diuretics, digoxin, and an ACE inhibitor at home. She is alert and oriented. She is on 2L of O2 with oxygen saturation at 93%. Vital signs are ordered every four hours. She is on strict I&O. She has a Foley catheter.
http://www.strategiesfornursemanagers.com/content.cfm?content_id=233639&oc_id=602#