DAY 9

#GOALS: IWBAT...

1. Make the correct decision
2. Define NA related terms
3. Describe the history of nursing
4. describe laws/regulations related to NA

WARM-UP (6min)

1. 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
2. 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

1. Intro to Nursing Assistant. (5 min)
   • What does an hour on the job look like? LINK
2. Terminology (12 min)
   • In your notes, copy and define the following:
   1. accountable
   2. delegate
   3. job description
   4. nursing task
   5. responsibility
3. History of the Nursing Assistant position
   1. Pre 1980's
      1. Nurse's Aides
         1. no training was required
         2. RN's trained NA's on the job
         3. Team nursing was common
   2. 1980's
      1. Primary Nursing
      2. Most hospitals hired only RN's
      3. Most NA's worked in nursing homes (long term care)
      4. too expensive!
   3. present day
      1. Patient-Focused Care
      2. specialized team-members who focus on certain tasks
         1. RN --> IV
         2. NA --> bedpan
         3. phlebotomist --> blood draw
         4. This saves money
4. Nurse Practice Acts
   1. Look up the following:
      1. OBRA
         1. sets minimum training requirement
         2. defines job descriptions (NA, LVN, RN, etc)
         3. requires licensure
      2. NATCEP (nursing assistant training and competency evaluation program)
   2. List 10 ways a NA could lose their license
   3. What is the trend? When compared to the past, does the NA profession have more or less regulation now?
   4. Other examples of how NA's are regulated
      1. Nurse Practice Act
         1. Google the NPA for CA.
            1. Choose "Article 4: Nursing Schools
               1. For a RN, topic 2786 describes the minimum number of years allowed
               2. for schooling. What is that number? 2
      2. The training program
         1. 60 hrs classroom
         2. 100 hrs supervised clinical
      3. Competency Evaluation (test)
         1. pg 836
      4. Registry
         1. Name, DOB, registry # & expiration, employment history, date test was passed, information of offenses/abuses
         2. Any health care agency can verify your info here
      5. Re-training
         1. 12hrs of training are required each year to keep skills fresh/current
         2. required after two years of not working
      6. Working in another state
         1. regulations may be different. You may need to retest, take add'l training.
   5. Rules for Nursing Assistants
   6. Review pg 25 Box 3-2
      1. Who is your direct supervisor?
      2. To whom do you report your observations?
      3. Who decides what is done for a patient?
      4. If you are not comfortable performing a task, who do you ask for help?
      5. Who decides which tasks you're allowed to do, your RN or state laws/job description?

HOMEWORK

1. Whose Job is it?
2. 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
3. Read the section on "Delegation" pg 27 & 30-33.
4. Copy the Five Rights of Delegation into your notes
5. Answer pg 33 1-15
6. Delegation
7. The scenario is below in fuscia.
   1. 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.
      1. 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#