Transcript File
Role of the Nursing Assistant Interdisciplinary Team • A group of professionals from different health care disciplines who each contribute their expertise to the care of a single patient Interdisciplinary Team • Members – Physicians make a diagnosis and prescribe medication – RN’s plan and direct the nursing care ordered by the physician – CNA’s provide direct patient care under the supervision of an RN or LPN – Aides, therapists, and support persons all contribute to this team The Nursing Team • RN – Licensed-pass a state board exam – Assess, plan, evaluate and coordinate aspects of patient care – Educate patients and their families – Provide nursing care and supervise duties they delegate to others – May specialize in any specific area of nursing practice HS-NE-10b The Nursing Team • LPN/LVN – Licensed-passed state board exam – Works under the supervision of a RN, MD or Dentist – Provides most of the care when patient’s nursing needs are not complex – Assists the RN in more complicated situations HS-NE-10b The Nursing Team • CNA – Trained to assist in the care of patients under the supervision of RN or LPN – May be called: • Patient care attendant • Nurse’s aide • Clinical support associate • Nursing assistant • Health care aide • Patient care technician • Personal care assistant HS-NE-10b Patient Focused Care • Emphasizes the needs of the patient above the convenience of other departments involved with patient care – Limits the # of people involved in the care – Contains cost – Meet patients’ needs efficiently • Cross-trained workers are utilized What can the CNA do to be an effective member of the team? • Recognize the importance of all team members • Appreciate each others’ contributions to the team • Learn as much as you can about your patient’s and • • • • their families to better understand their feelings and concerns Attend care plan conferences and give your observations/ideas Attend in-service training sessions Become cross-trained Cooperate with other team members to provide patient focused care HS-NE-10a Regulation of Nursing Assistant Practice • 1987-Omnibus Budget Reconciliation Act – Regulates CNA education and certification – Includes statements from the Dept of Health and Human Services and the Center for Medicare and Medicaid Services (states the minimum requirements for CNA training) – Nurse Aide Competency Evaluation Program was started to guide individual programs to meet the requirements of OBRA – Georgia Medical Care Foundation is Georgia’s regulatory agency and must meet federal standards HS-NE-6c Certified Nursing Assistant Training • Students must complete 85 hrs of classroom/lab • time plus clinical experience Clinical skills must include – – – – – – Basic nursing skills Basic restorative skills Mental health and social service needs Personal care skills Resident rights Safety and emergency care Certified Nursing Assistant Training • You are given 3 opportunities to meet the requirements of testing • You must work at least 8 hours for pay in a LTCF within 24 months time • You must receive 12 hours of continuing education every year • You must meet all requirements to renew every 2 yrs Line of Authority • Health care facilities all have different lines of • authority or chain of command LTCF’s – CNA, LPN, RN Charge Nurse, Director of Nursing, Administration • Hospitals – CNA, Nurse (RN, LPN), Charge Nurse, Nurse or Unit Manager, Director of Nursing, Administration • As a SNA, your teacher or the person designated as your supervisor (CNA) is your immediate authority Line of Authority • Know your facility’s organizational structure Registered Nurse Charge Nurse RN Team Leader RN or LPN CNA The Patient Physician Guidelines to Follow • Work with your line of authority when solving • • • problems Always begin with your immediate supervisor and work your way up if you hit a roadblock Only perform the tasks that you have been trained to do!! Always ask for help, even if it is related to a skill you have been trained to do. HS-NE-6b Guidelines to Follow • Remain within your scope of practice. • Politely refuse and explain why • CNA’s do not take orders from physicians or discuss the patient’s status, medical record or results of any tests or vital signs • Always be willing to learn new skills that are within your scope of practice CNA Role and Responsibility • Works directly with the patient, giving physical care and emotional support • CNA’s are interested in others and take pride in their work • CNA’s are willing to learn new skills to care for those who are ill • CNA’s can contribute much to the patient’s safety and comfort CNA Role and Responsibility • CNA’s see the patient more than any other • • member of the nursing team CNA’s make observations that can give valuable insight into the patient’s illness and attitude Patient’s may make more “bonds” with you than other members of the health care team and share with you “minor complaints” they may not tell their physician or nurse Personal Adjustments • Accept constructive criticism • Follow rules and orders promptly • Show dependability and accuracy be being on • • time and completing your assignments Respect your coworkers and the role you share on the health care team Be empathetic (not sympathetic), patient and tactful with others (patients and coworkers) Personal Adjustments • Develop good interpersonal relationships – Be warm and pleasant to others • Your attitude is the most important characteristic you bring to your job – Caring, courtesy, cooperation – Emotional control, tact, patience – EMPATHY or UNDERSTANDING Personal Adjustments • Develop good relationships with your patients • Show empathy for the patient by being eager to serve and by using a gentle touch • You may have patients with different problems or concerns, but to a patient, his/her own problems are the most important Personal Adjustments • Not all patient responses are about YOU or your job performance • Patients may become irritable, complaining or uncooperative because of – – – – – – Fear about their diagnosis, disability or death Pain Worries about family or the future Loss or lack of social support systems Dependence on others Financial concerns • A gentle touch and reassurance can help • Report these concerns to the nurse Personal Adjustments • You must also meet the family’s needs • They may also be uncooperative and demanding because they are worried about their loved one • Patience and tact are most useful here • Just listening can help • Watch body language as it may give you clues as to the family’s feelings Personal Adjustments • You are part of a team whose goal is to help the patient – – – – – Remember your role Do not overstep your authority Listen to instructions carefully Watch your tone of voice and body language Promptly carry out orders and report unfinished work – Offer to help others and accept help when you need it – Have a positive attitude Personal Adjustments • You are part of a team whose goal is to help the patient – Extend common courtesy and dignity to staff – Keep the common goal in mind and recognize coworkers as integral parts of the team – Understand and follow facility policies and procedures* – Treat all with respect – Practice good hygiene, nutrition and stress reduction HS-NE-6d Personal Hygiene • Bathe daily • Use deodorant • Good oral hygiene • Clean hair, pulled • Only stud earrings, • • back Short, clean natural nails-clear polish only • wedding band and watch are allowed Clean socks or stockings Well fitting shoes Uniforms • LCCS requires white • • • • with white shoes Clean, wrinkle free Repair torn hems and missing buttons Not worn when not on duty Remove inside out • ID badge required • Keep in mind that • your appearance says a lot about you in a patient’s eyes A well-groomed appearance says you have pride in yourself and your work Stress, Stress, Stress • Avoid burnout by reducing stress – – – – – – – Sufficient rest Good nutrition Leisure activities Stress reduction Group discussion Stress management Exercise programs • Personal Stress Reduction – Go for a walk – Devote time to hobbies – Herbal tea – Relaxation exercises – Quiet music – Warm, relaxing bath There are many ways to reduce stress other than relying on drugs or alcohol to change your mood. Don’t get into a situation you can’t get out of because of stress