Chapter 14 Nursing Health Care Science Technology Copyright

Chapter 14 Nursing Health Care Science Technology Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Objectives l l l 2 Summarize the roles and responsibilities of unlicensed nursing personnel, including certified/certificated nursing assistants, home health aides, dialysis technicians, and surgical technicians. Differentiate between the roles and responsibilities of licensed nurses, including licensed practical nurses and licensed vocational nurses, registered nurses, and advanced practice nurses. Successfully complete 16 nursing procedures. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Careers in Nursing 14 -1 Unlicensed Nursing Personnel l Licensed Nursing Personnel l 3 Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Careers in Nursing l Nursing offers many career opportunities. – 4 Aging population, increasing turnover because of age, and people exiting the nursing field create need for new trainees. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Careers in Nursing (cont. ) l Nursing can be divided into two areas: – Unlicensed nursing personnel l l 5 Certified or certificated nursing assistant. Home health aide. Dialysis technician. Surgical technician. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Careers in Nursing (cont. ) – Licensed nursing personnel l 6 Licensed practical nurse or licensed vocational nurse. Registered nurse. Advanced practice nurse. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel l l 7 Need generated by the rapidly rising cost of health care. Work under licensed nurses. Perform nursing tasks that can be safely done by people with specific training. There are unresolved issues on which tasks can be delegated. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Certified or Certificated Nursing Assistant – – 8 Regulated by state law – not federal. Federal government issued guidelines for training in Omnibus Budget Reconciliation Act (OBRA). Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Certified or Certificated Nursing Assistant (cont. ) – – – Nursing assistant is often primary caregiver. Often involves working evenings, nights, weekends, and holidays. Typically works in 3 types of facilities: l l 9 l Acute care. Long-term care. Residential care. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Certified or Certificated Nursing Assistant (cont. ) – Tasks delegated may include: l l l 10 l Answering call lights. Setting up rooms for new admissions. Keeping rooms neat to ensure safety. Delivering messages, supplies, and equipment. Serving and assisting with meals. Assisting with daily personal care. Assisting with toileting. Chapter 14 Copyright © The Mc. Graw-Hill Companies, Inc.

Unlicensed Nursing Personnel (cont. ) l The Certified or Certificated Nursing Assistant (cont. ) – Tasks delegated may include (cont. ): l l l l l 11 Making beds. Providing oral care. Assisting with skin care. Helping with shaving. Taking and reporting vital signs. Assisting with bathing and/or showering. Reporting changes in client’s condition. Helping clients transfer and/or ambulate. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Certified or Certificated Nursing Assistant – Long-Term Care – Perform the same duties as in acute care, but additional duties may include: l l l 12 Emptying bedpans. Cleaning incontinent patients. Reporting significant changes, including changes in mental status or self-care capabilities. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Certified or Certificated Nursing Assistant – Residential Care – Perform same duties as in acute care and long-term care, but additional duties may include: l l l 13 Assisting with medications. Assisting with taking clients shopping or other outings. Providing assistance with transportation to medical appointments. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Home Health Aide – – 14 Works with clients in their homes. l May work in one or multiple homes. l Clients are often elderly, disabled, or ill. Works independently with occasional supervisory oversight. l Supervisor is home health nurse who writes detailed plan of care. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Home Health Aide (cont. ) – – – Performs same tasks as certified or certificated nursing assistant. Assists with medications. Assists with personal care. l l 15 Cooks meals. Assists with eating, bathing, and dressing. Does light housekeeping and laundry. Changes bed linens. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Home Health Aide (cont. ) – – – 16 Assists with shopping. Takes clients to medical appointments. Provides assistance that allows client to remain safely in home. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Dialysis Technician – – – 17 Also known as hemodialysis or renal dialysis technician. Operate kidney dialysis machines. May perform maintenance and repairs on dialysis equipment. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Dialysis Technician (cont. ) – – Must minimize exposure of client’s blood to minimize spread of disease. Tasks may include any or all of the following: l l l 18 l Getting machines ready. Obtaining and recording client’s weight and vital signs before procedure. Administering anesthetics and medications before, during, and after procedure. Beginning the procedure. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Dialysis Technician (cont. ) – Tasks may include any or all of the following (cont. ): l l l 19 Monitoring the client and process. Checking for signs or symptoms of adverse reactions. Administering emergency care if needed. Cleaning equipment after procedure. Training clients on how to perform the procedure at home. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Surgical Technician – – – 20 Also known as operating room technician. Assist during surgical procedures. Work under supervision from surgeons, registered nurses, and others. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Unlicensed Nursing Personnel (cont. ) l The Surgical Technician (cont. ) – – – 21 Work in operating or delivery room. May work in outpatient facility for physicians or dentists. May set up an operating room before surgery. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Surgical Technician Job Responsibilities (cont. ) l The Surgical Technician (cont. ) – Other duties may include: l l l l 22 l Maintaining a sterile environment for surgery. Learning required surgical tools. Knowing the order in which surgical tools are required during surgery. Setting up and testing non-sterile equipment. Preparing for surgery by shaving, cleaning, and disinfecting client. Taking client’s vital signs. Checking medical charts for the surgeon. Transporting clients to the recovery room. Cleaning and restocking after surgery. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel l l Attend postsecondary education courses and pass a test. Obtain a license through a state agency. – Licensed nurses include: l l l 23 Licensed practical or vocational nurse. Registered nurse. Advanced practice nurse. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Licensed Practical or Vocational Nurse – – – 24 Perform care under supervision of physician or registered nurse. Typically receives training from vocational or technical school. Are required by all states to pass a licensing examination. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Licensed Practical or Vocational Nurse Job Responsibilities: – – – – 25 Taking vital signs. Treating bedsores. Administering injections. Giving enemas. Administering medications. Applying dressings. Applying ice packs and hot water bottles. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Licensed Practical or Vocational Nurse Job Responsibilities (cont. ): – – – 26 Inserting and caring for urinary catheters. Assessing clients for effects of medication and treatments. Assisting with meals. Recording intake and output. Helping with personal needs of clients. Helping with emotional needs of clients. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Licensed Practical or Vocational Nurse Job Responsibilities (cont. ): – – – 27 Assisting with the delivery of infants. Caring for and feeding infants. Supervising nursing assistants. Helping evaluate client needs and developing care plans. Making appointments and keeping records in physicians’ offices. Teaching clients how to care for themselves. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Nurse – Types of registered nurses: l l l l 28 Hospital nurse. Office nurse. Nursing home nurse. Home health nurse. Public health nurse. Occupational or industrial nurse. Head or supervisory nurse. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Nurse (cont. ) – – Must pass national licensing exam and be licensed in state where they work. Three training paths: l l l 29 Hospital training program. Associate degree from community college. Bachelor of science in nursing. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Hospital Nurse – Job responsibilities may include: l l l 30 Providing all care given by LPN/LVNs. Providing bedside nursing care. Starting IVs. Carrying out medical regimes as ordered by physicians. Supervising LPN/LVNs and unlicensed assisting personnel. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Office Nurse – Job responsibilities may include: l l l l 31 Providing care for outpatient clients. Preparing clients for examinations. Assisting physicians with examinations. Administering injections and IV solutions. Performing wound care. Assisting with minor surgeries. Maintaining documentation. Performing routine specimen collection and lab work. Chapter 14 Copyright © The Mc. Graw-Hill Companies, Inc.

Licensed Nursing Personnel (cont. ) l The Registered Nursing Home Nurse – Job responsibilities may include: l l l 32 Managing the nursing care for clients. Filling management positions. Participating in staff education. Handling administrative and supervisory duties. Assessing client’s medical conditions. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Home Health Nurse – Job responsibilities may include: l l 33 Providing periodic care to clients in their homes. Assessing the home environment for safety. Teaching clients and their family members how to care for themselves. Supervising the home health aide, possibly an LPN/LVN, to assist with cases. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Public Health Nurse – Job responsibilities may include: l l 34 Working in the community setting. Working with the selected populations to improve the health of the community at large. Educating community members in health maintenance, disease prevention, nutrition, and child care. Providing health screenings. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Occupational or Industrial Nurse – Job responsibilities may include: l l l 35 Providing workplace care to employees and customers. Assessing and educating on health hazards found in the workplace. Assisting with health examinations. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l The Registered Head or Supervisory Nurse – Job responsibilities may include: l l l 36 Managing the department. Planning work schedules and assigning duties. Planning and monitoring the budget. Supervising all personnel. Maintaining all required records. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l Advanced Practice Nurse – – – Takes advanced training to obtain advanced practice certificate or degree. Nurse practitioner is allowed to write prescriptions with physician’s approval. There are four specialties: l l 37 Clinical nurse specialist. Certified registered nurse anesthetist. Certified nurse-midwive. Certified registered nurse practitioner. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l Advanced Practice Nurse (cont. ) – The Clinical Nurse Specialist is a registered nurse who specializes in a specific nursing area such as: l l 38 Gerontology (care of older clients). Neonatology (care of prematurely born infants). Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l Advanced Practice Nurse (cont. ) – 39 The certified registered nurse anesthetist has additional training in the use of anesthesia. l Works in surgical suites. l Works under the supervision of an anesthesiologist or a physician who specializes in anesthesiology. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l Advanced Practice Nurse (cont. ) – The certified nurse-midwife assists with the delivery of infants. l l 40 Has training and expertise in the delivery process. May assist with birth in home of client. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Licensed Nursing Personnel (cont. ) l Advanced Practice Nurse (cont. ) – – – Duties depend on setting in which they work. Many work in rural areas where access to traditional care is scarce. May work in: l l 41 Physician’s office. Hospital outpatient area. Surgical area. Acute care, clinics, or in client’s home. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Section 14 -1 Apply Your Knowledge #1 What are three training paths for a registered nurse? Answer: 1. Hospital diploma. 2. Associate’s degree. 42 3. Bachelor of science in nursing degree. Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Section 14 -1 Apply Your Knowledge #2 One area that a clinical nurse specialist works in is gerontology. What group of people does this term reference? Answer: Clients over the age of 65. 43 Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Procedures in Student Text 14 A 14 B 14 C 14 D 1 14 D 2 14 E 1 14 E 2 14 F 44 Admitting a Client Transferring a Client Discharging a Client Making an Open or Closed Bed Making an Occupied Bed Measuring Oral Fluid Intake Measuring Urinary Fluid Output Positioning Clients Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Procedures in Student Text (cont. ) 14 G 1 14 G 2 14 H 1 14 H 2 14 H 3 14 H 4 45 Moving a Client Up in Bed with the Client’s Assistance Moving a Client Up in Bed Using a Turn or Lift Sheet Transferring a Client Using a Mechanical Lift Transferring a Client into a Wheelchair Transferring a Conscious Client from the Bed to a Stretcher Transferring an Unconscious Client from the Bed to a Stretcher Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Procedures in Student Text (cont. ) 14 I 1 14 I 2 14 I 3 14 J 1 14 J 2 14 J 3 14 K 46 Assisting with a Bath or Shower Performing a Partial Bed Bath Performing a Complete Bed Bath Providing Denture Care Assisting with Oral Care Performing Oral Care for a Helpless Client Nail Care Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Procedures in Student Text (cont. ) 14 L 1 14 L 2 14 M 14 N 1 14 N 2 14 O 1 14 O 2 47 Shampooing a Bed-Bound Client’s Hair Brushing or Combing a Client’s Hair Shaving Providing Female Perineal Care Providing Male Perineal Care Changing a Client’s Gown Undressing and Dressing a Client Who Has Limited Use of Limbs Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Procedures in Student Text (cont. ) 14 P 14 Q 1 14 Q 2 14 Q 3 14 Q 4 14 Q 5 14 Q 6 14 Q 7 48 Applying Elastic Stockings Providing a Bedpan Removing a Bedpan Providing a Urinal Removing a Urinal Indwelling Catheter Care Emptying a Catheter Drainage Bag Assisting with the Bedside Commode Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14

Chapter 14 Credits Slide 11 Slide 12 Slide 13 Slide 14 Slide 30 49 Mediscan/Visuals Unlimited Jeff Bates Photography David Joel/Getty Images Custom Medical Stock Photo Lou Bopp Photography Copyright © The Mc. Graw-Hill Companies, Inc. Chapter 14