Nursing Assistant Foundations (Unit 1)

Key Terminology

• Abuse

  • Willful infliction of injury, unreasonable confinement, intimidation, or punishment that results in physical harm, pain, or mental anguish.

  • “Willful” = deliberate action, even if harm was not intended.

• Advance Directives

  • Legal documents expressing a person’s wishes about life-support measures if unable to speak for themselves.

• Aphasia

  • Impaired ability to speak, understand, read, and/or write language.

• Bill of Rights (Residents’ Bill of Rights)

  • State & federal laws that protect residents in long-term-care facilities.

• Chain of Command

  • Organizational list showing who reports to whom.

• Confidentiality

  • Not sharing spoken or written resident information.

• Durable Power of Attorney (DPOA)

  • Person legally appointed to make health-care decisions when the client is incapacitated.

• Ethics

  • Standards distinguishing right from wrong.

• Etiquette

  • Polite, courteous, respectful behaviors.

• Exploitation

  • Taking advantage of a resident for personal gain.

• Facility

  • Provides rehabilitative, restorative, or skilled nursing care to residents needing assistance with ADL’s.

• Involuntary Seclusion

  • Isolating a resident without consent of the resident or their legal representative.

• Job Description

  • Written list of duties & responsibilities for a position.

• Living Will

  • Written advance directive listing treatments that should/should not be used to prolong life; can include pain control & organ donation.

• Neglect

  • Failure of facility/staff to provide goods & services necessary to avoid physical harm, pain, or mental anguish.

• Nurse Aide (NA)

  • Provides personal care under supervision of an LPN or RN.

• NA/R (MN Nurse Aide Registry)

  • Designation for NA listed on Minnesota registry.

• Ombudsman

  • Independent advocate who investigates & resolves resident–facility complaints.

• Patient

  • Individual receiving health-care services (often hospital setting).

• Person-Centered Care

  • Culturally & linguistically respectful care that honors resident choices in daily life.

• Resident

  • Person (often elderly) who lives in a long-term-care facility.

• Resident Representative

  • Person chosen by the resident to assist with decision-making, information, and finances.

• Teamwork

  • Working together to reach a shared goal.

• Values

  • Beliefs guiding behavior (e.g., compassion, courage, hope, responsibility).

Federal & State Laws

• OBRA (Omnibus Budget and Reconciliation Act)

  • Sets minimum standards for NA training & evaluation.

• Patient Self-Determination Act (PSDA)

  • Facilities must inform residents of rights to make treatment choices & possess advance directives (living will or DPOA).

• Residents’ Bill of Rights

  • Guarantees: information, choice, privacy, dignity, ability to refuse treatment & voice grievances.

• Minnesota Vulnerable Adult Act

  • Mandates reporting suspected maltreatment or neglect of vulnerable adults.

Nurse Aide Training & Scope

• Governing regulation: OBRA.

• NA works under direct supervision of an LPN or RN.

• Tasks NOT performed by NA:

  • Sterile procedures.

  • Taking physician orders.

  • Prescribing or administering medications beyond permitted duties.

Team Dynamics

• Core functions of a health-care team:

  • Collaboration.

  • High-quality patient/resident care.

  • Effective communication.

• Benefits of teamwork:

  • Faster task completion.

  • Better problem solving.

  • Increased creativity & idea sharing.

Employer Expectations of NA

• Arrive on time & avoid excessive absences.

• Follow policies & procedures.

• Be flexible with assignments.

• Remain drug-free; pass required screenings.

• Maintain professional appearance & conduct.

Maintaining NA Registry Status (Minnesota)

• Work a minimum of 8 paid hours providing nursing or nursing-related services every 24 months.

• Report any name or address changes to the registry immediately.

Ethics & Etiquette

• Ethics: professional standards of right/wrong guiding care decisions.

• Etiquette: day-to-day manners—polite speech, respect, kindness.

Resident Rights

• Decide what & when to eat.

• Choose clothing & personal appearance.

• Select shower/bath schedule & refuse treatments.

• Be fully informed of rights & facility rules.

• Manage personal finances or designate a representative.

Abuse, Neglect, Exploitation

• Physical Abuse: hitting, kicking, biting, scratching, pushing.

• Mental/Emotional Abuse: yelling, threatening, isolating, withholding call light, gaslighting.

• Financial Exploitation: theft, coercion, misuse of funds.

• Sexual Abuse: non-consensual sexual contact or harassment.

• Verbal Abuse: insults, humiliation, harsh language.

• Technological Abuse: unauthorized photos/videos, posting resident info online.

• Threats of Harm: any intimidating statement or gesture.

• Neglect examples:

  • Failing to place call light within reach.

  • Not providing meals/fluids.

  • Leaving bed in high position creating fall risk.

• Involuntary Seclusion: confining resident to room/area without consent.

• Exploitation: using resident’s property or labor for personal benefit.

Consequences of Not Reporting

• Job termination.

• Revocation of NA registration/license.

• Possible criminal charges (e.g., misdemeanor).

Person-Centered vs. Task-Oriented Care

• Person-Centered Care respects individuality; examples:

  • Offering preferred foods & dining times.

  • Scheduling showers when resident chooses.

  • Allowing resident to decide wake-up/bedtime.

  • Providing unhurried, respectful interactions.

• Why Preferred: Recognizes that each resident has unique needs, values, and life histories—leads to higher satisfaction and better outcomes than one-size-fits-all task lists.

Advanced Directives & Decision-Making

• Living Will: specifies which life-sustaining measures (e.g., ventilation, tube feeding) are desired.

• Durable Power of Attorney: names a decision-maker for health-care choices when the individual is incapacitated.

• Facilities must document and honor these directives per PSDA.

Chain of Command: Following the chain ensures proper reporting of concerns, errors, or abuses.

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Personal & Professional Values

• Compassion, courage, hope, responsibility guide ethical caregiving.

• Upholding these values fosters trust & quality care.

Practical Application & Real-World Relevance

• Proper team communication prevents errors, improves resident safety.

• Awareness of laws shields both resident & caregiver from legal consequences.

• Person-centered techniques align with modern regulatory focus on dignity & quality of life.

Quick Reference Numbers

• Minimum work to stay active on registry: 8\text{ hours} / 24\text{ months}.