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Pt.1

Nursing Roles & Responsibilities

  • RNs supervise LPNs/LVNs and cannot write doctor's orders or prescribe treatments.

  • RNs decide on the facility type needed for the patient.

  • Director of Nursing oversees entire nursing staff.

  • Nursing Assistants report changes in patient conditions (not medications/orders).

  • Delegation:

    • RNs and LVNs can delegate tasks, but must know their role before doing so.

    • Nurse decides if delegation is appropriate for the patient.

    • Accepting a task makes you responsible for your actions.

Types of Care Facilities

  • Assisted Living Residence:

    • Provides housing, meals, housekeeping, laundry.

    • Not suitable for terminal illness or complex rehab.

  • Hospice provides care for dying patients.

  • Accreditation shows quality/excellence but is voluntary.

  • A license is required for an agency to operate.

Laws & Regulations

  • OBRA (Omnibus Budget Reconciliation Act, 1987):

    • Federal law requiring competency evaluation (written & skills test).

    • Allows at least 3 testing attempts.

  • State Nurse Practice Act defines legal roles of nursing assistants.

  • Job description outlines employer expectations.

Health Team Members

  • Dietitian: Assesses/plans nutritional needs.

  • Social Worker: Addresses social, emotional, environmental issues.

  • Activities Director: Plans recreational activities.

  • Speech-Language Pathologist: Works with communication/swallowing issues.

Insurance & Payment

  • Medicare: Health insurance for individuals 65+.

  • Medicaid: For low-income individuals (not detailed but important).

Ethics & Legal Issues

  • Neglect: Ignoring patient needs, e.g., failing to respond to call lights.

  • Abuse: Must report suspicions to the nurse immediately.

  • Abandonment: Leaving without notification after accepting an assignment.

  • Defamation/Harassment: Offensive speech and behavior are unacceptable.

  • Will Requests: Decline politely, explain, and inform the nurse.

Professionalism

  • Appearance: Adhere to dress code; maintain personal hygiene.

  • Avoid jewelry due to safety/infection risk.

  • Attitude: Maintain a positive outlook; respond appropriately to mistakes.

  • Speech: Use soft, respectful language; avoid slang or affectionate terms like "sweetie/honey."