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Unit 1Unit 1Introduction to Health Introduction to Health
CareCareCNACNA
Introduction to Health CareIntroduction to Health Care
As a member of the Nursing Department, the nurse aide plays an important role in resident care.
The nurse aide spends more time in direct contact with the resident than any other member of the health care team.
Introduction to Health CareIntroduction to Health Care(continued)(continued)
A knowledge of the role, function, legal limitations, expected qualities, personal habits and obligations is important to provide quality care. This unit also explores the types, purposes and organizational structure of health care facilities that employ nurse aides.
CNACNA
Role of the Nurse AideRole of the Nurse Aide
• Important in the care of people who are ill & unable to care for themselves
• Assistant to the licensed nurse• Provide physical care and
emotional support
Role of the Nurse AideRole of the Nurse Aide
• Important in the care of people who are ill & unable to care for themselves
• Assistant to the licensed nurse• Provide physical care and
emotional support
• Contribute to the resident’s comfort
• Make observations and report• Directed and supervised by
licensed nurses
Role of the Nurse AideRole of the Nurse Aide(continued)(continued)
The Nurse Aide Works In A The Nurse Aide Works In A Variety Of SettingsVariety Of Settings
• Hospitals• Long term care
facilities• Rehabilitation centers• Clinics• Hospices• Psychiatric facilities• Home care
Discuss the functions of the nurse aide in providing care to residents.Identify 22 functions of the nurse aide.
Functions of Nurse AideFunctions of Nurse Aide
• Hygiene• Safety• Nutrition• Exercise• Elimination• Mobility
Help residents with personal needs:
Functions of Nurse AideFunctions of Nurse Aide(continued)(continued)
• Communication• Socialization activities• Comfort measures• Restorative procedures
Help residents with personal needs (continued):
Functions of Nurse AideFunctions of Nurse Aide(continued)(continued)
Assist with resident care responsibilities:
•Collecting specimens•Measuring and recording vital signs•Transporting residents•Environmental cleanliness•Cleaning and care of equipment
Functions of Nurse AideFunctions of Nurse Aide(continued)(continued)
Assist with resident care responsibilities (continued):
•Standard precautions•Fire drills and disaster drills•Answering call signals•Observation of resident response to care
Functions of the Nurse AideFunctions of the Nurse Aide(continued)(continued)
Assist with resident care responsibilities (continued):
•Measuring and recording height/weight
•Intake and output•Admission and discharge of residents
List eight legal limitations for the nurse aide.
Legal Limitations of Nurse Legal Limitations of Nurse AideAide
• Nurse aides do not do sterile procedures.
• Nurse aides do not give information about the diagnosis or treatment plans to the resident or his/her family.
• Nurse aides do not give medications.• Nurse aides do not insert or remove
tubes from the resident’s body.
Legal Limitations of Nurse Legal Limitations of Nurse AideAide
(continued)(continued)• Nurse aides do not take oral or
telephone orders from a physician
• Nurse aides do not diagnose or prescribe treatments or medications for residents.
• Nurse aides do not supervise the work of other nurse aides.
Legal Limitations of Nurse Legal Limitations of Nurse AideAide
(continued)(continued)
• Nurse aides do not agree to do something beyond the nurse aide’s scope of practice as defined by the North Carolina Board of Nursing.
Describe the personal qualities and characteristics of the nurse aide.Discuss the importance of punctuality and commitment on the job.
Qualities and Characteristics Qualities and Characteristics of the Nurse Aideof the Nurse Aide
• Cheerful• Enthusiastic• Responsible• Considerate• Courteous• Cooperative
Qualities and Characteristics Qualities and Characteristics of the Nurse Aide of the Nurse Aide (continued)(continued)
• Dependable• Empathetic• Honest• Patient• Respectful• Trustworthy
Qualities and Characteristics Qualities and Characteristics of the Nurse Aide of the Nurse Aide (continued)(continued)
• Willing to learn• Tactful• Competent• Committed to
job• Punctual• Self-aware
Suggest ways for the nurse aide to maintain acceptable personal hygiene and exhibit appropriate dress practices.
Factors That Promote Good Factors That Promote Good HealthHealth
• Rest and sleep• Diet• Exercise• Good posture and body mechanics• Eye examinations• Dental care• No use of drugs, alcohol or
cigarettes
Personal Hygiene PracticesPersonal Hygiene Practices
• Taking a daily bath or shower• Using
deodorants/antiperspirants• Brushing teeth and using
mouthwash• Keeping hair clean and neatly
styled• Cleaning and maintaining short,
smooth nails
Personal Hygiene PracticesPersonal Hygiene Practices(continued)(continued)
• Washing hands after using bathroom
• Wearing clean underwear, socks or stockings and uniform daily
• Do not use products having odors that might be offensive to residents
Professional Dress PracticesProfessional Dress Practices
• Uniform clean, pressed• Shoes polished and
comfortable• Shoe laces clean• Stockings without holes/runs• Jewelry limited to watch and
wedding ring
Professional Dress PracticesProfessional Dress Practices(continued)(continued)
• Name tag or photo ID tag worn• Make-up worn in moderation• Strong perfumes/aftershave
lotions not used
List obligations of the nurse aide as a member of the health care team.
Guidelines For Working With Guidelines For Working With OthersOthers
• Know the responsibilities, functions and role expectations listed in job description
• Display qualities and characteristics befitting a nurse aide
• Be prompt in reporting to work
Guidelines For Working With Guidelines For Working With OthersOthers
(continued)(continued)
• Notify facility of absence ASAP• Display good health and hygiene
practices• Follow facility dress code policy• Practice ethical & legal actions• Direct questions about things you
don’t understand to supervisor
Guidelines For Working With Guidelines For Working With OthersOthers
(continued)(continued)
• Follow instructions and directions of supervisor
• Display pride in appearance • Promptly report unusual
observations to the supervisor• Make supervisor aware of family
and resident complaints
Guidelines For Working With Guidelines For Working With Others (COthers (Continued)ontinued)
• Perform duties in spirit of cooperation• Do not waste supplies and equipment• Follow facility rules and regulations• Be accurate in measuring, recording
and reporting• Notify supervisor when leaving and
returning to unit
• Assist other health care workers willingly
• Never use supplies or equipment belonging to the facility or resident
• Never discuss personal problems with the residents
Guidelines For Working With Guidelines For Working With OthersOthers
(continued)(continued)
Resident Care ConferencesResident Care Conferences
• Assist to develop/revise care plans
• Share care suggestions• Report observations
Explain the necessity for planning work assignments.
Work AssignmentsWork Assignments
• Made by a licensed nurse• Based on needs of residents
and availability of staff• Allows staff to work as team• Includes being cooperative
and helping others when asked
Work AssignmentsWork Assignments(continued)(continued)
• Includes never ignoring a resident that needs help, is uncomfortable or in danger
Work AssignmentsWork Assignments(continued)(continued)
• Includes notifying the supervisor of unfinished assignments
• Includes answering call signals even though not assigned to the resident
Considerations For Planning Considerations For Planning A Work AssignmentA Work Assignment
• Workload• Resident
condition• Time• Support services
assigned
Identify the need to establish priorities when providing resident care.
Establishing Priorities for CareEstablishing Priorities for Care• Activities of daily living
–Meeting hygiene needs
–Positioning and providing for exercise
–Maintaining proper nutrition
–Providing for elimination of wastes
Establishing Priorities for CareEstablishing Priorities for Care(continued)(continued)
• Examples of special procedures –Taking vital signs
–Measuring urine
Establishing Priorities for CareEstablishing Priorities for Care(continued)(continued)
• Support services–Providing drinking water–Delivering and picking up meal trays
–Providing clean linen and making beds
–Cleaning and caring for equipment
Establishing Priorities for CareEstablishing Priorities for Care(continued)(continued)
• Documentation/reporting–Presenting oral reports to supervisor
–Writing on record if directed to do so
Differentiate among the various types of health care facilities and agencies.
Long-term Care FacilitiesLong-term Care Facilities(Nursing Homes)(Nursing Homes)
• Provide health care services to individuals unable to care for themselves:–elderly persons–disabled or handicapped persons
–people with chronic illness
Long-term Care FacilitiesLong-term Care Facilities(Nursing Homes)(Nursing Homes)
(continued)(continued)
• Services provided–Medical–Nursing–Nutritional–Recreational/religious
–Rehabilitative
Long-term Care FacilitiesLong-term Care Facilities(Nursing Homes)(Nursing Homes)
(continued)(continued)
• Types of care–Home care– Intermediate care
–Skilled care
HospitalsHospitals
• Provide care for individuals of all ages with a broad range of health problems
HospitalsHospitals(continued)(continued)
• Services varied and extensive
–Diagnostic
–Medical
–Surgical
–Emergency
• Types of care: acute, chronic and terminal care
HospitalsHospitals(continued)(continued)
• Services varied and extensive
–Diagnostic
–Medical
–Surgical
–Emergency
• Types of care: acute, chronic and terminal care
Home Care AgenciesHome Care Agencies(continued)(continued)
• Services provided include:– Nursing– Physical therapy– Occupational therapy– Speech therapy– Social services– Nutritional and food services– Respiratory therapy– Homemaker services
Identify the organizational structure of health care facilities.
Identify the organizational structure of health care facilities.
Organizational ChartOrganizational Chart
• Displays chain of command
• Shows lines of authority
• Identifies health care worker’s position
• Identifies immediate supervisor
Organizational StructureOrganizational Structure
–Responsible for provision of safe and adequate care at a reasonable cost
–Makes facility policies–Delegates management
to an administrator
• Governing body (Board of Directors)
Organizational StructureOrganizational Structure(continued)(continued)
• Department heads–Have specific areas of responsibilities
–Supervise department staff•Finance•Ancillary services•Nursing
Organizational StructureOrganizational Structure(continued)(continued)
• Medical Director–Supervises medical staff activities•Physicians•Residents•Interns
Organizational StructureOrganizational Structure(continued)(continued)
• Director of Nursing and Assistant DON–Supervises nursing staff activities
–Responsible for safe nursing care
–Registered nurses
Organizational StructureOrganizational Structure(continued)(continued)
• Nursing supervisor–Assists director of nursing
–Licensed nurse–Assigned areas of responsibility
–Assigned to specific shift
Organizational StructureOrganizational Structure(continued)(continued)
• Charge Nurse –Supervises staff in specific area
•Registered nurses (RNs)•Licensed practical nurses (LPNs)
•Nurse aides (NAs)
Organizational StructureOrganizational Structure(continued)(continued)
• Charge Nurse –Supervises staff in specific area
•Registered nurses (RNs)•Licensed practical nurses (LPNs)
•Nurse aides (NAs)
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Unit 2Unit 2Communication Communication
AndAndInterpersonal SkillsInterpersonal Skills
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Communication And Communication And Interpersonal SkillsInterpersonal Skills
IntroductionIntroduction
Nurse aides communicate with residents, families, visitors and co-workers.
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Unit 2Unit 2Communication Communication
AndAndInterpersonal SkillsInterpersonal Skills
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Communication And Communication And Interpersonal SkillsInterpersonal Skills
IntroductionIntroduction(continued)(continued)
Nurse aides must frequently send and receive information about the care and observation of residents, report thoughts and feelings as clearly and objectively as possible and interact effectively with others.
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Communication And Communication And Interpersonal SkillsInterpersonal Skills
IntroductionIntroduction(continued)(continued)
Nurse aides need to be aware of nonverbal communications and need to develop skills in communicating with the sensory impaired.
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Communication And Communication And Interpersonal SkillsInterpersonal Skills
IntroductionIntroduction(continued)(continued)
In addition, nurse aides may document on the medical record, which is a legal document. Therefore, all documentation must be in legible, clear and accurate language so that there is no misunderstanding of the meaning.
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Demonstrate appropriate and effective communication skills.
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Elements That Influence Elements That Influence Relationships With OthersRelationships With Others
• Prejudices
• Frustrations
• Attitudes
• Life Experiences
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Requirements For Successful Requirements For Successful CommunicationsCommunications
• A message• A sender• A receiver
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Describe the importance of developing good listening skills.Identify nine listening skills that can be used by the nurse aide.
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Listening SkillsListening Skills
• Show interest• Hear message• Do not interrupt• Ask appropriate questions
for clarification
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Listening SkillsListening Skills(continued)(continued)
• Be patient and help resident express feelings and concerns
• Eliminate or reduce distractions
• Understand silence can be form of communication
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Recognize barriers to effective communication.
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Barriers to Effective Barriers to Effective CommunicationCommunication
• Labeling• Talking too fast• Avoiding eye contact• Belittling a resident’s feelings• Physical distance
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Barriers to Effective Barriers to Effective CommunicationCommunication
(continued)(continued)
• Mental or sensory impairment on the part of the resident such as:–Confusion–Blindness–Aphasia–Hearing impairment
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Barriers to Effective Barriers to Effective CommunicationCommunication
(continued)(continued)• Changing the subject• False reassurance• Giving advice• Ineffective communication
–Disguised messages–Conflicting messages–Unclear meanings–Clichés
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Explain how the nurse aide will need to modify his or her behavior in response to the resident’s behavior.Define the terms sympathy, empathy and tact.
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Interpersonal SkillsInterpersonal Skills
• Determined by –Standards and values–Culture and environment
–Heredity– Interests
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Interpersonal SkillsInterpersonal Skills(continued)(continued)
• Determined by –Feelings and stress
–Expectations others have for us
–Past experiences
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Dealing With Resident Dealing With Resident BehaviorBehavior
• Accept every resident
• Listen to every resident
• Comply with reasonable requests, when possible
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Dealing With Resident Dealing With Resident BehaviorBehavior(continued)(continued)
• Display patience and tolerance
• Make an effort to be understanding
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Dealing With Resident Dealing With Resident BehaviorBehavior(continued)(continued)
• Develop acceptable ways of coping with our own negative feelings–Leave the room after providing for safety
–Talk with supervisor, in private, about negative feelings
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Dealing With Resident Dealing With Resident BehaviorBehavior(continued)(continued)
• Develop acceptable ways of coping with our own negative feelings– Involve yourself in physical activity
–Learn to use relaxation techniques that ease stress
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Dealing With Resident Dealing With Resident BehaviorBehavior(continued)(continued)
• Be sensitive to residents’ moods
• Be able to handle disagreements and criticism
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Treat Residents As Unique Treat Residents As Unique IndividualsIndividuals
• Do things the residents’ way, when possible
• Anticipate their needs• Give good care• Ask for their opinions
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Treat Residents As Unique Treat Residents As Unique IndividualsIndividuals(continued)(continued)
• Be able to see things from the other person’s point of view
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Develop effective nonverbal and verbal communications skills.List six examples of nonverbal communication and six examples of effective verbal communication.
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Nonverbal CommunicationNonverbal Communication
• Body language–Posture–Gestures–Level of activity –Facial expressions–Appearance–Touch
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Verbal CommunicationVerbal Communication
• Speak clearly and concisely
• Give message by tone of voice
• Face resident, at eye level, when speaking
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Verbal CommunicationVerbal Communication(continued)(continued)
• Avoid words having several meanings
• Present thoughts in a logical, orderly manner
• Learn to paraphrase
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Identify proper telephone communication skills.
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Telephone Communication Telephone Communication SkillsSkills
• Speak clearly in a pleasant tone of voice
• Identify the area, yourself and your position
• Ask, “May I help you?”• Be courteous
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Telephone Communication Telephone Communication SkillsSkills
(continued)(continued)
Take messages:Take messages:name of individual calling
phone number (including area code)read back message for accuracy
date and time of call
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Telephone Communication Telephone Communication SkillsSkills
(continued)(continued)Take messages Take messages (continued):(continued):
ask for assistance if you are unable to handle message
permit caller to hang up firstfollow proper etiquette
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Identify actions that would facilitate communication with residents’ family and visitors
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Actions to Facilitate Actions to Facilitate Communication with the Communication with the
Resident’s Family Resident’s Family and Visitorsand Visitors
• Ask how they are doing
• Indicate that you are glad to see them
• Tell them about activities the resident has been involved with that day
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Actions to Facilitate Actions to Facilitate Communication with the Communication with the
Resident’s FamilyResident’s Familyand Visitors and Visitors
(continued)(continued)
• Be warm and friendly
• Use talking and listening skills you would use with resident
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Actions to Facilitate Actions to Facilitate Communication with the Communication with the
Resident’s FamilyResident’s Familyand Visitorsand Visitors
(continued)(continued)• Share knowledge about the unit
– Visiting hours– Restrictions to visitors– Any restrictions on bringing food– Activities that include
family
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Actions to Facilitate Actions to Facilitate Communication with the Communication with the
Resident’s FamilyResident’s Familyand Visitorsand Visitors
(continued)(continued)
• Report stressful or tiring visits to supervisor
• Refer requests for information on the resident’s condition to supervisor
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Actions to Facilitate Actions to Facilitate Communication with the Communication with the
Resident’s FamilyResident’s Familyand Visitorsand Visitors
(continued)(continued)• Share information from
family/visitors that would affect resident care with supervisor
• Report visitor concerns or complaints to supervisor
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Identify actions that would facilitate communication with hearing impaired residents.
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Actions to Facilitate Actions to Facilitate Communication with Hearing Communication with Hearing
Impaired ResidentsImpaired Residents
• Encourage to use hearing aid• Speak slowly using simple
sentences• Face resident at eye level when
speaking• Encourage resident to read lips,
if that helps
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Actions to Facilitate Actions to Facilitate Communication with Hearing Communication with Hearing
Impaired ResidentsImpaired Residents(continued)(continued)
• Lower pitch of voice• Direct speech to stronger ear but
do not shout • Use gestures when possible to
clarify statements• Write when necessary• Learn basic signing, if appropriate
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Identify actions that would facilitate communication with residents that have decreased vision.
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
Who Have Who Have Decreased VisionDecreased Vision
• Sit where resident can best see you
• Make sure lighting is sufficient• Encourage resident to touch
objects and yourself• Encourage resident to wear
his/her glasses
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
Who Have Who Have Decreased VisionDecreased Vision
(continued)(continued)• Use touch and talk frequently
to communicate your location• Use descriptive words and
phrases
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Identify actions that would facilitate communication with residents that have difficulty speaking.
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
Who Have Who Have Difficulty SpeakingDifficulty Speaking
• Encourage to use hands to point out objects
• Use communication boards/card
• Repeat what you heard to be sure you understood resident
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
Who Have Who Have Difficulty SpeakingDifficulty Speaking
(continued)(continued)• Encourage resident to cry
or express anger/frustration when he/she has trouble
• Ask yes and no questions• Let other staff members
know meaning of a sound or movement
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Identify actions that would facilitate communication with depressed residents.
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• Exercise patience• Allow time for resident
to say things• Sit quietly with resident• Return repeatedly until
resident responds
Actions to Facilitate Actions to Facilitate Communication with Communication with Depressed ResidentsDepressed Residents
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
with Memory Losswith Memory Loss
• Encourage to talk• Talk about things
resident remembers• Ask one question at a
time, containing one thought
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
with Memory Losswith Memory Loss
• Encourage to talk• Talk about things
resident remembers• Ask one question at a
time, containing one thought
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Actions to Facilitate Actions to Facilitate Communication with Residents Communication with Residents
with Memory Losswith Memory Loss(continued)(continued)
• Keep questions simple• Re-phrase questions not
understood• Avoid asking resident to
make a choice
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Identify actions that would facilitate communication with residents based on stage of development.
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Actions to Facilitate Actions to Facilitate Communication Based on Communication Based on
Stage of DevelopmentStage of Development
• Treat all residents with dignity and respect
• Encourage residents to make choices when appropriate
• Use simple sentences• Emphasize positive
qualities
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Actions to Facilitate Actions to Facilitate Communication Based on Communication Based on
Stage of DevelopmentStage of Development(continued)(continued)
• Never attempt to exert power over residents
• Encourage residents to do all they can for themselves
• Be patient
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Actions to Facilitate Actions to Facilitate Communication Based on Communication Based on
Stage of DevelopmentStage of Development(continued)(continued)
• Take time to explain what residents are to do or what you are going to do for them
• Use age appropriate speech• Encourage residents to express
feelings, ideas and frustrations
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Actions to Facilitate Actions to Facilitate Communication Based on Communication Based on
Stage of DevelopmentStage of Development(continued)(continued)
• Gain resident’s attention and speak clearly, in a normal tone of voice
• Orient residents to reality when appropriate
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Actions to Facilitate Actions to Facilitate Communication Based on Communication Based on
Stage of DevelopmentStage of Development(continued)(continued)
• Never assume that you aren’t heard or understood
• Never address residents as if they are children.
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Observe by using the senses to report resident behavior to the nurse.
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Examples using sight:• Rash• Skin color• Bruising
Methods of ObservationMethods of Observation
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Examples using hearing:• Wheezing• Moans• Words spoken by resident
Methods of ObservationMethods of Observation(continued)(continued)
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Methods of ObservationMethods of Observation(continued)(continued)
Examples using touch:• Lump• Temperature of skin• Change in pulse
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Examples using smell:• Odor of breath• Odor of urine• Odor of body
Methods of ObservationMethods of Observation(continued)(continued)
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ReportingReporting
• Reports are made:– immediately– thoroughly– accurately
• Use notepad and pencil to write down information for reporting
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Discuss differences between objective and subjective data.
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ReportingReporting(continued)(continued)
• When reporting, consider:– care or treatment given– time of treatment– resident’s response to care
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ReportingReporting(continued)(continued)
• When reporting, consider:–observations helpful to other health care workers
– information resident has given that would affect his or her treatment
–anything unusual about resident
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Identify the ways in which the nurse aide communicates with other staff members.
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Forms of CommunicatingForms of Communicating
• Body language
• Reporting or communicating orally
•Written communications
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Written Communications: Written Communications: Resident Care PlansResident Care Plans
• Resident care plans prepared by nurse
• One for each resident• Kept at nurses’ station
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Written Communications: Written Communications: Resident Care PlansResident Care Plans
(continued)(continued)
• Working record to provide consistent, well-planned care on a daily basis
• Changed and updated as needed by licensed nurse
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Written Communications: Written Communications: Resident Care PlansResident Care Plans
(continued)(continued)
• Information included (continued):–Short-term and long-term goals–Plan to attain goals–Date plan initiated and reevaluated
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Written Communications: Written Communications: Resident Care PlansResident Care Plans
(continued)(continued)
• Nurse aides contribute by:–Helping to identify problems
–Attending care conferences
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Written Communications: Written Communications: Resident Care PlansResident Care Plans
(continued)(continued)
• Nurse aides contribute by (continued):
–Directing questions about plan to supervisor
–Reporting resident response to treatment and activities
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Recognize the importance of maintaining the resident’s medical record.
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Written Communications: Written Communications: Resident‘s Medical RecordResident‘s Medical Record
• Includes information from all disciplines providing direct service to residents
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Written Communications: Written Communications: Resident’s Medical RecordResident’s Medical Record
(continued)(continued)
• A record of:–assessments, implementations, evaluations
–management plans–progress notes
• Permanent legal record
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Written Written Communications: Communications: Resident’s Medical Resident’s Medical
RecordRecord(continued)(continued)
• Purpose–Organizes all information on care in one document
–Accountability so care can be evaluated
–Documentation so there is knowledge of what each discipline is doing
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Written Written Communications: Communications: Resident’s Medical Resident’s Medical
RecordRecord(continued)(continued)
• Confidential information available only to health care workers involved in care of resident
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Review guidelines for charting in the resident’s medical record.
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Guidelines For Charting Guidelines For Charting If Allowed By FacilityIf Allowed By Facility
• Make sure entries are accurate and easy to read
• Always use ink• Print, unless script is
accepted form• Do not use the term
“resident”
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Guidelines For Charting Guidelines For Charting If Allowed By FacilityIf Allowed By Facility
(continued)(continued)
• Use short, concise phrases
• Always chart after care is performed
• Make sure writing legible and neat
communication 160
Guidelines For Charting Guidelines For Charting If Allowed By FacilityIf Allowed By Facility
(continued)(continued)
• Record in a logical and chronological manner
• Be descriptive• Make sure all forms
added to the chart contain identifying information
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Guidelines For Charting Guidelines For Charting If Allowed By FacilityIf Allowed By Facility
(continued)(continued)
• Avoid using words that have more than one meaning
• Use resident’s exact words in quotation marks whenever possible
• Always indicate the time of care
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Guidelines For Charting Guidelines For Charting If Allowed By FacilityIf Allowed By Facility
(continued)(continued)
• Leave no lines blank• Sign each entry with
first initial, last name and title
• Correct errors using facility procedure
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Document observations using appropriate terms.
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Medical TerminologyMedical Terminology
• Medicine has a language of its own
–Historical development
–Composed mainly of Greek and Latin word parts
–Consistent and uniform
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Medical TerminologyMedical Terminology(continued)(continued)
• Three components–Prefixes–Root words–Suffixes
• Medical dictionary–Used for reference–Spelling is important
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Recognize abbreviations used in documenting by the health care facility.
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AbbreviationsAbbreviations
• Help health care workers communicate quickly and effectively
• Are shortened forms of words
• Reduce time needed to chart important information
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AbbreviationsAbbreviations(continued)(continued)
• Conserve space on medical record
• Used primarily in written communication
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Demonstrate the ability to document accurate information following proper charting practices.
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Ethical and Legal Ethical and Legal IssuesIssues
IntroductionIntroductionAs a member of the health care team, the nurse aide will frequently be faced with ethical and legal decisions that govern his or her actions. A knowledge of ethical standards, resident’s rights and legal issues are important for the protection of nurse aides, employers, and residents.
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Define ethics.List at least six basic rules of ethics for the nurse aide.
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EthicsEthics• Discipline concerned with right
or wrong conduct• Guides to moral behavior• Making choices or judgments
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Nurse Aide Ethical Nurse Aide Ethical StandardsStandards
• Show respect for each resident as an individual
• Understand the limits of role–Perform only acts for which adequately prepared
–Perform acts only within legal scope of nurse aide
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Nurse Aide Ethical Nurse Aide Ethical StandardsStandards(continued)(continued)
• Carry out assignments to best of ability
• Be loyal:–Maintain a positive attitude toward institution that employs you
–Support co-workers
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Nurse Aide Ethical Nurse Aide Ethical StandardsStandards(continued)(continued)
• Be responsible citizen at all times –Respect others–Respect values that differ from yours
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Identify the kind of information that should be kept confidential.
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• Resident information should be kept confidential– Discuss only in appropriate places– Discuss only with proper people– Refer questions from residents
about their condition to supervisor
Nurse Aide Ethical Standards(continued)
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• Resident information should be kept confidential (continued)
– Refer questions about resident’s death to supervisor
– Respect personal religious beliefs
Nurse Aide Ethical Standards(continued)
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• Respect privacy of others:– while dressing– while performing personal hygiene– during examination or treatment– during visits with clergy– during visits with spouse or
significant other
Nurse Aide Ethical Standards(continued)
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• Put resident’s needs ahead of your own
• Be sincere, honest and trustworthy in performance of duties– caring and concerned– “golden rule”
Nurse Aide Ethical Standards(continued)
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Explain why nurse aides should not accept monetary tips for a health care service.
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• Do not accept monetary tips– Residents are paying for service– You are paid to provide service– Do not discriminate regardless of
race, creed, color, age, financial resources
– Provide care based on need
Nurse Aide Ethical Standards(continued)
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• Do not accept monetary tips (continued)– Display tactful and courteous
refusal of tips– Display continued desire to be
helpful
Nurse Aide Ethical Standards(continued)
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Demonstrate skills supporting age appropriate behavior by encouraging the resident to make personal choices, and by providing and reinforcing other resident’s dignity.
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Age Appropriate Age Appropriate BehaviorBehavior
• Dependent elderly residents are not children– If resident seen as a child– If resident treated as a
child– Then resident behaves as
a child
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Age Appropriate Age Appropriate BehaviorBehavior(continued)(continued)
• Residents are treated as adults in manner appropriate to person’s age
• Age-appropriate considerations:– Recreational
activities– Social activities
– Style of dress– Hair style and
grooming
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Age Appropriate Age Appropriate BehaviorBehavior(continued)(continued)
• Guidelines for Nurse Aide– Address resident in a dignified
way– Listen to what resident has to say– Converse with resident in an adult
manner– Respect resident’s privacy
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Age Appropriate Age Appropriate BehaviorBehavior(continued)(continued)
• Guidelines for Nurse Aide (continued)
– Don’t ignore or humor resident– Explain what care you are going
to give– Promote resident independence– Treat resident as you would want
to be treated
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Age Appropriate Age Appropriate BehaviorBehavior(continued)(continued)
• Guidelines for Nurse Aide (continued)
– Encourage resident to make choices:• select clothing to wear• select books to read• select television programs to
watch
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Age Appropriate Age Appropriate BehaviorBehavior(continued)(continued)
• Guidelines for Nurse Aide (continued)
– Encourage resident to make choices:• select food and nourishments• select activities of interest• select friends
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Age Appropriate Age Appropriate BehaviorBehavior(continued)(continued)
• Guidelines for Nurse Aide (continued)
– Encourage resident to make choices:• select food and nourishments• select activities of interest• select friends
198
199
List six legal responsibilities of a nurse aide.
200
Legal IssuesLegal Issues• Authorized or based on law
– Legislated by state and federal government
– Liable if laws not obeyed• Fines• Imprisonment
201
Legal IssuesLegal Issues(continued)(continued)• No fear of breaking laws if nurse
aide:– performs only acts within scope of
nurse aide– keeps skills and knowledge current– keeps resident’s safety and well-
being in mind– understands directions for care
202
Legal IssuesLegal Issues(continued)(continued)
• No fear of breaking laws if nurse aide:– follows facility policy– does no harm to residents or their
belongings• Laws designed to protect public
welfare
CHAPT 1 203
Give examples of malpractice and negligence.
204
Legal Issues: Legal Issues: Civil Law Examples Civil Law Examples
Of TortsOf Torts• Malpractice
– Giving care for which you are not allowed legally to do
– Providing improper care
205
Legal Issues: Legal Issues: Civil Law Examples Civil Law Examples
Of TortsOf Torts(continued)(continued)
• Malpractice– Example: nurse aide giving
medication– Example: nurse aide
performing treatment only allowed by licensed nurses
206
• Negligence– Unintentional wrong– Failure to perform in
reasonably prudent manner
Legal Issues: Legal Issues: Civil Law Examples Civil Law Examples
Of TortsOf Torts(continued)(continued)
207
• Battery– Example: nurse aide striking
resident– Example: does procedure
resident refuses
Legal Issues: Civil Law Examples Of Torts(continued)
208
• Battery– Get informed consent
• Written – safest• Verbal• Gesture
Legal Issues: Civil Law Examples Of Torts(continued)
209
• Invasion of privacy– Unnecessary exposure
of individual– Revealing personal
information without consent
Legal Issues: Civil Law Examples Of Torts(continued)
210
• Invasion of privacy– Example: giving news media
information without resident’s permission
– Example: giving information to insurance company without permission
Legal Issues: Civil Law Examples Of Torts(continued)
211
• False imprisonment– Restraining an individual– Restricting resident’s freedom
Legal Issues: Civil Law Examples Of Torts(continued)
212
• False imprisonment– Example: use of physical
restraints without authorization or justification
– Example: preventing resident from leaving facility against resident’s will
Legal Issues: Civil Law Examples Of Torts(continued)
CHAPT 1 213
• Defamation– False statements that cause a
resident to be ridiculed or cause damage to their reputation• Example: slander – spoken• Example: libel – written
Legal Issues: Civil Law Examples Of Torts(continued)
………. 214
Identify the responsibilities of the nurse aide when a resident wishes to make a will.
….. 215
WillsWills• Legal document giving direction
on how resident wants property distributed after death– Refer requests to prepare will to
supervisor– Nurse aide may witness signing
of will• Check facility policy• Discuss with supervisor
216
217
Support the resident’s right to make personal choices to accommodate individual needs.
218
Residents’ RightsResidents’ Rights
• Basic Human Rights– Protected by Constitution– Laws clarify these rights:
• Right to be treated with respect• Right to live in dignity• Right to pursue a meaningful life• Right to be free of fear
219
Residents’ RightsResidents’ Rights(continued)(continued)
• Basic Human Rights (continued)– Behavior that infringes on these
rights:• addressing residents as children• using demeaning nicknames for
residents• leaving door open during bath• threatening a resident with harm
220
Describe the Resident’s Bill of Rights.
221
• The Resident’s Rights– Ethical and legal basis– Federal and state regulations– Posted in facility– Distributed on admission in
many facilities
Residents’ Rights(continued)
222
• Residents have the right to:– Considerate and respectful care– Obtain complete current
information concerning diagnosis, treatment and prognosis
– Receive information necessary to give informed consent prior to treatments or procedures
Residents’ Rights(continued)
223
• Residents have the right to:– Considerate and respectful care– Obtain complete current
information concerning diagnosis, treatment and prognosis
– Receive information necessary to give informed consent prior to treatments or procedures
Residents’ Rights(continued)
224
– Examine bill and receive explanation of charges
– Be informed of any facility rules and regulations
• Residents have the right to (continued):
Residents’ Rights(continued)
225
Demonstrate behavior which maintains residents’ rights.
226
Behavior That Behavior That MaintainsMaintains
Residents’ RightsResidents’ Rights• Address as Mr., Mrs., or Miss
unless asked to use a specific name
• Never be rude or unkind– Never withhold social
responsiveness– Never ignore residents– Make eye contact
227
Behavior That Behavior That MaintainsMaintains
Residents’ RightsResidents’ Rights(continued)(continued)
• Never be rude or unkind (continued)– Allow to complete sentences prior
to leaving room– Don’t shut or slam door to quiet
resident– Never threaten or intentionally hurt
228
Maintain the resident’s environment and care through the appropriate nurse aide behavior.
229
• Explain care you plan to give
• Observe safety precautions
• Obtain proper consent after identifying resident
Behavior That MaintainsResidents’ Rights(continued)
230
• Treat all residents equally
• Promote positive attitudes
• Report errors to supervisor immediately
Behavior That MaintainsResidents’ Rights(continued)
231
Explain the purpose and value of a Resident Council.
232
Resident Council : Resident Council : advisory groupadvisory group
• Provides opportunity for discussion• Recommendations may be made
for:– Facility policies– Decisions regarding activities– Exploration of concerns– Resolving grievances
233
Resident Council : Resident Council : advisory groupadvisory group
(continued)(continued)• Gives residents a voice in
facility operations• Members
– residents– facility staff members
(you)– representatives from
community
234
235
Administer care which maintains the residents free from abuse, mistreatment, neglect, diversion of drugs, fraud, or misappropriation of property.
236
Mistreatment of the Mistreatment of the ElderlyElderly
Federal and State DefinitionsFederal and State Definitions
Abuse means willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.
237
Mistreatment of the Mistreatment of the ElderlyElderly
Federal and State DefinitionsFederal and State Definitions (continued)(continued)
Neglect means a failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness.
238
Misappropriation of property means deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a belonging or money without consent.
Mistreatment of the ElderlyFederal and State Definitions
(continued)
239
Diversion of drugs means the unauthorized taking or use of any drug.
Mistreatment of the ElderlyFederal and State Definitions
(continued)
240
Mistreatment of the Mistreatment of the ElderlyElderly
Federal and State DefinitionsFederal and State Definitions(continued)(continued)
Drug means any chemical compound that may be used on or administered to humans or animals as an aid in the diagnosis, treatment or prevention of disease or other condition or for the relief of pain or suffering or to control or improve any physiological pathologic condition.
241
Mistreatment of the Mistreatment of the ElderlyElderly
Federal and State DefinitionsFederal and State Definitions(continued)(continued)
Fraud means an intentional deception or misrepresentation made by a person with knowledge that deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable Federal or State Law.
242
Mistreatment of the Mistreatment of the ElderlyElderly
Resident’s Right To Be Free Resident’s Right To Be Free From AbuseFrom Abuse
• Physical• Verbal• Sexual• Mental• Corporal Punishment• Involuntary Seclusion
243
Mistreatment of the Mistreatment of the ElderlyElderly
Signs of abuseSigns of abuse
• Fractures• Bruises of face, upper
arms, upper thighs, abdomen
• Fearfulness• Withdrawn, paranoid
behavior
244
Mistreatment of the Mistreatment of the ElderlyElderly
Examples of AbuseExamples of Abuse• Threatening resident• Frightening resident• Pinching, slapping, pushing,
grabbing or kicking resident• Withholding food or fluids• Restraining resident against
her/his will without apparent reason and doctor’s order
245
Mistreatment of the Mistreatment of the ElderlyElderly
Examples of AbuseExamples of Abuse(continued)(continued)
• Leaving resident in soiled linen or clothing
• Yelling angrily at or making fun of resident
• Refusing to reposition or give treatment
• Not answering call signal
246
Mistreatment of the Mistreatment of the ElderlyElderly
Examples of AbuseExamples of Abuse(continued)(continued)
• Humiliating resident• Making disparaging,
derogatory remarks• Sexual coercion• Sexual harassment• Verbal harassment
247
Mistreatment of the Mistreatment of the ElderlyElderly
• Identification of residents at risk for abusing other residents– Residents with history of
aggressive behavior
248
Mistreatment of the Mistreatment of the ElderlyElderly
• Identification of residents at risk for being abused– noisy individuals– wandering individuals– philandering individuals– socially/logistically isolated
individuals
249
Report any instances of abuse to the appropriate facility/agency staff.
Reporting AbuseReporting Abuse
CHAPT 1 250
• If observed, stop abuse and report immediately to supervisor
• Cause for immediate dismissal of perpetrator and posted on NA I Registry if proven
• Know state law
251
252
Assist in resolving grievances.
253
AdvocatesAdvocates
• Plead cause of another• Resolve grievances• Protect resident’s rights
254
AdvocatesAdvocates(continued)(continued)
• Advocates can be:–You and your co-workers–Member of resident’s family/support system
–Resident’s guardian–Ombudsman
255
AdvocatesAdvocatesFacility policy components for Facility policy components for
resident grievanceresident grievance
• Acknowledgment• Prompt attempt to resolve• Resident kept apprised
256
Discuss key elements of Federal Grievance Procedures.
257
Grievance Grievance ProceduresProcedures
• Grievance Procedures
–Review federal grievance procedures
258
259
Residents’ Personal Residents’ Personal PossessionsPossessions
• Protect personal items
• These possessions may be all they have
• Items may be impossible to replace
• Report observed thefts
260
Residents’ Personal Residents’ Personal PossessionsPossessions
(continued)(continued)
• Handle personal items carefully
• Add new items to list of resident’s belongings
• Mark all items with resident’s name
261