Nurse Assistant Training Manual

Chapter Two: What Does a Nursing Assistant Do?

The nursing assistant is a member of a interdisciplinary care team that provides skilled nursing care. This is a team of professionals that is made up of the doctors, the nurses (registered and licensed practical) as well as the nursing assistant. Other professionals on this team are the dietitian, physical therapist, occupational therapist, respiratory therapist, as well as speech therapist, pharmacy technicians, but the most important part of this team is the patient and the family so that all of their needs are met one way or another.

What is the actual nursing team made up of and where can they work? The registered nurse (RN) is the professional who has a college degree and passes the state boards of some kind and thanks to this education is able to assess, plan for, evaluate, and coordinate many aspects of patient care. They also teach the patients and their families about good health practices, as well as provide care while still supervising and delegating duties to others of the team. The registered nurse is also able to perform duties in and on all medical departments.

The licensed practical/vocational nurse has an education that has earned them a diploma from a training program that lasts from one year to 18 months and then must pass a state board licensing exam. The licensed practical nurse (LPN) works under the RN and will perform most of the patient care that is not too advanced or complex where they will assist the RN.

This brings us to the nursing assistant position who is supervised by the RN and the LPN to perform the duties of Activities of Daily Living and taking Vital signs. The training is shorter about three months or one semester. The nursing assistant will have to pass a competency exam that is written and a practical exam showing that they can perform the necessary skills of a certified nursing assistant.

What are the kinds of nursing care?

Nursing care is organized into four patterns, which are primary care, functional nursing, team nursing, and patient-focused care. In more detail primary nursing is mainly given by the registered nurse for patients for their whole stay in the hospital who plans, teaches, and carries out treatments along with direct care and discharge plans. If the registered nurse is not on duty the licensed staff and assistants help with doing patient care. In a nursing facility as in long-term care there is an RN supervisor, but the LPN and CNA's (certified nursing assistants) care for the residents.

Functional nursing is task-oriented where a charge nurse is the one person that is responsible for all the patients. The charge nurse is also the person who assigns the various specific tasks from giving medications, performing treatments to providing hygiene care to the patients.

Team nursing is where a registered nurse as the team leader will determine the nursing needs of all the patients then give instructions and assignments to other staff members who will report back to the leader. This is the most common delivery method of nursing. The team has to work together to fulfill all the needed and required skills and activities to maintain patient health and safety.

Patient-focused nursing care is organized where a nurse or nursing assistant will be allowed to perform other skills that may be needed as a multi-skilled worker, for example phlebotomy or taking blood samples or doing other skills as in performing EKG's, giving breathing treatments. This is to limit the number of people needed to care for the patient and to contain costs so to meet the patient's needs more efficiently.

In order to become a certified nursing assistant a person will and must have a minimum of 75 hours of theory and clinical practice and pass the Nurse Aide Competency Evaluation. There are also other programs that offer 80 to 120 program hours of oral and written activities and learning clinical skills. The nurse aide trainee will have three chances to pass this state exam both written and clinical exam. The test will include questions dealing with basic nursing skills, basic restorative skills, patient care skills, mental health/social service skills, resident/patient rights, safety and emergency skills.

The nursing assistant must follow the lines of authority and follow their lead from the unit manager, nurse manager, charge nurse, and report back to them when their assignment or duties are completed. The nursing assistant should familiarize themselves with the line of authority for the whole organization. Always ask your team leader if you have any doubts on what you are to do and remember patient safety is of the utmost importance.

Some guidelines for the nursing assistant is to and the most important is to only perform the tasks you have been trained to do and follow you 'scope of practice' which means doing the skills the nursing assistant is legally permitted to perform by state regulations. If you are asked to do such a task be polite and tell them that you are not allowed and were not trained to perform that particular task. Nursing assistants do not take orders from doctors or tell families about the contents of patient care plans or records. (I always told the family members to talk to the registered nurse or doctor.)

As a nursing assistant always be willing to learn new ways and skills from your registered nurse or nurse educator. These two leaders will also show through examples how the nurse assistant works in the areas of the facility.

They show that by giving physical care and emotional support and making various observations during patient care will be written in the patient's chart. The nursing assistant is the person who the patient sees the most and as a nursing assistant you must show pride in yourself and learn all you can learn. You, the nursing assistant, may be the one that can give some insight into the care of the patient that others more qualified may miss.

All nursing assistants must dependable and accurate, respect, and understand to a point of human relationships. Such as in dealing with 'interpersonal relationships' or the interactions between people. You must begin to understand these relationships when you start to understand your own personality and attitudes and get along with others. In this profession it is really about the 'attitude' you have. You must have a positive attitude in doing this form of work that requires one to have courtesy, be cooperative, have emotional control, understanding, tact, and sympathy.

In general the nursing assistant is one very busy person who needs to meet the patient's needs, the family's needs and even the staff needs at times, and all must be made with a gentle touch not only in words but also by gestures. Just be aware of all your surroundings in working with others in this field. Other ideas that are important to being a good nursing assistant is in how one sees you. Nursing assistants must be well-groomed and show pride in themselves and in their careers by performing your own person hygiene in a proper way and having clean uniforms. Also, as a nursing assistant and dealing with stress, which you will, you will need to make sure to get sufficient rest, eat properly, participate in some sort of activity that is important to you. One must look out for 'burnout' that is an extreme mental, emotional and times physical exhaustion. Here are a few ways to combat burnout. Take a break as allowed and just go somewhere and shut your eyes and practice deep breathing with your feet up or just talk to someone.

(Please remember- This is only to give the reader a very basic understanding of what being a nurse assistant includes. These chapters are just giving basic information.) Please read, comment, and maybe a tip all would be appreciated.