Chapter 1: The Nursing Assistant in Long-Term Care

What are three questions nursing assistants should ask themselves before accepting a delegation?

1. Do I have all the information I need to do this job? Are there questions I should ask? 2. Do we both understand who is doing what? 3. Do I have the needed supplies, equipment, and other support?

What are three questions nurses consider before delegating a task?

1. What is the level of resident stability? 2. Is the nurse available to give the supervision, support, and help that the nursing assistant needs? 3. Can the nurse give appropriate direction and communication?

Which of the following should a nursing assistant wear to work? A) A watch B) Bangle bracelets C) A nose ring D) Perfume

A) A watch

Which of the following is part of proper grooming for a nursing assistant? A) Long hair that is tied back B) Long beards that are combed C) Long, clean nails D) Dramatic eye makeup

A) Long hair that is tied back

Another name for a long-term care (LTC) facility is a(n) A) Nursing home B) Home health facility C) Assisted living facility D) Adult day services apartment

A) Nursing home

A person who lives in a long-term care facility is called a resident because A) The facility is her home B) She is picked up at the end of each day to go home C) She does not have any living family members D) She does not need skilled care

A) The facility is her home

Nursing assistant Doug Albin is helping resident Sam Perkins to the bathroom. Sam walks slowly and has to rely on his walker for help. Doug notices that his shift is over in five minutes and says, "Can you walk a little faster? I'm leaving in five minutes!" How could Doug have been more patient and understanding?

Answers May Vary Doug should be more patient and understanding that Mr. Perkins is, or could be, ill and disabled. Doug should help Mr. Perkins and then be worried about leaving his shift, not rushing the resident.

Nursing assistant Wayne Leach just found out his facility is short-staffed tonight, and he will have to help five additional residents get ready for bed. "Oh great," he says. "Now I'll never get this done!" How could Wayne have been more enthusiastic?

Answers May Vary He should've been more positive. He should have shown interest in others, including their situations and problems. He should make people want to be around him. He should be encouraging and have a positive influence on others.

Nursing assistant Rob Brown is tidying Ms. Lee's room. He notices a Buddha statue and asks, "I'm a Christian. Why don't you believe in Christ?" How could Rob have acted in a courteous and respectful manner?

Answers May Vary Rob should be kind, polite, and considerate. He should respect others' beliefs even though they are different from his own.

Nursing assistant Samantha Stevens is late for five shifts in a row. On the fifth day, her supervisor asks her about this. Samantha replies, "It's not my fault. Traffic has been horrible, and I have to drive a long time to get to work." How could Samantha have been more humble and open to growth?

Answers May Vary She should admit that she was in the wrong and quit making excuses. She should apologize for her mistake and probably get up earlier and leave for work at an earlier time.

Resident Hannah Stein is dying. She tells nursing assistant Jennifer Wells that she always wanted to be nicer to her son and to have a better relationship. Jennifer replies, "Well my son won't even talk to me because I wouldn't tel him go to a basketball game on a school night." Then Jennifer proceeds to tell Mrs. Stein about her divorce and how her son's father never helps out. How could Jennifer have been more empathetic?

Answers May Vary She should be more understanding of Mrs. Stein's relationship with her son. Ms. Wells should not bring up her own troubles and problems, she should comfort Mrs. Stein as best as she can.

Nurse Cathy Connell verbally gives nursing assistant Sandra Levy a list of things she wants done. Sandra says she will do them, but when she turns the corner, she forgets what Nurse Connell wanted her to do first. "Oh well," she shrugs. "I'm sure it's not the end of the world." How could Sandra have been more dependable?

Answers May Vary She should have either started out by writing everything down, or repeating it back to Mrs. Connell in order to reassure she knows what to do. After she forgot she should've gone back to Cathy and asked again to be sure of what to do. She should NEVER just not do a task she was assigned.

Nurse Frederico Gonzalez tells nursing assistant Mary Lupko about a resident's diagnosis of a sexually-transmitted infection. He gives specific instructions about the resident's care. Mary sees a fellow nursing assistant across the hall, and says, "How did Joann Timbly get an STI? Her husband hasn't visited in months." How could Mary have been more trustworthy?

Answers May Vary She should have kept the residents confidential information private and not shared the information with her fellow nursing assistant. If she had a question she could have asked in private without yelling it across the hall for other resident's to hear.

Nursing assistant Tracy Fleming is assigned to help Mr. Ming, a Chinese resident, eat his dinner. Even though she has never met Mr. Ming, she complains, "I can never understand anything these kinds of residents are saying." How could Tracy have been more tolerant and unprejudiced?

Answers May Vary Tracy should've kept her opinion to herself. She should give Mr. Ming the same quality care all residents should be getting. And she shouldn't judge based on his accent. Her's is probably just as hard to understand for Mr. Ming as his is to her.

Look at the tasks commonly performed by nursing assistants. Which task do you think you will enjoy the most? Which do you think will be the most difficult for you?

Answers Will Vary

Think of one task that might be assigned to a nursing assistant that is not mention in the book.

Answers Will Vary

Which of the following best shows professionalism by a nursing assistant? A) A nursing assistant arrives late for her shift, knowing her coworkers can cover for her. B) A nursing assistant takes a while to document carefully. C) A nursing assistant uses profanity sometimes, but only if a resident does it first. D) A nursing assistant accepts a tip from a resident's son for taking care of his mother.

B) A nursing assistant takes a while to document carefully.

Which of the following should a nursing assistant wear to work? A) Hoop earrings B) An identification badge C) Acrylic nails D) After-shave lotion

B) An identification badge

How does home health aide care differ from nursing assistant care? A) Home health aides do not assist with personal care. B) Home health aides may clean the home and do laundry. C) Home health aides do not have supervisors. D) Home health care takes place in a hospital, rather than in a long-term care facility.

B) Home health aides may clean the home and do laundry.

Assisted living facilities are usually for A) Residents who need around-the-clock intensive care B) Residents who are generally independent and do not need skilled care C) Residents who will die within six months D) Residents who require acute care

B) Residents who are generally independent and do not need skilled care

Inter-generational care is A) People of the same generation spending time together B) Pets brought into a long-term care facility to help brighten a resident's day C) Adult and child care merged so that young and old can spend time together D) The generation caring for children and aging parents at the same time

C) Adult and child care merged so that young and old can spend time together

How often should a nursing assistance bathe? A) Several times per week B) Every day C) Every other day D) Twice per week

C) Every other day

A program of care given by a specialist or a team of specialists to restore or improve function after an illness or injury is called A) Acute care B) Subacute care C) Rehabilitation D) Hospice care

C) Rehabilitation

Katie is a new nursing assistant at Parkwood Skilled Nursing Care and wants to make a positive first impression. Which of the following would be the best way for Katie to demonstrate professionalism at her new job? A) She can avoid asking questions so as not to bother her supervisors. B) She can tell a residents about another resident's condition in order to gain the resident's trust. C) She can avoid unnecessary work absences. D) She can address residents by using affectionate nicknames like "Sweetie."

C) She can avoid unnecessary work absences.

Which of the following is true of fingernails? A) Gel nails are the best kind of nails for nursing assistants to wear to work. B) Acrylic nails are the best kind of nails for nursing assistants to wear to work. C) Short, smooth natural nails are the best kind of nails for nursing assistants to wear to work. D) Long, polished nails are the best kind of nails for nursing assistants to wear to work.

C) Short, smooth natural nails are the best kind of nails for nursing assistants to wear to work.

True or False? Dementia is not a common cause of admission to a long-term care facility.

False

True or False? Medicare will pay for any services requested by the resident.

False

True or False? Most residents living in long-term care facilities are male.

False

True or False? No one younger than 65 is covered by Medicare.

False

True or False? Residents with the longest average stay in a healthcare facility are residents admitted for terminal care.

False

If a nursing assistant is unsure about a task that is delegated to him, what should he do?

He should ask for help and ask if he needs more information or is unsure about something.

True or False? A person with limited income might qualify for Medicaid.

True

True or False? It is important for nursing assistants to know each resident individually than to know general facts about most residents.

True

True or False? Lack of outside support is one reason to care for the whole person instead of only the illness or disease.

True

True or False? Medicare and Medicaid pay a fixed amount of services based on residents' needs.

True

True or False? Medicare is a health insurance program for people who are 65 years of age or older.

True

True or False? Poor health is not the only reason residents are admitted to long-term care facilities. Often they are admitted due to lack of a support system.

True

Physical therapist (PT or DPT)

administers therapy in the form of heat, cold, massage, ultrasound, electrical stimulation, and exercise to muscles, bones, and joints

Nurse

assesses residents, creates the care plan, monitors progress, and gives treatments and medication

Registered dietitian (RDT)

assesses the resident's nutritional status and plans a program of nutritional care

The chain of command describes the line of _______________ in a facility.

authority

What are activities of daily living (ADLs)?

bathing, skin, nail, and hair care, mouth care, and assistance with walking, eating, and drinking, dressing, transferring, and toileting

When a nursing assistant has a problem with another department, it should be reported to an immediate supervisor or the _______________ nurse.

charge

Medical social worker

determine residents' social needs and helps them get support services, such as counseling or financial assistance

Physician or Doctor (MD or DO)

diagnoses disease or disability and prescribes treatment

Occupational therapist (OT)

evaluates a resident's ability to do activities of daily living and develops a treatment plan to help him adapt to disabilities

Following the chain of command helps protect staff from _______________, which is a legal term for being help responsible for harming someone else.

liability

Team nursing

method of care in which a nurse acts as the team leader of the group giving care

Functional nursing

method of care in which each member of the care team is given specific tasks to perform for a large number or residents

Primary nursing

method of care in which the registered nurse gives much of the daily care to residents

Person-centered care

method of care that revolves around the resident and promotes each individual's preferences, choices, dignity and interests

The _______________ will usually be the nursing assistant's immediate supervisor.

nurse

Nursing assistant (NA)

performs assigned tasks, such as bathing residents and assisting with toileting, and has the most direct contact with residents

Resident

person who the care team revolves around

Activities director

plans activities for residents to help them socialize and stay physically and mentally active

A _______________ is a course of action to be taken every time a certain situation occurs.

policy

A complete list of every facility policy is found in the _______________.

policy manual

A _______________ is a specific way of doing something.

procedure

The exact way to complete every resident procedure is found in the _______________.

procedure manual

Speech-language pathologist (SLP)

teaches exercises to help residents improve or overcome speech problems and evaluates ability to swallow food and drink