1. Chapter 14 Nursing Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc.

2. Chapter 14 2 Careers in Nursing Nursing offers many career opportunities. – Aging population, increasing turnover because of age, and people exiting the nursing field create need for new trainees.

3. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 3 Careers in Nursing (cont.) Nursing can be divided into two areas: – Unlicensed nursing personnel Certified or certificated nursing assistant. Home health aide. Dialysis technician. Surgical technician.

4. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 4 Careers in Nursing (cont.) – Licensed nursing personnel Licensed practical nurse or licensed vocational nurse. Registered nurse. Advanced practice nurse.

5. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 5 Unlicensed Nursing Personnel Need generated by the rapidly rising cost of health care. Work under licensed nurses. Perform nursing tasks that can be safely done by people with specific training. There are unresolved issues on which tasks can be delegated.

6. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 6 Unlicensed Nursing Personnel (cont.) The Certified or Certificated Nursing Assistant – Regulated by state law – not federal. – Federal government issued guidelines for training in Omnibus Budget Reconciliation Act (OBRA).

7. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 7 Unlicensed Nursing Personnel (cont.) The Certified or Certificated Nursing Assistant (cont.) – Nursing assistant is often primary caregiver. – Often involves working evenings, nights, weekends, and holidays. – Typically works in 3 types of facilities: Acute care. Long-term care. Residential care.

8. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 8 Unlicensed Nursing Personnel (cont.) The Certified or Certificated Nursing Assistant (cont.) – Tasks delegated may include: Answering call lights. Setting up rooms for new admissions. Keeping rooms neat to ensure safety. Delivering messages, supplies, and equipment. Serving and assisting with meals. Assisting with daily personal care. Assisting with toileting.

9. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 9 Unlicensed Nursing Personnel (cont.) The Certified or Certificated Nursing Assistant (cont.) – Tasks delegated may include (cont.): Making beds. Providing oral care. Assisting with oral care. Assisting with skin care. Helping with shaving. Taking and reporting vital signs. Assisting with bathing and/or showering. Reporting changes in client’s condition. Helping clients transfer and/or ambulate.

10. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 10 Unlicensed Nursing Personnel (cont.) The Dialysis Technician – Also known as hemodialysis or renal dialysis technician. – Operate kidney dialysis machines. – May perform maintenance and repairs on dialysis equipment.

11. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 11 Unlicensed Nursing Personnel (cont.) The Dialysis Technician (cont.) – Must minimize exposure of client’s blood to minimize spread of disease. – Tasks may include any or all of the following: Getting machines ready. Obtaining and recording client’s weight and vital signs before procedure. Administering anesthetics and medications before, during, and after procedure. Beginning the procedure.

12. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 12 Unlicensed Nursing Personnel (cont.) The Dialysis Technician (cont.) – Tasks may include any or all of the following (cont.): Monitoring the client and process. Checking for signs or symptoms of adverse reactions. Administering emergency care if needed. Cleaning equipment after procedure. Training clients on how to perform the procedure at home.

13. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 13 Unlicensed Nursing Personnel (cont.) The Surgical Technician – Also known as operating room technician. – Assist during surgical procedures. – Work under supervision from surgeons, registered nurses, and others.

14. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 14 Unlicensed Nursing Personnel (cont.) The Surgical Technician (cont.) – Work in operating or delivery room. – May work in outpatient facility for physicians or dentists. – May set up an operating room before surgery.

15. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 15 Surgical Technician Job Responsibilities (cont.) The Surgical Technician (cont.) – Other duties may include : Maintaining a sterile environment for surgery. Learning required surgical tools. Knowing the order in which surgical tools are required during surgery. Setting up and testing non-sterile equipment. Preparing for surgery by shaving, cleaning, and disinfecting client. Taking client’s vital signs. Checking medical charts for the surgeon. Transporting clients to the recovery room. Cleaning and restocking after surgery.

16. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 16 Licensed Nursing Personnel Attend postsecondary education courses and pass a test. Obtain a license through a state agency. – Licensed nurses include: Licensed practical or vocational nurse. Registered nurse. Advanced practice nurse.

17. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 17 Licensed Nursing Personnel (cont.) The Licensed Practical or Vocational Nurse – Perform care under supervision of physician or registered nurse. – Typically receives training from vocational or technical school. – Are required by all states to pass a licensing examination.

18. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 18 Licensed Nursing Personnel (cont.) The Licensed Practical or Vocational Nurse Job Responsibilities : – Taking vital signs. – Treating bedsores. – Administering injections. – Giving enemas. – Administering medications. – Applying dressings. – Applying ice packs and hot water bottles.

19. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 19 Licensed Nursing Personnel (cont.) The Licensed Practical or Vocational Nurse Job Responsibilities (cont.): – Inserting and caring for urinary catheters. – Assessing clients for effects of medication and treatments. – Assisting with meals. – Recording intake and output. – Helping with personal needs of clients. – Helping with emotional needs of clients.

20. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 20 Licensed Nursing Personnel (cont.) The Licensed Practical or Vocational Nurse Job Responsibilities (cont.): – Assisting with the delivery of infants. – Caring for and feeding infants. – Supervising nursing assistants. – Helping evaluate client needs and developing care plans. – Making appointments and keeping records in physicians’ offices. – Teaching clients how to care for themselves.

21. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 21 Licensed Nursing Personnel (cont.) The Registered Nurse – Types of registered nurses: Hospital nurse. Office nurse. Nursing home nurse. Home health nurse. Public health nurse. Occupational or industrial nurse. Head or supervisory nurse.

22. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 22 Licensed Nursing Personnel (cont.) The Registered Nurse (cont.) – Must pass national licensing exam and be licensed in state where they work. – Three training paths: Hospital training program. Associate degree from community college. Bachelor of science in nursing.

23. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 23 Licensed Nursing Personnel (cont.) The Registered Hospital Nurse – Job responsibilities may include: Providing all care given by LPN/LVNs. Providing bedside nursing care. Starting IVs. Carrying out medical regimes as ordered by physicians. Supervising LPN/LVNs and unlicensed assisting personnel.

24. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 24 Licensed Nursing Personnel (cont.) The Registered Office Nurse – Job responsibilities may include: Providing care for outpatient clients. Preparing clients for examinations. Assisting physicians with examinations. Administering injections and IV solutions. Performing wound care. Assisting with minor surgeries. Maintaining documentation. Performing routine specimen collection and lab work.

25. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 25 Licensed Nursing Personnel (cont.) The Registered Nursing Home Nurse – Job responsibilities may include: Managing the nursing care for clients. Filling management positions. Participating in staff education. Handling administrative and supervisory duties. Assessing client’s medical conditions.

26. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 26 Licensed Nursing Personnel (cont.) The Registered Head or Supervisory Nurse – Job responsibilities may include: Managing the department. Planning work schedules and assigning duties. Planning and monitoring the budget. Supervising all personnel. Maintaining all required records.

27. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 27 Licensed Nursing Personnel (cont.) Advanced Practice Nurse – Takes advanced training to obtain advanced practice certificate or degree. – Nurse practitioner is allowed to write prescriptions with physician’s approval. – There are four specialties: Clinical nurse specialist. Certified registered nurse anesthetist. Certified nurse-midwive. Certified registered nurse practitioner.

28. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 28 Licensed Nursing Personnel (cont.) Advanced Practice Nurse (cont.) – The Clinical Nurse Specialist is a registered nurse who specializes in a specific nursing area such as: Gerontology (care of older clients). Neonatology (care of prematurely born infants).

29. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 29 Licensed Nursing Personnel (cont.) Advanced Practice Nurse (cont.) – The certified registered nurse anesthetist has additional training in the use of anesthesia. Works in surgical suites. Works under the supervision of an anesthesiologist or a physician who specializes in anesthesiology.

30. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 30 Licensed Nursing Personnel (cont.) Advanced Practice Nurse (cont.) – The certified nurse-midwife assists with the delivery of infants. Has training and expertise in the delivery process. May assist with birth in home of client.

31. Copyright © The McGraw-Hill Companies, Inc. Chapter 14 31 Licensed Nursing Personnel (cont.) Advanced Practice Nurse (cont.) – Duties depend on setting in which they work. – Many work in rural areas where access to traditional care is scarce. – May work in: Physician’s office. Hospital outpatient area. Surgical area. Acute care, clinics, or in client’s home.