Washington nurse works to ease nursing shortage

[NRSKarenRN, BSN, RN]

University of Washington Nurse Informs Lawmakers to

Ease RN Shortage

Copyright 2002 AScribe Inc.

AScribe Newswire...08/14/2002

http://webpublisher.lexisnexis.com/index.asp?layout=story&gid=1730000973&did=46HF-M8K0-0077-22C4-00000-00&cid=1920004392&b=s

SEATTLE, Aug. 14 -- A nurse researcher from the University of Washington has been working with state policy makers and legislators to evaluate policies that help older adults with disabilities delay or avoid nursing home placement. This has led to new legislation that is also providing creative solutions to the shortage of registered nurses available to help such individuals, who are living longer lives thanks to improvements in health care.

Dr. Heather Young, who also directs the de Tornyay Center for Healthy Aging in the School of Nursing, designed a research study at the request of legislators to evaluate the impact of using nursing assistants to perform specific health care tasks under an RN's supervision. The study showed that many individuals were entering nursing homes because they required skilled nursing services, such as help with medications, that were not allowed to be delivered in less institutional settings such as assisted living communities or adult family homes. Furthermore, out of necessity, some care providers who were not RNs were already providing services that were not formally sanctioned, although there was no system in place for training or supervising them.

Under the new legislation, registered nurses are training and supervising nursing assistants to perform specific health care tasks. Besides opening up a wider range of nursing care possibilities, this allows seniors with functional and health needs to continue living in less restricted environments. The legislation also provides Medicaid coverage for services performed by nursing assistants. Under the old system, only skilled services performed directly by a registered nurse were eligible for coverage.

Young notes that Washington state has been a leader in improving health care policies for older adults, and she credits nursing with helping lawmakers make decisions based not just on science, but also on the impact policies will have on people's lives.

"Policies are being drafted that allow consumers to have more control over their own health care," Young says. "With the competition for health care services as baby boomers age, we can no longer just be passive recipients."

Trained as a gerontological nurse practitioner as well as a researcher, Young is also collaborating with lawmakers on House Bill 1880, which allows persons with disabilities to use state funds to hire their own independent provider and direct them in performing specific health care tasks. This legislation is also being evaluated by nursing research funded by the state.

"HB 1880 has the possibility of improving quality of life for many people," Young explains, noting that persons with disabilities are more able to have freedom of choice and take responsibility for their own lives and care. "It is helping individuals be more independent who know what needs to be done but who for physical reasons just can't do it themselves," she explains.

Policies such as these are shifting the roles of registered nurses towards providing education and consultation to care assistants and also consumers, thereby equipping them to manage care more effectively. Such approaches are also reducing nursing workforce demands in a time of severe state and national shortages. In addition, Young points out, "We are helping to give a voice to the disabled, who are largely invisible in our society."

CONTACT:

Kathleen Dannenhold, Univ. of Washington, 206-221-2456;

FAX: [phone], [email protected].

[Cascadians]

In Oregon, care in the home has been most interesting. There are rules, and then everybody out there breaking all the rules. The climate right now is that rulebreakers are PREFERRED. Less expensive, less paperwork, etc. The RNs do not want to delegate anybody and put their license on the line. As one RN with over 30 years' experience recently told us with regard to the preferred in-home care provider: the stupider the better. Meaning the less a person is aware of, the less advocacy and noise will be made.

What amazes us is that the safety of the patient is no longer even considered.

We are on a couple committees just watching all this morph and flex and come down. Meanwhile what we see in homes and assisted living facilities is enough to fry our eyeballs in horror screens.

Amidst all the snarls and health, inheritance and decency looting, the patients are getting the short shrift. And it looks to get even worse. Attitudes are bad.