Maryland Delegating Nurse

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Hi everyone. Lets start by saying thank you in advance for your positive comments!

Currently I am a RN that is looking to start working as a delegating nurse in the state of Maryland. I have fulfilled the requirements of the state to do so. But of course I have a problem. I am seeking four clients for my first job assignment. The assisted living manager that I am working with does not have any healthcare/nursing experience. On the other hand he has fulfilled all requirements of the state as well. He gets calls everyday from clients seeking placement. The problem is that many of these people have mental illnesses. Am I wrong for not wanting to place them due to the ALM lack of experience? Also the ALM does not understand the selecting client process which I have explained multiple clients. For example, he called me saying that a 37 y/o male with Bipolar and a 87 y/o male with severe dementia is looking for placement. Both require care but need to be cared for differently. Any suggestions? This is my first time doing delegating nurse position and his first time starting assisted living. Am I making this complicated?

Helpppppp

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Specializes in Med/Surg, Ortho, ASC.

I guess I really don't know what you're asking us, but that might be because I don't know what a delegating nurse is. I also don't understand the relationship that you're describing with the assisted living manager.

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Maybe this will help

Delegating nurse- The registered nurse who serves as the case manager/ delegating nurse (RN, CM/DN) must complete the Maryland Board of Nursing and OHCQ approved case manager/delegating nurse curriculum offered by a community college and other approved educational sites prior to serving as a delegating nurse. The RN, CM/DN may:

1. Teach the medication administration training program;

2. Serve as the case manager/delegating nurse in Assisted Living

This responsibility includes:

a. perform an initial and 45 day assessment during the site visit to the home. The follow-up site visit must occur at a minimum of every forty-five (45) days

b. assessing the clinical status of the client every 45 days.

c. assessing the competency of the medication assistant administering medication at the same time as the 45 day site visit.

d. assessing the task to be delegated included complexity.

e. assessing the environment in which the task is to be performed.

f. determining the instruction and frequency of supervision required to monitor the caregiver.

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It sounds like you need a psychological type of service. Med-Options offers on site services and can be contacted for official assessments etc. They came to the LTC facility where I worked and would consult for older dementia as well as younger pts who had a psychiatric diagnosis. They are a psychological counseling service only and make referrals to the psychiatrist for any recommended medications. I would not put the elderly dementia patient and the young bipolar patient together as each has a different need and the age difference may impact their life styles. It sounds like the manager is just looking to fill up the open beds, and does not quite understand the acuity levels involved with nursing care etc. Not sure how you can remedy this. If you have any nurses with psych background I would recommend them for any of the psychological type pts. You can pretty much bet on the dementia and bipolar patients requiring more nursing care/interventions.

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Delegating Nurse ? I started at a new facility and per the new regs, I have to fill out a new 45 day on each resident. The regular 45's are due July 17. Can I use the 45 I'm doing now as the 45 due in July?

Called and emailed MBON, no replies. Thanks!

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Specializes in Family Nurse Practitioner.

I'm not sure I really understand what you do either but as someone working in psych I have encountered the confusion and difficulties in placing my patients from my acute inpatient psych unit who require long term care. Unless there is severe intellectual disability I'm not sure why a 37yo with Bipolar would need to go into long term placement and we would be pushing for an assisted living program such as a group home.

The best advice I can offer is when attempting to place a patient with a mental health diagnosis is to be sure to discern if this is even relevant. I get calls on so many patients on medical units and God forbid they have a Bipolar Dx. The staff wants them sent to the locked mental health unit when in fact they have suffered a CVA and need medical treatment it isn't about their Bipolar disorder.

I don't know if you have any political contacts in your position but if you do please relay to the powers that be that Maryland has done a grave severe disservice to many of our chronically mentally ill patients by doing away with state mental hospitals. To think a majority of the chronically ill population can be safety and therapeutically managed on an outpatient basis is both ignorant and cruel.

Depending on his present state the 87yo with dementia might require an Alzheimer's Unit of which there are too few but they do exist.

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Hi are you still working in Maryland as a Delegating Nurse? I am seeking a delegating nurse. I am in the process of opening an Assisted Living and Must identify a Delegating nurse. The location is Waldorf, Charles County Maryland

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Hi there! I am seeking employment as a brand new DRN in MD. I was wondering if you had any tips, suggestions, cheat sheets? I feel like I am in over my head currently trying to figure out what needs to be done for each client, what all of my responsibilities are...I've tried googling DRN cheat sheets, duties, etc...but to no avail. I have a very good understanding of what is to be done as I have worked in AL since 2011, but now that I AM the DRN I want to bring my A game. Anything would help. Thank you!

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