What does a nurse usually do in a nursing home?

[supersopa]

Hi,

I am a newly graduated italian nurse and I am going to go to UK for work as a nurse, likely I will start in a nursing home. As the question object I would like to ask if there is someone that knows what a nurse does in a nursing home. I am just graduated and I want and I have to improve my nursing skills, so I would not to get a job where I just do basic tasks (like a carer) such as feeding, cleansing, moving and so on.

the problem is my language skills, I have still to improve it and for now I cannot aim to a position into a hospital. please can you give my any advices?

thanks

[JBMmom, MSN, NP]

You are going to find variation between nursing responsibilities in nursing homes, however, the basic care you mention above generally falls to the responsibility of the CNAs. Nurses are often responsible for medication administration, treatments- including dressing changes, application of prescription creams/powders, etc. There are admission assessments and paperwork, in some facilities you are responsible for calling lab results to the MDs and making the associated medication changes. There are orders to be filled- labs, x-rays, etc if an outside company comes on site to perform those. There's charting, and more charting. I'm sure there are other responsibilities that I'm forgetting, good luck with your job search. If you search through these threads, you'll find many others with similar questions.

[supersopa]

Thanks for your reply. I am going to search through the website. do you know if a nurse, in the nursing homes, usually take blood samples and manage intravenous/drip? likely my first position will be in a nursing home with elderly patients and patients with dementia. thanks

[bluegeegoo2, LPN]

In my facility, we do IV's if necessary. We do not do blood draws, lab techs come in and do those. We do all the things JBMommy said. Med pass, assessments, charting, admits, discharges, call abnormal labs to MD's, get new orders from MD's and process those, call family for notification, etc. It doesn't seem like much to list it like that, but believe me it's a lot. Most days, I'm tickled to clock out for the day having accomplished nothing more than not sending someone out and keeping them all off of the floor, lol.

[supersopa]

Thanks! I am interested on improving my nursing skills since I am newly graduated I would not like to work in a place where I only undertake simple tasks (what carers do).... I asked about IV because knowing how incanulate a vein is very important for a nurse....so I hope that in my future facility we will not have the lab services

[nursemaid48]

ummmm....i found that you may have to do everything....including unclogging toilets, checking general maintence things if you work 2 or 3rd shift.

[Silverdragon102, BSN]

OK I have moved this to the UK forum as things will certainly be different that in the US.

Last time I visited a nursing home in the UK no IV therapy was done there, Generally if blood samples was required I believe the district nurse went in to do them. It may vary from area to area but I would suggest before you apply see if you can have a look round. Jobs will also be hard to find as many UK nurses are struggling to find work due to many being laid off from hospitals

I would definitely recommend improving your language skills as many Elderly will have problems understanding

[carol dimon]

In UK, care homes differ according to owns them ie NHS, company, large company, individual, charity. There are CQC standards in England which also apply to hospitals but care homes differ regarding policies, procedures eg food and hygiene recommendations. Residential homes are not required to employ anurse- senior carers can be inn chatrge. Nursing homes may have only one nurse present on shift depending on it's size. Hence it is a very challenging area- not second rate at all. The manager is actually registerd nd responsible for everything ultimatley but nurses of course, remain accountable. Issues of care differ. There are clinical aspects in many homes eg syringe drivers, taking bloods, intravenous infusions, NG tubes. Not all nurses have these skills but district nurses are not meant to attend to residents in care homes. You need firstly to be aware of all policies within the care home and CQC regulations. If you are not a union member, I would recommende ACAS- a free independent advisory service as the NMC no longer advise.You need good English for care homes and hospitals. I take it you know about adaptation training? Depends on individual need- according to NMC who now also test English.

[skylark, BSN, RN]

Even thought the CNAs (they are called HCAs in the UK btw) do the hands-on care, you are still responsible for the overall patient care. So if they wash a patient, you should be around to observe pressure areas, skin condition, mouth care, etc, and ensure that your findings are documented.

Same with meals, the HCAs will likely feed or assist patients, but you need to observe and record input, and problems, such as change in appetite, lost dentures, etc.

Same with toiletting, be aware for signs of UTI, constipation etc.

patients transfers - supervise and/or assist, take responsiblity for checking hoist safety, availability of slide sheets, etc.

Meds will be your sole responsbility, includes ordering repeat scripts, ensuring blood glucose and coumadin/warfarin monitoring and adjusting meds accordingly.

Reporting changes in condition to the doc, arrange transfer to hospital if needed.

Communicate with relatives, they usually know the patient best!

In short, you need to work alongside your HCAs, even if you cannot find time to actually assist ADLs, at least be on hand to observe and document. Work as a team, and treat the HCAs with respect, you cannot do the job without them : )

[Razvannus]

What about paperwork? I heard it is a lot of paperwork! Someone know about how many, or what kind of chart ?