Delirium is almost always a sign of an acute medical condition.
----- Original Message -----
From: C Hannant
Sent: Tuesday, January 06, 2004 9:57 AM
Subject: Re: RNAC per facility numbers

I agree since it is possibly the sign of an acute medical condition and needs thorough review...cher

Holly Sox, RN, RAC-C wrote:
I think Corey's point was that the Delirium RAP is often related to other complex medical issues that are  more likely to be in the nurse's body of knowledge than a social worker's.  I do the Delirium RAP for my residents for that reason as well.  I am fairly certain Corey wasn't slamming social workers, or indicating that they weren't capable of completing any RAPs.  Just that in her experience (and mine), the Delirium RAP seems more in the nursing domain.
 
Holly
Holly F. Sox, RN, RAC-C 
Clinical Editor, Careplans.com
www.careplans.com
[EMAIL PROTECTED]
----- Original Message -----
Sent: Tuesday, January 06, 2004 7:26 AM
Subject: Re: RNAC per facility numbers

These are folks with BSW's and/or MSW's?  Gosh I think at that level they'd be more than able to understand and do a RAP.  After all the MSW had to do a thesis and that be much more complicated.  And they have more education than I do as a diploma nurse.  Every social worker I've had the pleasure of working with did both the MDS sections as previously indicated and their RAPs.  Some needed my help, seminars or help from their consultants but they did the RAPs and well.  I have had some resist doing the RAPs foreigning ignorance, but once it became clear it was part of their job and needed to be done or another social worker who could do the RAPs would be sought the problem cleared up.  Yes, we often do the nursing aspect of the MDS, but ideally we should be coordinating the team that deals directly with the resident to complete the assessment and care planning process.  I think we need to aim for that as much as possible.
 
 
In a message dated 1/5/2004 10:09:38 PM Eastern Standard Time, [EMAIL PROTECTED] writes:
With all due respect to the many overworked, underpaid SNF social workers out there (and there are many), I do not think it reasonable to have a non-medical person work on a delirium RAP.  There are too many complex items in the mix: medicines, illness, change of psychosocial status, loss of home, pain, and then mix in a possibly pre-existing dementia.  It's unreasonable to expect a BSW, or even an MSW  w/o special medical training to work their way thru that RAP.  I think they can do cognition (most of them), mood & behaviour, but have often found the Activities person to be much more capable of doing psychosocial than social workers, although they are almost always the ones assigned to it.
 
 
Susann Irwin, RN
MDS Coordinator
Garner, NC
 
 

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