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I realize
that there are a lot of Medication attendants or one type or other of ÂC.N.A.âs with special training to do med passes
with limitations and needing to be supervised by an RN (I donât want to be that
RN) and I realize the need for current health care administrations to reduce cost,
and make the nurse staffing more cost effective and efficient, but in a world that
already has difficulty determining the roles of the varied levels of nurses, understaffing,
overworking, liabilities, getting cited for failure to perform RN assessments, etc.
itâs not my idea of good practice. I realize that many places have had these in
place with little or no Âproblems, have been
told errors are low because they donât get interrupted like the other nurses do,
and that is all they have to think aboutâ.but IÂ still believe that med pass time is a perfect opportunity for the
nurse to eye ball the resident, assess the multiple medical issues, correlate
the meds vs physical assessment and note for side effects, effectiveness, etc.
tasks rarely consistently accomplished these days even with the nurse is a nurse
ânurseâ due to patterns of increased LPN staffing, part time staffing, float, pool
and alternative staffing. Of course just my opinion. There are good opinions, bad
opinions and then there are the unrealistic and optimistic/ high standards opinions.
Unfortunately unless you are the DON or administrator, this opinion means little.
Itâs just another symptom of a sick and financially poor health system. -----Original
Message----- STATE COUNCIL LEGISLATIVE COMMITTEE REPORTÂÂÂÂÂÂÂ FlÂÂÂÂÂ 2/6/04 . Ã A very large
number of bills are already being proposed for the 2004 session and the
committee has, so far, selected only three to focus and comment on: 1. SB 492 /
HB 189 -Â creates "Certified
Geriatric Specialists". Pilot study in two Gold Seal
nursing homes that would allow C.N.A.'s to attain this specialist
certification. After completing
training, aides in those two facilities would be allowed to administer
medications and treatments to residents, and would also be counted as licensed
nurses for purposes of meeting minimum nursing staff criteria. A steering committee would be created to
guide and provide oversight of the study. 2. SB 1558
(no companion House bill yet)Â -Â would allow some nursing home staffing
changes. 3. HB 267 /
SB 1062 - would allow alternative bed uses in nursing homes & also includes
some other health care facility related changes. Ã There are
two additional bills the committee will soon be examining (before the 2004
session begins in March). However, we
don't know much about these bills yet, so no decision has been made
whether to recommend any changes: 1. SB 1226
(no companion in House yet)Â -Â related to Long-Term Care Service Delivery
Systems (DOEA's top priority bill to study) 2. "Florida
Caregiver Institute Act" (has no bill# yet)Â -Â related to development
of caregiving as a nonlicensed paraprofessional activity à Regarding
the first three bills already mentioned, the committee approved some
recommended changes to the bills and/or listed some concerns about these bills,
as follows: 1. SB 492/HB 189
(Pilot Study on Certified Geriatric Specialists) ÂÂ
COMMITTEE RECOMMENDATIONS: The education program should
be standardized and approved by the Board of Nursing. Page 4, Section 2. It should be made clear who
makes up the training faculty (e.g., facility staff or independent
trainers). Page 4, Section 2(4), lines
23-25. Strike all references to ALFs
(the words "Part III") throughout the entire document because
in ALFs there would usually be no licensed nurse to supervise the Geriatric
Specialists. Clarify the meaning of
"under the direction of" a registered nurseâ. Page 7, Section 6, line 19. Strike section that says
"based on the individual's educational preparation and experience in
performing certified geriatric specialty nursing" and replace with the
words "based on training, education, and professional care standards". Page 8, lines 3 - 5. Change the word
"board", to instead read "Board of Nursing" (so it's clear
which board is referenced). Page 8,
lines 17, 26, & 29. Strike the words "has
the ability to communicate in the English language, which may be determined by
an examination given by the department" and replace with
"demonstrates the ability to comprehend and communicate in written and
oral English language". Page 9,
lines 1-3. Strike the words "for
purposes of computing nursing staffing minimums and ratios, certified geriatric
specialists shall be considered licensed nursing staff". Page 14, Section 10, lines 27-29.   CONCERNS: When a C.N.A. enters the
Geriatric Specialist Training, who would then do the work of that person in the
facility? If a licensed nurse is
supervising a Geriatric Specialist in training, who covers the responsibility
of the licensed nurse? Where is the funding coming
from for this program and how much will it cost? Who, specifically, will be
teaching the training courses? Who, specifically, will be
supervising these specialists while in training? ÂÂÂÂÂÂÂÂÂ RATIONALE
FOR CHANGES/CONCERNS:Â These Certified Geriatric Specialists are NOT licensed nursing
staff and, if considered as such, it would decrease the quality of care that
residents are entitled to, and that they expect. Sincerely, |
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