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As you go through your day at the nursing home, you’ll encounter a variety of caregivers with many different roles. I always believe it’s helpful to know a bit about the education and responsibilities of each of these employees.
Back in May, we looked at the rehab department in the nursing home. Today, let’s focus on the nursing team.
Licensed Practical Nurse
Most nurses working in nursing homes are LPNs (also called LVNs or Licensed Vocational Nurses in some states). While LPNs possess a wide range of expertise and responsibilities in the nursing home, they need to work under the direction of a Registered Nurse.
The educational requirement for an LPN is generally either a one-year certificate/diploma program or a two-year program leading to an associate degree. The individual must also pass a national licensure exam.
Would you like to know what a nursing home nurse does all day? You can find out in this guest post I was honored to write for FreshRN.
Registered Nurse
Federal law requires Medicare & Medicaid funded nursing homes to provide an RN on duty for at least 8 hours a day, 7 days a week. An RN usually holds a 4-year baccalaureate degree in nursing or a 2-year associate degree. They also must pass a national exam.
The roles of an RN and an LPN often overlap in a nursing home setting. However, some roles and procedures require an RN. These vary depending on the Nurse Practice Act of each state, as well as the policies of individual facilities.
Certified Nursing Assistant
As far as I’m concerned, Certified Nursing Assistants are the backbone of the nursing home staff. They provide direct, basic cares for residents under the direction of a licensed nurse.
The federal government requires a minimum of 75 hours of training for a CNA to work in a Medicare & Medicaid-funded facility. Passing a competency exam is also necessary to become certified.
Training varies between states but usually involves 4-12 weeks of instruction. This includes both classroom and clinical rotations.
Trained Medication Aide
You might see some people administering medications at the nursing home who are not licensed nurses. These employees are Trained Medication Aides (or Certified Medication Aides in some states).
TMAs are usually CNAs who have received an additional 25-50 hours of classroom and clinical education in medication administration. They also must pass a state exam. TMAs work under the supervision of an RN or an LPN.
In some areas, nursing students attending a program to become an LPN or RN can also take the state exam and work as a TMA.
While not all nursing homes choose to employ TMAs, I’ve found them to be a valuable part of the nursing team. By administering medications, they free up the nurses to focus on other important areas of resident care that require the expertise of a licensed nurse.
Nurse Practitioner
The primary additional responsibilities of nurse practitioners are diagnosing illness and prescribing medications and treatments. Besides being an RN, a nurse practitioner has either a master’s or doctoral degree in a specialty area of nursing.
Some nursing homes employ their own NPs. More often, the NPs are employees of a clinic and work in conjunction with an MD who makes rounds at the nursing home.
In other situations, the NP might come to the nursing home in the role of a consultant. For example, a facility might call upon the expertise of a wound care nurse or a psychiatric nurse practitioner.
Working on the nursing team is a challenging job, both physically and mentally. But the rewards are priceless. Please take a moment this week to thank the nursing staff at your nursing home!
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