One Nurse’s View on Patient Care
By Beth Smith
Do you want an 18-year-old with only a year of experience and less than two weeks of education administering medication to you in a nursing home or assisted care living facility? Or do you want this same untrained and uneducated person providing this level of care to your family member?
If your answer is no, then your action is needed to get your state representative to vote against HB 1607, which the House Health and Human Resources Committee will consider today.
Proposed by the association representing nursing homes and sponsored by state Sen. Diane Black and Rep. Debra Maggart, HB 1607 would allow certified medication aides, who would be registered with the Board of Nursing, have a year’s experience working in a nursing home or assisted care living facility, and 75 hours of training, to administer medications to individuals in nursing homes and assisted care living facilities.
Proponents of the bill say that it will give nurses more time to do other nursing jobs, but what is more important than providing nursing care? They also argue that the amendment only allows for routine medications to be administered; however, those “routine” medications include heart drugs, blood pressure medicines, diabetes drugs and antibiotics, just to name a few. The average nursing home patient receives eight different medications.
Nurses argue that this is a patient safety issue. It takes knowledge and education to understand how drugs affect the body and is more difficult when multiple medications are given.
It takes skill and experience to be able to identify drug interactions and side effects, especially in an elderly patient with chronic illness.
Medication administration offers the nurse an opportunity to “lay hands on” the patient. This is one of the most substantive times a nurse spends with a patient and provides time to observe the patient, discuss any health care concerns with them and determine necessary treatment if there are any changes in the patient’s health. Giving the nurse less time to deal with the patient and delegating this authority to a medication aide will force registered nurses into even more administrative roles, such as reviewing charts and overseeing staff, instead of having registered nurses providing patient care.
Tennessee’s nursing homes already do not meet national safety and quality standards – 111 of the 319 nursing homes in the state received the lowest rating of one star according to the Center for Medicaid Services, and only 22 have received CMS’s highest score of five stars. To check the quality of nursing homes in your area, please visit http://www.cms.gov. Nursing home patients deserve improvement in their level of care. This bill takes several steps backward and will further decrease the quality of care our most vulnerable citizens receive.
Individuals in nursing homes and assisted care facilities are our most frail and vulnerable citizens, often unable to advocate for themselves. The addition of another layer of uneducated and undertrained health personnel between the patient and licensed health care provider will only create further confusion and further distance between those most qualified to give care and those most in need of the care.
Please call and e-mail your representatives and voice your opposition to HB1607. We must ensure that properly educated, trained and licensed individuals are providing this care.
The reason they are called nursing homes is because these patients need nursing care.
Let’s ensure our most vulnerable citizens are given a voice in the legislature and that their needs are put first and not at the bottom lines of nursing homes and assisted care living facilities.
Beth Smith, a registered nurse who holds a doctorate, has been in nursing practice and health education for more than 30 years in the Tri-Cities area. She has served as a member of the nursing faculty at East Tennessee State University and Milligan College. She is involved in clinical health care research.
Advertisement
Reader Reactions
No, your not taking off today.
It is a news story about a Republican event paid for by HMO’S where the good Dr. presented his plan to derail the health care debate.
I know that makes you feel good.
I try to make you happy you know, by misspelling words so you get to prastice your editing skills and by copy and pasting storys so you can worry about me claiming credit for it. I am glad I can give your life such fulfillment.
Grandpa always said when people want to help you make it easy for them. How am I doing ? Am I making things easy for you ?
Dad, if you you wrote that 10:09 PM entry I’m a fighter pilot.
I just hope no one gets a nurse caring for them like my father had who was practicing medicine as a physician without a license, after a review by the TN board of licensure, it was called “horrifying” but quite acceptable ! ACCEPTABLE FOR A NURSE ACTING AS A DOCTOR IS ACCEPTABLE ? I don’t get it.
www.wisecountyissues.com/?p=62
Dr. Luntz, the man who developed language designed to promote preemptive war in Iraq and distract from the severity of global warming, is at it again—this time with a messaging strategy designed to sink our historic opportunity for health care reform.
Dr. Luntz’s new game plan to stop change is being embraced by leaders in the Republican Party. In a briefing where Dr. Luntz presented his strategy to Republican House members, Rep. Mike Pence from Indiana, the chairman of the House Republican Conference, made it official by saying, “Frank is back.“
So expect a massive misinformation campaign coming to a health care debate near you. Opponents using Dr. Luntz’s doublespeak will argue for a “balanced, common sense approach” to health care but what they really want is to keep the system the way it is. They’ll say that a public plan will not be “patient centered,“ but their real goal is to block accessible health care for every American. They’ll say reform will deny Americans “choice” even when every American will be allowed to keep their health insurance and their doctor. They’ll claim that the “quality of care will go down,“ while callously ignoring the fact that millions of Americans have no health care at all and millions more are denied the medications and procedures they need.
In his memo, Dr. Luntz lays out multiple ways that opponents of health care reform can trick and manipulate the American public. One strategy that stood out to me is to call efforts to reform our broken health care system a “bailout for the insurance industry.“ This is ridiculous. This statement is developed to serve the same interests who stopped at nothing to derail health care reform in the 90’s, who blocked health care coverage for low-income children, and whose top Medicare priority for 15 years has been transferring money from seniors and taxpayers to the insurance industry.
You folks need to relax, this problem is on President Obama’s agenda. Soon, all your healthcare concerns, whatever they may be, will be history.
They’ll use the VA hospitals as an example of what to do, or they’ll use the success they’ve had in education, or they may even use the business model used by the Post Office. Thank goodness there’s all kinds of successful government programs to use as a model.
The Uneducated are causing a problem now. Busy nurses and Doctors leave things like records transfers to these people and it never gets done. I only recently found out my mother’s medical records never got transfered after 3 years and she had not been getting treated for type 2 diabetes. When vitising her I saw something was wrong and made her an appointment then went with her to the doctor. He tried to blow her off with a take a pill and the old COUNTRY HEE HAW rush to get out of the room. I raised cane and they began actually checking her out.
Her sugar was 343. Today she has gotten it down to 141 still not below 130 but maybe the damage to her organs will be much less.
Her medical records from her old doctor who got sick and retired showed he had been treating her for type ll diabetes for over 5 years. When she took her record of her sugar levels to the knew doctor who did not have her records he told her she did not need to check her sugar any longer.
Now 3 years later and we are payers her kidneys are not damaged or other organs.
The State of Tennessee is very SORRY oversight of the Medical Industry. Some Docotrs keeping their office open and letting nurses run the office when they are too ill to actually see paitients.
It is an embrassment how Tennessee allows this stuff to go on year after year.
Doctors call up Patients 2 or 3 times a years and make all of them Appointments before the Docotrs take a month or two vaction. My mother has recieved many calls like that just out of the blue.
“ He wanted to see you before he went on Vaction.“ Guess they need to get a lot of Medicare Money to pay for that Eroupean Vaction.
I do not know Sen. Diane Black or Rep. Debra Maggart, but I would bet they are both republican. Does anything more need to be said?
Health care is in dire need of reform, profit care comes ahead of patient care in America. www.wisecountyissues.com
Sounds like an attempt to break the Nurses Organization so they can break down each job then farm it out.
Few nurses needed and then lower wages.
Wornder who would benifit from all that ?
HMO’S ??
I find this situation truly frightening. As a registered nurse now working in the pharmaceutical industry, no medication should EVER be considered routine and NO medication should be delivered to a patient just because the order has been written. It takes someone with a sound knowledge base of drugs and their physiological properties to understand when to adminster or when to withhold a particular drug.
Our healthcare system is in crisis. Instead of passing bills which would only contribute to a further decline in healthcare safety, our legislators should be passing bills to strengthen oversight of our patients such as nurse to patient ratios.
Linda McKinney, BSN, RN
Advertisement