New York Nursing
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In New York, there exist various laws and regulations governing the nursing practices, especially for Registered Professional Nurses and the unlicenced Assistive Personnel. In most cases, Unlicensed Assistive Personnel serves as a usually trained personnel that offers a helping hand to the licensed and registered nurses with health-related tasks and non-nursing activities for offering patients direct care. Therefore, the article will address the UAPsprimary roles, RNs general and delegation responsibilities, as well as the crucial differences between the medical-surgical and ICU environment.
In New York State, particular classifications of unlicensed health care providers, like dialysis technicians, operating room technicians, and nuclear medicine technicians, have a specific limited way of performing some tasks as per the nursing practising scope. The supervising Registered Nurse should undertake patient assessment responsibilities, as the UAP cannot acquire such professional responsibility (Carder et al., 2016). In most cases, Unlicensed Assistive Personnel serves as a usually trained personnel that offers a helping hand to the licensed and registered nurses with health-related tasks and non-nursing activities for offering patients direct care. In the State, the primary non-nursing services include clerical, housekeeping, dietary, and transportation activities (Carder et al., 2016). Only the competence UAPs can administer the health-related( direct client care functions without the legally protected scope of nursing practice) responsibilities. Therefore, the health-related task does not need expert judgment or critical thinking and requires the application of a unique algorithm for execution.
The primary roles of the UAPs include assisting in the daily tasks (bathing, grooming, toileting, feeding, bathing, turning, and positioning), performing necessary intake and output, and provision of oral suctioning and mouth care. Also, they measure vital disease signs to patients, delivering care of nails, hair, and skin as well as applying clean dressing to medical facility beds (Carder et al., 2016). Besides, competent UAPs have additional responsibilities as per the nursing practice law in New York. They take EKGs operations, using a glucometer in diabetic patients, and performing phlebotomy responsibilities (Carder et al., 2016). Also, they undertake catheters caring and help in the placement of the braces and prostheses in the patients. Therefore, the UAPs in New York do not prepare care plans, administer immunizations, offer nasogastric tube feedings, among other sophisticated services.
The Registered Professional Nurse (RN) has specific responsibilities as per the New York State Board of Nursing. They undertake health assessment and evaluation among the patients. Therefore, RNs in clinical facilities take health histories and develop physical examinations in the process of identifying health problems and solving unattended needs (Carder et al., 2016). RNs in nursing homes create nursing care plans for the patients as well as teaching and counselling patients concerning their patients. Also, RNs in hospitals, they administer medications and offer medical care to the patients as prescribed by the dentist, physician, among other authorized personnel. More so, in cases of the family escalated illness, RNs provide emotional support and health teaching. Besides, they offer mental health counselling to patients in promoting individual healthy conduct (Carder et al., 2016). RNs also perform health screening to patients in various institutions to detect uncertainty conditions for diseases and then offering viable referrals.
While delegating patient care tasks, the RN has specific obligations to consider. He or she should examine viable activities for delegation based on the patient’s needs. For the delegated tasks, RNs should evaluate the delegate to ensure they have appropriate education, skills, and experience (Carder et al., 2016). They should assign and supervise the delegatee while communicating effectively for task completion and reporting on patient’s concerns. They should also organize workload for effective time control of delegated activities. More so, they should utilize the delegation five rights, that is, task, circumstances, person, communication, and supervision (Carder et al., 2016). Besides, the RNs should evaluate the delegatee management skills as well as delegated activities for their timely completion.
Medical-surgical is general nursing include operations mostly in adults ranging from post-operative patients to stroke patients to pneumonia to cancer. In New York, most smaller community hospitals have med-Surg floors. While in large hospitals, they have transitioned separations rooms for different surgical patients. The UAPs provide non-nursing services to the patients. Intensive Care Units, whether medical, cardiac, burn, neonatal, etc., are units where people need 1:1 nursing care, constant monitoring of vital signs, life support, multiple IV medications, and remarkably consistent observation (Schenk et al., 2017). These patients experience adverse situations; that is, their condition is not stable, and they are permanently not left unmonitored for a minute. Hence “intensive.” But because their requirements are so acute, only RNs care for them (Schenk et al., 2017). Therefore, the UAPs do not provide any support in the ICU.
In New York, the Board of Nursing has identified UAPs as individuals rendering direct services to clients, such as non-nursing services and health-related functions. Therefore, the RNs should not delegate medical-related responsibilities to them. The RNs have the mandate of offering medical counselling to patients, providing emotional support to critically ill patients, administering medication to the patients, and screening the patients for early detection of diseases. Finally, the Medical-surgical requires frequent attention, and therefore, the UAPs can offer services, like administering of non-nursing services. The ICU environment, especially in New York, only requires the attention of the RNs.
References
Carder, P. C., & O’Keeffe, J. (2016). State regulation of medication administration by unlicensed assistive personnel in residential care and adult day services settings. Research in gerontological nursing, 9(5), 209-222.
Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. (2017). Time motion analysis of nursing work in ICU, telemetry, and medical‐surgical units. Journal of nursing management, 25(8), 640-646.