So I finished up the Medication Conference today that was put on by WHCA. It was cool & I got a lot out of it, but it wasn't meant for me. I wasn't overseeing medication staff. I'm not writing policies & procedures. I'm not doing Med Audits & I am NOT doing a med pass. I do training. At night I work for hospice and give meds in client's homes on a very individualized basis. I don't do anything near the definition of a med pass anymore (& if you know someone who does...take them a Snickers tomorrow...They work really hard).
I was sold on the invitation when I saw that they were going to be talking about Nurse "delegation" in the Nursing Homes.
Yep... The rumors are true. I've heard talk of this hear & there. Nothing official, just talk. In healthcare, there is talk everywhere & I work in 3 different fields of nursing (acute care, long term care & education) so I get talk from EVERYWHERE (and we all need to start being a bit nicer with our words, but that's another blog post)! So when I saw that someone from the Department of Health was going to be giving a presentation on this, I was sold and knew I had to go.
So why do I put the term "delegation" in apostrophes?
Well, anyone who knows me knows that I'm quite sarcastic. So yes, I'm being a bit sarcastic because that's who I am. But there is a bigger reason. When we talk about Nurse Delegation in Nursing Homes, we are misinterpreting the word. Let me tell you the difference:
Nurse Delegation: The Program
In Long Term Care (Assisted Living, Adult Family Homes & Individual Providers) we have known of Nurse Delegation as a DSHS Program. It's an alternate for our residents who need medication administration. It allows stable & predictable residents to get medication administration in their home without requiring them to move into an institutional setting or hire round-the-clock nurses. It's a good program & there is a good amount of data from other states that shows that Nursing Assistants who are properly trained & delegated have significantly lower med error rates than nurses. There are ALOT of requirements and ATON of paperwork.
Delegating Nursing Assistants: The Nursing Commission
When we become nurses, we are instructed on our Scope of Practice & the expectations that come with our with our license. Nursing is becoming more & more everyday, an administrative/supervisory position. We are allowed to delegate nursing procedures to trained staff members. Nursing procedures include a lot more than medications. In Hospice we "delegate" our NACs to do bed baths, vital signs, nail care & (sometimes) housework. As part of our "delegation" we are expected to oversee their competency in these nursing tasks. In fact it is a Medicare requirement that we "supervise" (this means asking the family if they are getting their needs met) the nursing assistant every month. When we use the term "Delegating" is this respect, it isn't a PROGRAM, it's part of our SCOPE OF PRACTICE. In the same respect, we often "delegate" housekeeping staff to clean up hazardous waste & contaminated equipment. These are nursing procedures that require more than a knowledge of 409 & Dawn. They have to be trained Infection Control & know their safety risks. So "delegation" according to the Nursing Commission is not just with nursing assistants & not just with medications. It's much broader.
Medication Assistants Endorsed (MAEs)
So now, the Department of Health is offering a new program called MAEs. This is a new credential. When I've been hearing rumors of "Nurse Delegation in Nursing Homes", I saw today, that we are using the wrong terminology & it's leading to a lot of confusion. This is NOT an extension of the DSHS Nurse Delegation Program. This is a whole new credential. It's not a new REQUIREMENT. It's an optional program that facilities may utilize if they wish.
This is a good thing! This means that facilities have more flexibility in the way they provide care to the residents. It's another option and when we have more options, then residents get much better care.
I will talk more about MAEs in the weeks coming up. I hope to be able to offer the program (although I have a few hoops to jump through). I also am always interested in programs that give ur communities more options at great care & I think this may be one of them.
I am trying to wrap my head around what communities are looking for and how NAC's are feeling about adding this credential and education to their portfolio. I've put together a short & simple survey that I'd love your help in. Everyone who fills it out will be entered to win a $100 gift card to Amazon.com. If you share the survey, I will give you an additional entry. If you leave me a comment, I'll give you another entry.
Your opinion matters. Tell me what you think! Contest will go on for 2 weeks & end on September 11th at midnight.
http://tinyurl.com/MAECred
