Skilled nursing is essential for home care because of the multiple problems experienced by seniors. Seniors fight for their independence, or they may isolate, denying that they have any problems. Aging can be a challenging process when you take into account complex diseases that might need to be monitored daily; falls that might result in a fractured hip, diabetes that needs constant control, cardiac issues that need to be evaluated, and multiple medications.
Skilled nurses are a group of individuals who help shape the world and its people. Nurses are the gatekeepers for medical care, focused on achieving and maintaining a state of wellness. RNs can provide education to the family caregiver, making their tasks more manageable. Those taking care of “grandma” may need more understanding on how her prescriptions work and interact with over-the-counter medications, or could use coaching on diet, bathing and incontinence care. They may need ideas on how to keep her engaged with the world around her. RNs can work with the physician to arrange home physical therapy for safer ambulation and improved functionality.
Safety in the home is of great importance to elders. Patients with memory impairment may need adaptations to their environment. An experienced nurse is able to anticipate potential dangers in a home. Do all smoke detectors have new batteries? Is everyone familiar with appropriate escape routes? Are medications safely stored? Does the caregiver administer the meds in a safe manner? Medications should be evaluated and set up by an RN. While family members can give meds, agency caregivers cannot.
Since Home Health Care, Inc. does not utilize Medicare, our nurses are not limited to a set number of visits per week; therefore, our nurses are available for daily skilled needs such as dressing changes. RNs can provide care and case management for clients who have out-of-town relatives, making monthly or weekly visits to ensure patients’ safety, while watching for ongoing issues or symptoms of new problems.
All nursing interventions are ordered by the patient’s physician. All nursing evaluations are sent to the physicians, the family (DPOA) and anyone the patient wants to provide with information concerning his or her care. Of course, the patient must sign for others to receive personal information. Skilled nursing can be done for agencies that do not have RN oversight. A caregiver does not have the education, or the varied experience needed to safely case manage an elder in the home environment. Caregivers need to be checked upon in order to ensure that care is appropriate for the patient, especially if his or her condition has changed.
In summary, RNs can do wound care, set up bowel care, administer IV medications, perform home safety evaluations, blood draws, train family members, provide supplemental support for hospice patients, post-operative care, give injections and perform many other interventions not listed here. RNs are extremely important members of the medical team. Their job is to recognize changes, treat new problems, understand the patient and family and help them adjust to a changing life.
The goal of the RN is to improve the life of the patient with continuity and quality of care.