Restorative Nursing Assistant

BASIC FUNCTION

The Restorative Care CNA provides nursing and nursing related services to residents consistent with each resident's comprehensive assessment and plan of care, including restorative care and services to help the resident maintain or attain the highest practicable level of functioning and independence.

EDUCATION, QUALIFICATIONS, CREDENTIALS

Successful completion of a state-approved Nursing Assistant training and competency evaluation program or acceptable verification of this from State Nurse Assistant Registry. No finding in the Registry concerning abuse, neglect or misappropriation of resident property. Prior experience giving personal care to impaired individuals in a healthcare setting is preferred.

RESPONSIBLE TO: Restorative Care Nurse Supervisor, Charge Nurse, DON

ESSENTIAL FUNCTIONS

The employee must be able to perform each essential function effectively to be successful in this position.

* Delivers quality care in a compassionate manner with kindness and respect for resident dignity and individuality.
* Receives and completes all patient care assignments and other activities assigned by the charge nurse or unit manager.
* Provides direct care to improve or maintain a resident's abilities according to the resident's plan of care.
* Provides care in a manner that protects and promotes resident rights, dignity, privacy, confidentiality, self-determination and active participation.
* Responds to call lights/buzzers promptly (within 5 minutes of first ring), courteously treating each as an emergency until answered.
* Keeps resident units assigned clean and orderly, changing linens, making beds, cleaning bedside tables after meals, positioning call light cords, providing fresh water, etc.
* Records accurate, legible information about resident care, conditions, and observations in the appropriate locations in the clinical record.
* Observes and immediately reports to the Charge Nurse significant changes in a resident's psychosocial behaviors such as patterns of decreased social interaction, angry or sad behaviors, and refusals of care or treatment.
* Observes and immediately reports to the Charge nurse changes in physical symptoms as evidenced by discolored or odorous urine, constipation, or signs or verbal expressions of pain or discomfort.
* Attends all mandatory inservice training meetings as posted.
* Participates and listens to shift reports between shifts.
* Promotes residents' rights to dignity, privacy, and comfort at all times for example, refers to residents by proper names unless a resident requests otherwise
* Prevents undue exposure of a resident's body when providing personal care and services.
* Follows infection control procedures at all times, for example, washes hands before and after taking care of every resident, and keeps clean and soiled items separated (linens, clothing, etc.) to prevent cross-contamination.
* Assists with the planning, implementation, and evaluation of care plans for assigned residents, reports resident's responses to interventions, and suggests alternative approaches to the Restorative Care Nurse.
* Follows and implements written restorative plans for residents on restorative nursing caseload. Documents restorative services performed in a timely and accurate manner.
* Regularly communicates with the Restorative Care Nurse about assigned residents throughout the shift.
* Assists residents with activities of daily living (ADLs), providing set-up assistance, verbal prompts, physical support, or more extensive assistance as more fully described below:
* Bathing - Assists transporting resident to tub or shower, adjusts water temperature, washes/rinses resident, and dries body thoroughly with clean towels while maintaining privacy for resident at all times. Gives complete baths at frequency stated in the Nursing Care Policies. Cleanses resident when bed linen and/or clothing is wet or soiled. Provides proper skin cleansing after each occurrence of incontinence.
* Dressing - Locates, selects, and obtains clothing for resident. Assists residents with snaps, zippers, and buttons during dressing and undressing. Assures resident is dressed in clothing appropriate to season.
* Grooming - Shampoos and combs hair of residents as instructed. Shaves male residents daily and women with facial hair as needed. Cleans and soaks fingernails and toenails before trimming, and trims when needed or assigned. Assists residents with oral hygiene as instructed.
* Elimination/Toileting - Promptly assists resident to bathroom according to toileting schedule or promptly brings clean bedpan or urinal. Opens, removes clothing in preparation, cleans resident afterward if resident unable to clean self, adjusts clothing, and cleans resident hands and own hands. Measures and records output when required by plan of care. Provides catheter care according to facility procedures and infection control policies.
* Mobility - Provides weight-bearing assistance or physical support for ambulating. Assists with or performs range of motion exercises to all joints or as care planned. Monitors resident progress toward mobility goals and reports responses to Charge Nurse.
* Transfer - Positions resident properly for transfer and explains procedure. Uses correct body mechanics, transfer techniques, and safety devices or equipment according to the resident's care plan and in compliance with the facility's lifting policies.
* Eating - Prepares resident for meals - washes face and hands, positions at the table, and applies bib as instructed. Provides set-up assistance for meal tray - opens, pours, unwraps, and cuts food if resident is unable to help self. Feeds those who require total assistance according to their plan of care. If indicated, actively cues and encourages residents to eat, chew, and swallow. Socializes with residents during mealtimes. Documents and reports fluid intake and output accurately when ordered. Reports any change in a resident's appetite and carefully watches food intake of diabetics. Serves between meal nourishments ordered and offers bedtime snacks.
* Related Clinical Duties - Offers drink of water during care and meals to promote good hydration, unless contraindicated. Records intake and output when required. Accurately takes and records residents' weights when scheduled. Encourages residents to actively participate in ADLs such as grooming, dressing, and eating.
* Communicates with each resident according to individual functional abilities and needs, for example,
* Uses communication board or communication book when available.
* Uses effective language skills and auditory comprehension skills for residents who have dysfunction in these areas.
* Uses behavior management skills to approach and care for residents with behavioral problems.
* Provides preventive and restorative care, for example,
* Changes position of bedfast residents at least every two (2) hours to maintain body alignment and relieve pressure on skin areas; and checks chair-bound residents hourly for alignment, release, or exercise.
* Keeps residents' skin clean and dry and assures pressure relieving devices are in place when ordered.
* Reports any redness, rash, irritation, bruising or abrasions of a resident's skin to the Charge Nurse.
* Assures that devices ordered to prevent contractures are in place such as hand rolls, braces, splints, slings, etc.
* Performs range of motion exercises during a.m. and p.m. care and as instructed.
* When restraint is ordered, provides appropriate care and release; and implements alternatives when directed.
* Protects resident safety at all times, for example,
* Places call light cords within easy reach of residents and notifies nurse if cords need attention.
* Promptly checks exit(s) in assigned areas when door alarms or personal safety devices are activated.
* Properly positions bed rails after care and before and after meals.
* Uses lifting equipment and proper body mechanics to perform resident lifts and transfers.
* Participates in the preparation for state inspections and interacts appropriately with state surveyors as instructed.
* Participates in fire/disaster drills, and carries out assigned duties in emergencies to assure resident care and safety.

The preceding list of essential functions is not all-inclusive and may be supplemented.