When visiting a home, take advantage of the opportunity to speak with staff members. One type of employee that you should talk to in order to learn more about the nursing home is a nurse. Speaking with a nurse will give you a good idea of the day-to-day operation of the nursing home. This can help you determine if it is the right fit for your loved one.
Medical Emergency Plans
It is not uncommon for medical emergencies to arise in a nursing home. You need to understand your nursing home’s medical emergencies policy. This way, you will know how a sudden medical issue gets dealt with. Talk to a nursing staff about their typical procedure when such an issue arises. Will a nurse try to figure out what is wrong first, or immediately call a doctor? When is a resident transported out of the nursing home? At what point in the process is the family contacted? Will the home contact the resident’s doctor? These are questions to determine how well your loved one will be cared for in a medical emergency.
Interview Process Review
Make sure that each staff member gets interviewed before hired by a nursing home. This is especially the case with nurses. Make sure that the nurses had to provide resumes, qualifications, and past experiences. Also, an interview should have taken place before they got hired. Making sure that every staff member has been screened can ensure that each employee will do their job.
You should inquire about the staff member that has been at the nursing home the longest. Also ask a nurse how many staff members have been at the home for over a year, over five years, over ten years, etc. This will give you a good idea of the turnover rate at the home. A high turnover rate can increase the risk of neglect and abuse. The more employees that have stayed at the home for many years, the better.
It is important that you do not pick a nursing home where the staff feels overworked. Overworked and tired nurses are oftentimes burnt out, tired, and frustrated. This is a bad combination when working with residents that need compassionate care. When speaking with a staff member, you should subtly ask them what their hours are like. Before visiting the home, you may be able to look up staff hours and shift rules on the nursing home’s website.
If you cannot find this information, ask nurse or another staff member. This can get you the answers that you need. Asking not only what a typical shift is like, but if shift rules get broken and how often will be telling. Some staff members might not want to talk about this. But, you might find one that will talk to you about hours and shift schedules. This can help you make a decision about the nursing home.
Role RNs Play
There are many different types of nurses. But, only registered nurses should oversee other employees and making decisions for residents in a home. Ask about the role of the registered nurses on staff. Are they involved in decision-making? Do they dictate to nurse’s assistants and other staff members? It is important to know that the nurses in the home are hands-on and involved with all residents.
Care Plan Execution
Creating a care plan is great, but having a care plan means nothing if the plan won’t be executed. You need to understand who will be in charge of executing the care plan and how often care plans are followed in the nursing home.
In general, it is always best to have a registered nurse execute a care plan or supervise others executing the care plan. This will make sure that nothing goes wrong from a medical standpoint. When talking with nurses and other staff members, you will be able to understand more about the execution of care plans by asking the following questions:
- Who is in charge of the care plans?
- Who makes sure that care plans are being followed?
- What happens if a care plan is violated?
- For the residents that you take care of, do you have their care plans on your person during the day?
- What do you do if a part of the care plan is not working well?
- Who is permitted to carry out care plans for residents?
Questions such as these will help you understand how care plans are executed in the nursing home.
Number of Residents
In order for your loved one to receive the best care possible in a nursing home, they need consistent and individualized attention. Most nursing homes have nurses that take care of specific residents during their shifts. It is important to make sure that the nurses and staff members do not have too many residents assigned to their care at one time. Think about it – if you are in charge of 20 people to take care of, you will probably give each individual less attention and time than if you had five residents to look after. Ask nurses and other staff members roughly how many residents they are in charge of at any given time. This will give you a good idea of the staff to resident ratio. This ratio can greatly impact response time, treatment, and the likelihood of neglect and abuse.
Types of Nurses
Not all nurses are created equal! There are different types of nurses, and it is important that you understand which types the nursing home in question employs, as well as their policies regarding these nurses. The main types of nurses that a nursing home might employ are:
- Registered nurses.
- Certified nursing assistants (CNAs).
- Licensed vocational nurses/licensed practical nurses.
A registered nurse is one who has passed a licensing exam, obtained a nursing license, and graduated from nursing school. A registered nurse should always oversee procedures concerning your loved one in the nursing home. The registered nurse works with other types of nurses and assistants to establish care plans and treat residents in a nursing home. You should ask a staff member or a nurse who oversees treatment to make sure that it is a registered nurse that is in charge of your loved one’s care at all times.
Licensed Vocational Nurse
A licensed vocational nurse or licensed practical nurse is a licensed nurse who can take care of sick, disabled, or injured residents. These nurses must be given direction from registered nurses, but are now supervised by physicians. Again, you should make sure that your loved one’s care is not entirely left to a licensed practical nurse, but rather, that a registered nurse is in charge of their treatment.
Certified Nursing Assistant
A certified nursing assistant is a nurse’s assistant and may provide basic care to residents in a nursing home, but only under the supervision of a member of the nursing staff. Basic care that a certified nursing assistant can provide includes feeding, dressing, grooming, and bathing residents, and other basic tasks. To become a certified nursing assistant, the assistant must undergo training and be licensed by the state.
If you are speaking with a certified nursing assistant in the nursing home, ask them what kind of tasks they are in charge of and how much supervision they receive from the registered nurses in the facility. If a certified nursing assistant tells you that they do something like administer medication without the help of a registered nurse, this is a red flag. Certified nursing assistants should not have too much freedom in the nursing home because they are oftentimes not qualified to make medical decisions or handle residents on their own.
Another important question to ask a nurse is what interactions and communication between staff members is like. Even if staff members are polite to residents, if they have a hostile work environment, this can affect the culture of the home. You should ask a nurse how the staff gets along and if there are any issues between staff members. These issues could potentially affect communication about your loved one and end in neglect or other issues. The interaction between staff members should be friendly and helpful in order to prevent these issues.