Nursing Blog – CNA Training, And Other Nursing Job and Information

The definition of Nursing Agency as appearing in Florida Statutes 400.462 states “A person who gets, makes the offering, does the promise for getting healthcare contracts for healthcare professionals like registered nurses, Licensed practical nurses, certified nursing assistants, home health aides, companions or home makers, who are compensated by fees as independent contractors including, but not limited to, contracts for provision of services, to patients and contracts to provide private duty or staffing services to health care facilities licensed under chapter 395, this chapter or chapter 429 or other business entities”.

A nursing agency is a business entity providing nurses and normally healthcare assistants also referred as certified nursing assistants to person, who are requiring the services of health care assistants. The nurses get temporary employment through the nursing agency at the hospitals, care homes, and other health care providers to assist them during overload of work period or in situations of their staff on long leave to fill the necessity of the health care providers. Some of the nurses are sent to the homes of the patients, who require nursing care at their homes.

In US the Nursing Agency is also called nursing registry, being nursing staff providers on per day basis or for longer duration to the hospitals, medical offices and individual persons. The nursing agencies are small establishments managed by individuals.

Operating a Nurse Agency:

To operate the Nursing Agency one requires lot f funds, because the nurse agencies pay to the nurses as and when they work in a hospital, whereas the nursing agency gets the payment after 3 to 4 months. The nursing agency operates on a margin of 4 % to as high as 70 % depending upon the quality of the nurses engaged by the agency.

The nursing agency operates to meet the seasonal needs of the hospital. The hospitals prefer paying overtime to their staff during holidays instead of availing the services of a nursing agency for hiring nurses through them. In the summer months, when the hospital staff goes on vacations of long duration, there is good business for the nursing agency.

Nurse Agency requires lot of responsibility on the part of the operator in respect of the nurses being provided to the hospital involving undertaking of the liability claims on behalf of the nurse provided in the event any negligence or in-appropriate action takes place at the place of work in a patient handled by the nurse. There can be law suits pertaining to any injury to the patient occurred while the patient was under the care of such a nurse. The nurse agency must insure itself against malpractice conduct of the nurses provided to be on safe side for provision of damages in a law suit.

Existence of Online Nurse Agency Services:

In view of the present draw backs in carrying out the profession of the nurse agency and the technology advances offered by the internet the nurse agency now put up job boards on their website, whereby the employer’s need of the certified nursing assistant or any other required nursing professional can be compared with the data of Registered Nurses of the nurse agency. Thus a direct contact of the candidates with the employers can be arranged eliminating any liabilities on the part of online nurse agency.

Nursing care plan helps the nurse for deciding the right approach in caring for the patient during the stay of the patient up to the time the patient is discharged. The nursing care plan becomes a written document. It is up dated from time to time, depending on the status health of the patient and incorporating any changes required. It can mean addition of some thing or elimination of some thing from the previous planned care.

Nursing practice needs thoughtful and focused planning of the care of the patient based on the laboratory investigation records and history of the patient and from time to time checking the progress made in the light of anticipated goals.

The Principle Underlying the Approach:

The basic principle about each Nursing care plan is it’s specific customization for each patient and can not be substituted by a stereotype plan of a particular disease. When there is proper nursing staff ratio in the health care set up, the nurse gets ample time to do the desk job of patient care planning and complete the records of the patient from the stage of admission to discharge of the patient followed by a home care plan based on the history, medical records, physical assessment and nursing diagnosis. The patient shall be performing care at home as suggested by the nurse either by self or with the assistance of a help.

But in practical situations, the right nurse patient ratio is never present. The night shifts are overstressing hardly any time to plan and write any thing. Writing a comprehensive nursing care plan requires lot of time. One tries to take help of the standard care plans instead of making a comprehensive nurse care plans. Standard care plans, software generated plans and plans copies from care plan books are just the resources for reference and are not substitutes for comprehensive nurse plans.

The Lacuna Needing Correction:

Comprehensive patient care planning although very vital; often is neglected as wastage of time and considered a futile exercise, thus neglecting an activity on which shall depend patient’s health. Nurse care plan is like a guide post in patient’s healthy recovery, from which all the health care workers seek guidance from time to time patient is admitted in the hospital.

The nurse care plan is left at the discretion of the nurse in-charge of the patient care. Thus other members of the health care team belonging to different disciplines get excluded. The nurse becomes overloaded with work affecting effectiveness. Patient care planning should be a joint effort in planning and executing the plan.

The patient care plan begins with correct assessing considering all the factors. When the patient is in acute condition the initial care plan should be thoroughly assessed at the time of admission and subsequently reassessment is required to be done with the changes in the status of the patient after admission till the condition of the patient gets stabilized.

Different Situations & Appropriate Plans:

When the patient requires long term care, the assessment and formulating of the nurse care plan, is based on the Minimum Data Set. In the case of home patient care nurse, uses oasis assessment plan. In other situations there are protocols on the basis of which the assessment is made and patient care plan devised and reassessment is carried out as specified in the protocol.

Having arrived at the first assessment, problems are listed, which is just simple process or one can involve Resident Assessment Protocol and minimum data set. While listing the problems one also include the strengths, the patient is having or even relations with his other family members, which are causative factors for the disease and general well being of the patient.

Finding Answers from Questioning:

The next stage is looking at the specific problem and the step poses a question in the mind of the nurse “is the problem going to be corrected or some thing can be done to reduce the intensity of the problem.” The yes answer means making a goal for resolving the problem or attempt it’s improvement during the review period, which shall be of longer duration in long term and home health care plan in comparison to acute patient’s nurse care plan . The Goal has to be specific with defined parameters of measuring the progress and achieving visible improvement.

If the problem presented by the patient has very uncertain chances of improvement, the next thoughts are can the worse progression be arrested or delayed? Such a situation is usually found in diabetic and congestive heart failure patients. The question is can an intervention minimize the problem although marginally.

Care Plan of Terminally ill Patients:

In case the problem in any manner can not be improved and the worse is imminent, what can be done to improve the quality of life till the patient is living. The examples are of Alzheimer’s disease or nutritional issue in case of terminally ill patients. The nurse care plan is till the patient is admitted in the hospital or after discharge at the home is convalescing. In case of terminally ill patients all angles and probabilities should be studied before drawing nurse care plan focusing on what comforts can be accommodated because, it is going to remain in implementation stage till the end of the life of patient.