Discussing Learning Objectives with Nursing Home Partner

Welcome back! We’ve thought about your learning objectives and and we have some ideas for you. Why don’t you let us know what you want to talk about first.

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Click a learning objective below.

Examine the roles and associated responsibilities of RNs in a nursing home.
Conduct assessments and apply evidence-based interventions related to common ‘geriatric syndromes.’
Plan and provide person-directed care for residents.
Participate in interdisciplinary activities.
Examine the roles and associated responsibilities of other professions in the nursing home. (Review Module 3 on Learning about the RN role in nursing homes.)
Manage and coordinate the nursing home care provided by a staff team for a group of residents.

I think it would be informative for students to work with the RN coordinators when they work on completing the MDS assessments and care plans for residents. They normally meet with the direct care staff to get information about the residents’ physical and cognitive functioning as well as solicit information about what staff have learned about the residents’ routines and preferences. Many sections on the MDS require that residents be interviewed as well as some physical assessment such as skin inspection, range of motion and balance, and so forth. Students could get a lot of experience with this type of assessment.

One way for students to see the RN role is by attending interdisciplinary administrative team meeting from 8-9 a.m. every Friday. The attendees for this meeting include the director of nursing, assistant director of nursing, nurse coordinators, and the directors from dietary, physical and occupational therapy, and activities. We typically discuss the care of residents, staffing, and care coordination.

I can think of a couple of ways students could learn about the role of the RN in our facility. First, students could shadow the RN coordinator when he or she makes rounds on the unit and leads care conferences. This would give students an opportunity to observe communication with residents, family members, and other health care team coordinators. Students could also participate in the focused assessments that the RN coordinator conducts with residents who might be having physical or behavioral symptoms that were reported on the morning report.

Since you mentioned that you want your students to have experience with assessing and managing common geriatric syndromes, I think it would be useful for your students to compare their assessments to the ones that our nurses have completed. They could also review the plan of care for the resident to determine how the issue is being addressed.

We can help students learn person-directed care for our residents by planning and providing care for activities of daily living, for example bathing. Bathing provides the opportunity for students to assess a resident’s functional level, skin integrity, nutrition, communication, and so on. In our facility, bathing is delegated to nursing assistants who work with residents. Throughout the eight weeks that students are with us, each of them can have at least one experience to bathe a resident. They can talk to the resident ahead of time to determine the resident’s preferences and patterns for bathing, and use that information to help provide a positive bathing experience. This will also help students understand how nursing assistants work with residents, which can help students to be better leaders and delegators of nursing care.

I’m really proud of our interdisciplinary approach to care for our residents. I think a good way for students to learn about how an interdisciplinary team works together is to work on some of our quality improvement projects. Currently, we have two interdisciplinary quality improvement initiatives: one is to reduce falls and its consequences and the other one is to increase delirium detection. The students could participate in different phases of those projects. For example, students could participate in project meetings, help to identify assessment tools that are easy to use, and adapt clinical guidelines for falls and delirium detection and management in our facility. The students could provide education to our staff about the use of the assessment tools, interpretation of the results, and implementation of the clinical guidelines. Also, the students could help us collect data to evaluate the outcomes of our quality improvement projects.

I think it’s important for students to learn all the key professions and how they work together to provide care for residents. Some of the other professions include physical therapy, occupational therapy, speech language pathology, dietary/nutrition, social work, spiritual care, and therapeutic recreation and activities. We can help facilitate students’ learning about the services provided by these professionals to better understand how they contribute to the overall care of the residents and the collaborative role they have with nurses.

You mentioned in your email that you wanted groups of three students to provide team care and take leadership for groups of 10 residents... I think this is something we could consider; it would require good communication to ensure that expectations of all were understood.

I think this would work well on my unit. I have at least one admission and discharge every day and students could get experience with managing patient flow, communicating with physicians and nurse practitioners, conducting initial assessments, and so forth.

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