The Minnesota Star-Tribune reported that an assisted-living facility is being held responsible for the death of a resident who suffered head injuries from a fall and received no medical attention for days afterward.

The Health Department’s investigative report says that Lighthouse of Columbia Heights “failed to report changes” in the resident’s condition to a nurse and “failed to seek medical attention in a timely manner” after the resident fell in November 2011 and developed a sizable bump on one side of her head and a smaller one on the other side.

The resident was hospitalized three days later before dying on Dec. 5.  Her death certificate concluded the fall caused her death.  In citing the center for neglect, the report noted that the facility had no registered nurse available for unlicensed staffers to call after hours in the event of changes in residents’ conditions.

Illinois State Senators and consumer advocates are concerned about nursing home operators failing to increase RN staffing according to articles in the State Journal-Register and the Illinois Times.  Advocates for residents and operators of nursing homes both say they support increases in direct-care staffing required by the state’s 2010 landmark nursing-home reform law.  The law, spurred by a series of articles published by The Chicago Tribune, calls for a total of 3.8 hours per resident per day of “nursing and personal care” in skilled-care facilities by 2014.  By 2014, the proposed requirement works out to about 0.75 hours of RN time — only 46 minutes — allotted to each resident each day.

The state’s nursing homes currently operate without any minimum RN staffing levels.  Registered nurses are best equipped to spot changes in residents’ health and intervene, and the presence of RNs has been proven in research to improve care.  Advocates for residents and officials from Gov. Pat Quinn’s administration say nursing homes can afford to hire more RNs.

“When you don’t have registered nurses, you have urinary-tract infections, bed sores, more hospitalizations and even deaths occurring in some nursing homes,” said state Sen. Jacqueline Collins, D-Chicago. 

Comstock said two-thirds or more of residents in most for-profit nursing homes are on Medicaid. The percent of residents on Medicaid is much lower in most not-for-profit homes, which also may receive funding from foundations and religious organizations, she said.

Proposed RN staffing requirement

*A proposal to be considered Tuesday by the Illinois General Assembly’s bipartisan Joint Committee on Administrative Rules would require 20 percent of the “nursing and personal care” provided daily for each nursing home resident to be provided by a registered nurse.

*The nursing-home reform law signed by Gov. Pat Quinn in July 2010 requires:

— 2.5 hours of nursing and personal care each day per resident in skilled-care facilities, effective July 1, 2010; and 1.7 hours for residents in intermediate care.

— 2.7 hours of nursing and personal care each day per resident in skilled-care facilities, effective Jan. 1, 2011; and 1.9 hours for residents in intermediate care.

— 3 hours of nursing and personal care each day per resident in skilled-care facilities, effective Jan. 1, 2012; and 2.1 hours for residents in intermediate care.

— 3.4 hours of nursing and personal care each day per resident in skilled-care facilities, effective Jan. 1, 2013; and 2.3 hours for residents in intermediate care.

— 3.8 hours of nursing and personal care each day per resident in skilled-care facilities, effective Jan. 1, 2014; and 2.5 hours for residents in intermediate care.

 

Matthew Reed writes articles for http://lpntornbridge.org/, a website dedicated to providing students with the information and tools needed in order to pursue their LPN to RN program.  He sent us the latest article called " 25 Reasons to Become An RN".  

With 2.6 million jobs and counting, the career path of the registered nurse (RN) can take a whole host of paths in the medical field. With hiring opportunities in hospitals, doctor’s offices, nursing homes, labs, clinics, specialty care facilities, and more, becoming an RN can be as rewarding as the nurse or student themselves dictates. However, with loads of different careers from licensed practical nurse to nurse practitioner available and in demand, which is the best for you?

To help those considering a move into the world of the registered nurse, we have gathered the below 25 reasons to become an RN. They include many statistics, figures, and even words of wisdom from registered nurses themselves on the subject. So whether you’re looking for an anecdote or just some serious salary information, they are all contained in the article.

 

Great editorial in the StarTribune from Eileen Weber about nursing homes trying to save money by changing the law on requiring registered nurses to provide care and conduct assessments instead of less qualified licensed practical nurses.  Eileen Weber is a nurse attorney serving on the board of directors of the Fourth District Minnesota Nurses Association. She lives in Washington County.

Weber begins with a history lesson.  She discusses the nurses’ strike 25 years ago.  Payers now want to save money by reducing the expensive inefficiency of rapid rehospitalization.  Nurses then and now say, "Duh." When it comes to the big picture of meeting health care needs, cutting corners rarely cuts costs.

Registered nurses, whom the law calls "professional nurses," won the seniority battle,
keeping more wisdom at the bedside. They now face a new corner-cutting threat to their
professionalism. The Minnesota Board of Nursing, charged with licensing all levels of nurses, seeing that they meet state educational requirements and protecting the public from unsafe care, is under pressure to allow less-educated licensed practical nurses (LPNs) to do what RNs do now. The chair of the subcommittee drafting the board’s proposal is himself an LPN.

Only legislators may define nursing practice, but instead of taking this issue to them, the board is
putting a new spin on the law to appease those who would benefit if organizations that deliver
health care can get an RN at an LPN price.

Vulnerable populations, especially in rural communities with fewer resources, are often the
canary in the mine of health care corner-cutting.  If LPNs do more than the job they are educated  for, the effects will be suffered by patients who are least likely to understand what’s missing, who are not inclined to complain, and who are found where LPNs usually work: in home and institutional long-term care.

If there’s anyplace that needs an RN’s better-trained ability to assess what is going wrong in a person with multiple problems, to decide what is needed, to connect that patient with the right problem-solver and to judge if the solution is working, it’s exactly where corner-cutters would like to replace RNs with less-expensive caregivers.

The differences among the rungs of the nursing career ladder all come down to education. Certified nursing assistants (CNAs) take a basic technical course, are the backbone of basic nursing care and have the aching backs to prove it. They report to RNs and LPNs. LPNs have more education than CNAs, can give some medications if trained to do so, and know more of what problems to look for. They report to an RN. RNs have college degrees, more in-depth education in the science, specialties and basic law of health care, ethics and care management. When they can’t independently solve a problem, they call on doctors or advanced practice nurses. Advanced practice nurses, like nurse practitioners, are RNs who get at least master’s degrees to specialize in areas like pediatrics, midwifery, geriatrics and more.

Additional education brings additional independence, accountability and pay. The answer to someone on the nursing ladder who wants to do more has always been to go back to school.

Instead of cutting corners to get around this safeguard of quality care, the Board of Nursing should be pressuring the Legislature and nursing schools to do what is necessary to produce more of all the kinds of nurses needed to assure excellent care of a growing, aging, diverse population with increasing acute and chronic health care needs.

Eileen Weber is a nurse attorney serving on the board of directors of the Fourth District Minnesota Nurses Association. She lives in Washington County.

South Carolina’s Board of Nursing has Advisory Opinons that mandate that RNs should conduct assessments although LPNs may collect necessary data like blood sugar levels, vital signs, and oxygn saturation, and RNs should provide direct care for treatment of pressure ulcers.